Missouri State Board of Health
Death Certificate
Race: Colored
Status: Single
Occupation: Laborer
Date of birth: "Unknown" (About 43 years of age)
Date of death: Kansas City, Missouri in the Old City Hospital, Pavillion Ward
Father: John Evans (born MO) (Informant)
Mother: Saly Johnson (Born MO)
Death Certificate
Race: Colored
Status: Single
Occupation: Laborer
Date of birth: "Unknown" (About 43 years of age)
Date of death: Kansas City, Missouri in the Old City Hospital, Pavillion Ward
Father: John Evans (born MO) (Informant)
Mother: Saly Johnson (Born MO)
Missouri State Board of Health
Death Certificate
Race: Colored
Status: Single
Occupation: Laborer
Date of birth: "Unknown" (About 43 years of age)
Date of death: Kansas City, Missouri in the Old City Hospital, Pavillion Ward
Father: John Evans (born MO) (Informant)
Mother: Saly Johnson (Born MO)
Death Certificate
Race: Colored
Status: Single
Occupation: Laborer
Date of birth: "Unknown" (About 43 years of age)
Date of death: Kansas City, Missouri in the Old City Hospital, Pavillion Ward
Father: John Evans (born MO) (Informant)
Mother: Saly Johnson (Born MO)
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