THE STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Division of Vital Statistics
REGISTER OF DEATH

County of Whitman
City or Town of Pullman
Registration Dist. No. R12
Registered No. 15

1. FULL NAME: Henry Tabor Lingg
3. Sex: Male
4. Color or Race: White
5. Single, Married, Widowed: Married
6. Date of Birth: May 19, 1852
7. Age: 75 yrs. 2 mos. 25 ds.
8. Occupation: Farmer
9. Birthplace (State or Country) New Jersey
10. Name of Father: Joseph Lingg
11. Birthplace of Father (State or Country): Switzerland
12. Maiden name of Mother: Judith (not known)
13. Birthplace of Mother (State or Country): (Not known)
14. The above is true to the best of my knowledge
    
    (Informant) [signed] James Lingg
    
    (Address) Pullman, Wm
    

    Filed Aug. 15, 19__ [signed] D. C. Dow / Registrar

    Date of Death: Aug. 18, 19__ /(Month) (Day) (Year)

    I HEREBY CERTIFY, That I attended the deceased from (not filled in)
    

    The CAUSE OF DEATH was as follows:
    

    Stomack troubles (I did not get these till after death.)
    (signed) [signed] C. H. Russell, M. D.
    [Month & Date place crossed out] 19__ {Address) Pullman Wm
    

    Residence information left blank
    

    Place of Burial or Removal: Pullman Wm / Date of Burial: Aug. 16, 19__

    Undertaker: Rimball & Son / Address: Pullman Wm

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