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Full Name: Opal Marie Gorham Place of Death: Ray County, Grape Grove, Missouri Sex: Female Race: White Single Date of Birth: December 30th, 1907 Age: 11 years 6 Months 2 Days Occupation: School Girl Birth Place: Ray County, MO Name of Father: Jesse Franklin Gorham
Birth Place: Ray County, MO Name of Mother: Minnie Pearl Mansur
Birth Place: Ray County, MO Informant: Oscar Gorham of Richmond, MO Date of Death: July 2nd, 1919 I hearby certify that I attended the deceased from July 1st, 1919 to July 2nd, 1919 and that the death occured on the date stated above at 3:20 am The cause of death was as follows: Accidental burn from gasoline Place of burial: New Hope Cemetery on July 3rd, 1919 Undertaker: A.W. Mansur from Richmond, MO Source:Missouri State Board of Health/Certificate of Death Submitted by: Patricia Anne Zecchino Pierce
Alna, Maine
pjas@clinic.net
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