State of California; Dept. of Health Services, Doc. No. 26-046534

PLACE OF DEATH: District no. 1901
COUNTY OF: Los Angeles (i.e., 1551 West 50th Street)
LENGTH OF RESIDENCE: 14 years
DATE OF DEATH: 5 Oct 1926 TIME: 3:05a.m.
CAUSE OF DEATH: Carcinoma of uterus

FULL NAME: FAIRIE E. SELDEN
WIDOW OF: Harvey L. Selden
D.O.B.: 10 Jan 1866
BIRTHPLACE: Missouri
NAME OF FATHER: Frank Freeland
MAIDEN NAME OF MOTHER: Martha (Anna Maria) Johnson
BIRTHPLACE OF MOTHER: Illinois

UNDERTAKER: The Ruppe Mortuary, 842 So. Figueroa St., Los Angeles