Standard Certificate of Death
Place of Death: Monson Mass
Full Name: Clymena P Fuller
Maiden Name/Husband: Willis Fuller
Resdience: Amherst St. Holyoke, Mass
Sex: Female; Color: W; Condition: Widow
Date of Birth: Oct. 29, 1826 [Hard to read. Misindexed as 1836 but 1826 consistent with age at death and census records]
Age: 86 y. 8 m. 1 d.
Occupation: Retired
Birthplace: Mass.
Father: Emory Peirce
Birthplace: U.S.
Mother: Sophronia Barnses [sic]
Birthplace: U.S.
Informant: Clifton Hobson / Palmer, Mass
Date of Death: June 30 1913
Cause: Suicide by Drowning
Place of Burial: Four lot Cem / Palmer, Mass; Date of Burial: July 2 1913