Jefferson County: Death Record Forms

Examples & Descriptions of Death Records

Held by the Jefferson County Historical Society


Death Certificate


City Clerk Burial Permit


ISBH Burial Permit



The Burial Permits in the Historical Society's collection were mainly issued by the City Clerk of Madison; however some were also issued by the Indiana State Board of Health, and in a few cases by both offices. The majority of the burial permits were for Springdale Cemetery, although a few other cemeteries were also included.

The Transit Permit accompanied bodies being transfered to or from a different county or state. The Indiana State Board of Health's form included divided sections containing the Physician's or Coroner's Certificate, giving the age, residence, place and cause of death; the Permit of the Local Board of Health to transfer the body; and the Certificate of the Undertaker, certifying preparation. The Undertaker's Paster section was detached from this form and tacked on the end of the box before shipping. It contained the route the body was shipped and the final destination. Some of the existing records are still intact, not having been separated, while others have only certain sections surviving.

One of the more interesting forms from a genealogist's standpoint, but not as many in this collection, are the Death Returns which give in addition to the Death Certificate information, the occupation, the parents' names and birthplace and the mother's maiden name.