STATE OF HAWAII
County (or City and County) of..........................
CORONER'S INQUEST
An inquisition taken at............... county (or city and county) of............... on the..... day of............... in the year 20..... before............... coroner of the county upon the body of............... there lying dead, resulted as follows:
That the deceased was named...............; and a native of...............; was aged about.....; that the deceased came to h..... death, on the..... day of............... 20....., from...............
IN WITNESS WHEREOF, the coroner has hereunto set the coroner's hand on this..... day of ............... 20...... .
HRS § 841-7