Clarence Dean Carver Death Certificate 1918.11.27 Joplin Missouri
Description:
Clarence Dean Carey Death Certificate
Note: Clarence was actually born in 1900 and was 18 years old at this time, not 16.
Source:
Missouri Dept of Vital Statistics
Transcription:
Clarence Dean Carey Death Certificate
Note: Clarence was actually born in 1900 and was 18 years old at this time, not 16.
Source:
Missouri Dept of Vital Statistics
Transcription:
Place of death
|
County: Jasper City: Joplin (Smelter Hill)
Registration
District No: 411
Primary
Registration District No: 2002
|
Full Name:
|
Clarence Carver (residence not listed)
|
Sex:
|
M
|
Color or Race:
|
W
|
S/M/W/D:
|
Single
|
Date of Birth:
|
Mar 28, 1902
|
Age:
|
16 years
|
Birthplace:
|
Nebraska
|
Name of Father:
|
Orland Carver
|
Birthplace of Father:
|
Wisconsin
|
Maiden Name of Mother:
|
Annie Hubbard
|
Birthplace of Mother:
|
Vermont
|
Informant:
|
Mrs. Annie Carver
Address: Joplin, Mo
|
Filed:
|
Nov 29, 1918
|
Date of Death:
|
11-27-1918
|
I hearby certify that I attended deceased from:
|
11-26-1918 to 11-27-1918.
That I last saw him alive on: 11-27- 1918. That death occurred
on the date stated above, at 5 pm.
|
The Cause of Death was as follows:
|
Lobar pneumonia /
Contributory: Influenza
|
Place of Burial:
|
Fairview Cemetery, 11-29-1918
|
Image:
0 comments:
Post a Comment