Jun 21, 2018

Florence Sholes Carey Death Certificate 1921.05.21 Bristow Nebraska

Description:
Florence Sholes Carey Death Certificate

Source:
Nebraska State Department of Health, Bureau of Vital Statistics

Transcription:
Place of Death
County: Boyd 8 - Township: Lynch – Registered No 4031
Full Name
Florence Octavia Carey
Sex
Fem
Race
White
Origin
American
Spouse
C. D. Carey
Date of Birth
Dec 31 1890
Age
31 years 4 months 22 days
Occupation of Deceased
Housewife
Birthplace
Nebr
Name of Father
Chas Sholes
Birthplace of Father
Not Known
Maiden Name of Mother
Annis Hubbard
Birthplace of Mother
Vermont
Informant
C. D. Carey 17 W Madison St, Norfolk, Nebr
Filed
6/1/1921 Norfolk, Nebr, Talich/Registrar
Date of Death
5-22-1921
I hereby certify that
I attended deceased from May 17 through May 22, 1921
Last saw her alive on May 21, 1921
Death occurred at 6 am
Cause of Death
Pelvic Peritonitis, duration 8 days
Disease COntracted at
At her home
Did an operation proceed death?
No
Autopsy?
No
What Test Confirmed Diagnosis?
Microscopical
Signed
Ron Place, M. D. 5/23/1921, Bristow, Nebr

Image:
Nebraska State Department of Health, Bureau of Vital Statistics Lynch, Boyd, NE Registered No 4031

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