Florence Sholes Carey Death Certificate 1921.05.21 Bristow Nebraska
Posted Thursday, June 21, 2018
In Carey, ClarenceCarey, FlorenceSholes, Sholes, SourceDocs
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Description:
Florence Sholes Carey Death Certificate
Source:
Nebraska State Department of Health, Bureau of Vital Statistics
Transcription:
Image:
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
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Race
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White
|
Origin
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American
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Spouse
|
C. D. Carey
|
Date of Birth
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Dec 31 1890
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Age
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31 years 4 months 22 days
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Occupation of Deceased
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Housewife
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Birthplace
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Nebr
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Name of Father
|
Chas Sholes
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Birthplace of Father
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Not Known
|
Maiden Name of Mother
|
Annis Hubbard
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Birthplace of Mother
|
Vermont
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Informant
|
C. D. Carey 17 W Madison St, Norfolk, Nebr
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Filed
|
6/1/1921 Norfolk, Nebr, Talich/Registrar
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Date of Death
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5-22-1921
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I hereby certify that
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I attended deceased from May 17 through May 22, 1921
Last saw her alive on May 21, 1921
Death occurred at 6 am
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Cause of Death
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Pelvic Peritonitis, duration 8 days
|
Disease COntracted at
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At her home
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Did an operation proceed death?
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No
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Autopsy?
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No
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What Test Confirmed Diagnosis?
|
Microscopical
|
Signed
|
Ron Place, M. D. 5/23/1921, Bristow, Nebr
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Image:
 |
| Nebraska State Department of Health, Bureau of Vital Statistics Lynch, Boyd, NE Registered No 4031 |
