MySource:Parsa/Erastus Varner (1) Death Certificate

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MySource Erastus Varner (1) Death Certificate
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Place Jasonville, Greene, Indiana, United States|Jasonville, Greene, Indiana
Year range -
Surname Varner
Citation
Erastus Varner (1) Death Certificate.

Certificate of Death of Erastus Varner

The certificate of death for Erastus Varner.

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Facsimile of death certificate
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Facsimile of death certificate


Transcript

Indiana
State Board of Health
Division of Vital Statistics
Indianapolis, Ind.

I, Wm. F. King, Secretary of the State Board of Health, do hereby certify the following to be a true and correct copy of the CERTIFICATE OF DEATH of
Erastus Varner
on file with the State Board of Health of Indiana.
Year 1932 Volume 9 Certificate 4197

1. Place of Death
County of Greene
Township of Wright
City of Jasonville

2. Full Name Erastus Varner

Personal and Statistical Particulars
3. Sex Male
4. Color or Race White
5. Name of Husband or Wife Margarett Varner
6. Date of Birth June 16, 1846
7. Age 85 years 8 months 1 days
8. Occupation Miner
9. Birthplace of Deceased N.C.
10. Name of Father Alex Varner
11. Birthplace of Father N.C.
12. Maiden Name of Mother Unice Johnson
13. Birthplace of Mother N.C.
14. The Above is True to the Best of My Knowledge
(Informant) Curtis Varner
(Address) Jasonville - Ind
15. Filed 2 - 19 - 1932
Name and Address of Health Officer or Deputy Q[?].A. Burkhart

Medical Certificate of Death
16. Date of Death Feb. 17, 1932
17. I HEREBY CERTIFY, that I attended deceased from
2-10-1932 to 2-15-1932
that I last saw him alive on 2-15-1932
and that death occured on the date stated above at 1 P.M.
The CAUSE OF DEATH was as follows:
Hypostatic Pneumonia
Contributory (Secondary) C V R Disease
(Signed) J. D. Rogers, M.D.
2-19, 1932 (Address) Jasonville
18. LENGTH OF RESIDENCE (unfilled)
19. PLACE OF BURIAL OR REMOVAL Ashboro Cem., DATE OF BURIAL 2-20-1932
UNDERTAKER Floyd McClanahan, WAS THE BODY EMBALMED? Yes
ADDRESS Jasonville, EMBALMERS LICENSE No. 2577

IN TESTIMONY WHEREOF, I have hereunto subscribed my name
and caused my official seal to be affixed, at Indianapolis,
this 20th day of July in the year
of our Lord one thousand nine hundred and 32
[Signature] Wm F King, Secretary State Board of Health