| MySource |
George Banks Certificate of Death |
| Author |
State of Kansas. State Board of Health, Division of Vital Statistics |
Coverage
| Place |
Independence, Montgomery, Kansas, United States |
| Year range |
1924 - |
| Surname |
Banks |
Citation
| State of Kansas. State Board of Health, Division of Vital Statistics. George Banks Certificate of Death. |
Repository
| Name |
Kansas Office of Vital Statistics |
Death Certificate for George Lovell Banks
Information taken from a certified copy of the Certificate of Death of George Lovell Banks.
Transcript of important information
1. PLACE OF DEATH: County Montgomery
Registered No.: 117
City: Independence, No. 417, N. 5th St., 1st Ward
2. FULL NAME: George Lovell Banks
(a) Residence. No. 417 N. 5th St., 1st Ward
PERSONAL AND STATISTICAL PARTICULARS
3. SEX Male, 4. COLOR OR RACE White, 5. Single, Married, Widowed, or Divorced Married
5a. If married, widowed, or divorced HUSBAND of (or) WIFE of Helen J Banks
6. DATE OF BIRTH Oct 13 1839
7. AGE 84 Years, 10 Months, 6 Days
8. OCCUPATION of DECEASED (a) Trade, profession, or particular kind of work Retired Farmer
9. BIRTHPLACE (city or town) Unknown (State or country) Lake Co. Ohio
10. NAME OF FATHER Orin Banks
11. BIRTHPLACE OF FATHER (city or town) Unknown (State or country) Schoharie Co. New York
12. MAIDEN NAME OF MOTHER Olive Brown
13. BIRTHPLACE OF MOTHER (city or town) Unknown (State or country) Schoharie Co. New York
14. Informant W N Banks (Address) Independence Ks
15. Filed Aug 22 1924 Registrar ?Kreinhagen?
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH (month, day, and year) Aug 20 1924
17. I HEREBY CERTIFY, That I attended deceased from
July 1 1924, to Aug 17 1924
that I last saw him alive on Aug 17 1924
and that death occurred, on the date stated above, at 1210 am.
The CAUSE OF DEATH was as follows: Paralysis following palsy and senility
(duration) 2 yrs.
CONTRIBUTORY (Secondary) unknown
18. Where was disease contracted if not at place of death? —
Did an operation precede death? no
Was there an autopsy? no
What test confirmed diagnosis? [illegible] clinical
(Signed) C. C. S---- [illegible], M. D.
8/21 1924 (address) Indep. Ks
19. PLACE OF BURIAL, CREMATION, OR REMOVAL Mt. Hope Cemetery. DATE OF BURIAL Aug 21st 1924
20. UNDERTAKER Edwin Potts 229 S. 15th St. [stamped] INDEPENDENCE, KANSAS
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