1. Place of Death: (a) County: ARK (April 22, 1971) (b) City/Town/Location: DEWITT
(c) Inside City Limits: yes (d) Name of hospital/institution: DEWITT CITY HOSPITAL
2. Usual Residence: (a) State: ARK (b) County: ARK (c) City/Town/Location: DEWITT
(d) Inside City Limits: yes (e) Blank
3. Name of deceased: OPHELIA PORTER THARP
4. Date of death: 4-6-1971 Time: 8:15AM
5. Sex: FEMALE
6. Color: WHITE
7. Social Security Number: 481-96-0209-T
8. Date of Birth: 3-22-1898
9. Age: 93
10. Usual Occupation: HOUSEWIFE
11. Birthplace: ETHEL, ARK
12. Citizen of what country: USA
13. Widowed
14. Surviving Spouse: NO
15. Father Name: ISSAC MORGAN
16. Mother Maiden Name: NANCY PORTER
17. (a) Informant Name: MRS DAN KRABLIN (b) address: Rt 1 DEWITT, ARK 72042
18. Immediate Cause of death: (a) Pneumonia (401) Approximate interval: 5 days.
(c) due to or a consequence of: arterio-scleulio hypertension - Approximate interval: 2 yrs.
Lines 19& 20 are Blank
21. (a) I attended the patient from 1960 to (b) 4-6-71(c) last saw her alive: 4-6-71
(d) did view body after death (e) death occured 8:15AM.
22. Blank
23. (a, b)signature and typed name of R.H.Whitehead, MD. (c) date signed: 4-15-71
( d) address DeWitt, Ark
24. (a) BURIAL (b) Cemetery: HOCKENBERRY CEMETERY - TICHNOR, ARK (c) Date: 4-8-71
25. Funeral Director: Jack W. Essex. 423 W.2nd, DEWITT, ARK 72041
26. Embalmer signature: Jack W. Essex License Number 810
27. Date Rec'd by local Reg: 4-20-1971
28. Registrar's Signature: Norma Jean VanHorn
Source: Photocopy of original Death Certificate.