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DEATH CERTIFICATES
FATHER'S NAME: Michael Costello
Name of operation: NoneMonroe County Arkansas Genealogy Trails COSTELLO, Patrick STANDARD CERTIFICATE OF DEATH State Department of Health Division of Vital Statistics STATE OF IOWA PLACE OF DEATH
8/15/31County: Lee State: IOWA Township: Keokuk City: Keokuk No. St. Joseph Hospital FULL NAME: Patrick Costello Residence: Holley Grove, Ark. PERSONAL AND STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH SEX: Male COLOR OR RACE: Wh DATE OF DEATH: Aug 17, 1931 MARITAL STATUS: Married I HEREBY CERTIFY, That I attended deceased from Aug 15, SPOUSES NAME: Katherine Costello to Aug 17, 1931, I last saw him alive on Aug 17, 1931 death is DATE OF BIRTH: Aug 15, 1876 said to have occurred on the date stated above at 12:30. AGE: 55 years, 0 months, 2 days. The principal cause of dath and related causes of importance in order OCCUPATION: Live Stock Buyer of onset were as follows: Fracture at base of skull Date of onset: Contributory causes of importance not related to principal cause: BIRTHPLACE:
Boston, Mass.
Automobile accident
BIRTHPLACE: Ireland What test confirmed diagnosis? Exam Was there an autopsy? No MOTHER'S MAIDEN NAME: (illegible) Casey If death was due to external causes (violence) fill in also the following: BIRTHPLACE: Ireland Accident, suicide or homicide? Accident Date of injury: Aug 15, 1931. Where did injury occur? Lerna, Ill. INFORMANT: Jas Costello, Memphis, Tenn. Manner of injury: Automobile accident BURIAL: Memphis, Tenn. Nature of injury: Fractured skull LICENSED EMBALMER: Paul Haneshoff No. 2303 Hamilton, Ill. (Signed) W. M. Hogle, M. D. Filed 8/18/1931 Pearl C West, Registrar. Keokuk, Iowa |
| (Contributed by Tonya Boltz, Keokuk Public Library, Keokuk, IA.; transcribed by A. Newell) |
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