North Carolina State Board of Health
Office of Vital Statistics
Certificate of Death
Stamped: Feb. 10, 1975
| Registration District No: 02-00 |
Registrar's Certificate No: |
58 |
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Name of deceased: Ruth Cline Meadlock
Date of Death: January 15, 1975
Sex: Female
Color/Race: White
State of Birth: North Carolina
Date of Birth: 12-22-1900
Age: 74 Years
Place of Death: Alexander County
City: Taylorsville
Name of Hospital: Alexander County Hospital, Inside city Limits: Yes
Usual Residence: State: NC; County: Alexander; City: Taylorsville: Street address: 207-7th Ave. NW. Inside City Limits: Yes
Widowed
Citizen: USA
Social Security Number: 381-22-4675A
Occupation: Housewife
Father's Name: John Cline
Mother's Name: Dollie Julian
Informant's Name/Address: William A. Meadlock, 20930 Michael Court, St. Clari Shores, Mich. 48081
Cause of Death: Acute Myocardial infarction nespected, due to artrial scleratic heart disease.
Other significant conditions: heart acute pulminary edema due to (illegible)
Autopsy: no
I attended the deceased from 12-21-1974 to 1-15-1975 and last saw her alive on 1-15-1975. Death occurred at 5:05pm on the date stated above and in my opinion from the causes stated.
Signed: Walter N. Lang, Jr. M.D. 1-19-1975, Taylorsville, NC
Burial Date: 1-18-75
Cemetery: Antioch Cemetery, Rt. 2, Taylorsville, NC.
Funeral Home: Adams Funer Home, Taylorsville, NC
Signature of Funeral Director: Roy E. Chapman, License No. 236
Signature of Embalmer: Roy C. Chapman, License No. 32
Dated rec'd by local Reg: 1-20-75
Signature of Registrar: Melvin F. Eyerman, M.D.
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Transcribed from photocopy of original document |
