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Lincoln County, North Carolina
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Jessie Lee Barger |
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North Carolina State Board of Health
Office of Vital Statistics
Stnadard Certificate of Death
| Registration District No: 25-5720 |
Registrar's Certificate No: 7 |
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1. Place of Death: County: Lincoln; State: NC; Township: Lincolnton
2. Full Name: Jessie Lee Barger (No residence listed)
3. Sex: Male
4. Color or Race: White
5. Child
6. Date of Birth: Nov. 3, 1920
7. Age: 1 yr, 2 ms, 13 ds
8. Occupation: blank
9. Birthplace: Catawba County
10. Name of Father: H.M. Barger
11. Birthplace of father: Catawba County
12. Name of mother: Willie E. Bost
13. Birthplace of mother: Lincoln County
14. Informant: H.M. Barger, Lincolnton, NC
15. Filed: 1/17/1922; Registrar: D.A Yoder
16. Date of death: Jan. 16, 1922
17. I hereby certify that I attended deceased from Jan. 10, 1922 to Jan. 16, 1922 and I last saw him alive on Jan. 16, 1922 and that death occured on the date stated above at 7p.m.
The Cause of Death was as follows: Broncho Pneumonia. Duration: 6ds.
18. Where was disease contracted: Lincolnton. Did operation preced death: No. Was there an autopsy? No. Was test confirmed diagnosis? none. Signed: J.F. _____, MD. 1/17/1922, Lincolnton, NC
19. Place of Burial: Hickory Cemetery; Date of Burial: Jan. 17, 1922
20. Undertaker: Warlick Funeral Co. Lincolnton, NC
(Source: Transcribed from copy of original document)
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