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Lincoln County, North Carolina
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Brady Jonas Hoffman, Sr. |
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North Carolina State Board of Health
Office of Vital Statistics
Certificate of Death
Stamped: Nov. 5, 1974
| Registration District No: 55-70 |
Registrar's Certificate No: |
36390 |
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1. Name of Deceased: Brady Jonas Hoffman, Sr.
2. Date of Death: Oct. 3, 1974
3. Sex: Male
4. Color or Race: Cau.
5. State of Birth: North Carolina
6. Date of Birth: May 27, 1895
7. Age: 79
8. Place of death: county: Lincoln; City: Lincolnton; Hospital: Crowell Hospital; Inside city Limits: Yes;
9. Usual Residence: State: NC; County: Lincoln; City: Lincolnton; Street address: Route #4; Inside city limits: No
10. Married
11: Surviving Spouse: Leila Nalley
12: Citizen of what country: USA
13. Social Security No.: ---------
14. Occupation: Contractor; Construction
15. Father's name: A.F. Hoffman
16. Mothers Maiden Name: Mary Jane Smith
17. Informant: Mrs. Leila N. Hoffman, Route #4, Lincolnton, NC 28092
18. Cause of Death: Acute Coronary Occlusion, duration: 2 days
19-20. Blank
21. I attended the deceased from 4-19-1973 to 10-3-1974 and last saw him alive on 10-3-1974 death ccurred at 7:15 a.m. on the date stated above and in my opinion, from the cases stated.
22. blank
23. Signature of Certifier: Karl L. Lauw; Date: 10-8-74; address: Rt 5 Lincolnton, NC
24. Burial: Date: 10-4-1974; Piwqah U. Meth. Ch. Cem.; Lincolnton County, NC.
25. Funeral Home: Drum Funeral Home, Lincolnton NC
26. Signature of Funeral Director: Melvin W. Drum, License # 1429
27. Date Rec'd by local Reg: 11 OCT 1974
28. Signature of Registrar: Mevlin E. Eyerman
29. Signature of Embalmer: Dean W. Humphries, License # 1029
(Source: Transcribed from copy of original document)
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