Certificate of Death |
|
Cheshire, Gallia Co., Ohio |
|
55139 |
Full Name: |
Ambrose R. Little |
Registration Dist. No.: |
|
Residence: |
|
Primary Reg.: Dist. No.: |
4638 |
Sex: |
Male |
Registered No. |
26 |
|
Color or Race: |
White |
Date of Death: |
Oct. 8, 1914 |
| S/M/W/D: |
Single |
Time of Death: |
10 am |
| Spouse: |
|
Served in Military: |
|
| Date of Birth: |
Jan. 18, 1904 |
Institution: |
|
| Age: |
9y 8m, 20d |
Cause of death: |
Membranous Croup |
| Trade/Profession: |
---------- |
| Industry: |
|
|
| Date last worked: |
|
Contributory Causes: |
Diphtheria |
| Birthplace City: |
Wellsville |
| Birthplace Co./St: |
Ohio |
| Father: |
Willis (?) Little |
Born: |
W. Va (?) |
| Mother: |
Elmira McIntire (?) |
Born: |
Wellsville, O |
| Informant: |
Willis (?) Little |
Address: |
Cheshire, Ohio |
| Burial, Cremation or Removal: |
Burial |
Date of Burial: |
Oct. 9, 1914 |
| Cemetery Location: |
Wellsville, O |
|
|
| Undertaker: |
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Address: |
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| NOTES: |
| Source: State of Ohio Department of Health, Division of Vital Statistics |
| Contributed by: |
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