Certificate of Death |
|
Jackson Twp. , Jackson, Ohio |
|
65039 |
Full Name: |
Nellie Austin |
Registration Dist. No.: |
4950 |
Residence: |
So. Minnesota Ave. |
Primary Reg.: Dist. No.: |
|
Sex: |
Female |
Registered No. |
|
|
Color or Race: |
African-American |
Date of Death: |
December 12, 1922 |
| S/M/W/D: |
Divorced |
Time of Death: |
2:00 pm |
| Spouse: |
Lon Kelley |
Served in Military: |
No
|
| Date of Birth: |
May 8, 1891 |
Institution: |
|
| Age: |
31y 7m 4d |
Cause of death: |
Pulmonary Tuberculosis |
| Trade/Profession: |
House Wife |
|
|
| Industry: |
|
|
|
| Date last worked: |
|
Contributory Causes: |
|
| Birthplace City: |
|
| Birthplace Co./St: |
Ohio |
| Father: |
Elijah Austin |
Born: |
Ohio |
|
| Mother: |
Amanda Bariski or Banister |
Born: |
Ohio |
|
| Informant: |
Elijah Austin |
Address: |
Richmon??? R. D. #1 |
| Burial, Cremation or Removal: |
Burial |
Date of Burial |
December 14, 1922 |
| Burial Location |
Mount Siani |
| Undertaker: |
Charles Wood |
Address: |
Jackson, Ohio |
| Source: State of Ohio Department of Health, Division of Vital Statistics |
| NOTE: |
| Contributed by:
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