Certificate of Death |
|
Jackson Co., Jackson , Ohio |
|
23065 |
Full Name: |
Agnes Vaughn |
Registration Dist. No.: |
643 |
Residence: |
|
Primary Reg.: Dist. No.: |
8269 |
Sex: |
Female |
Registered No. |
|
|
Color or Race: |
white |
Date of Death: |
Mar 27, 1920 |
| S/M/W/D: |
widow |
Time of Death: |
12:30 pm |
| Spouse: |
not given |
Served in Military: |
|
| Date of Birth: |
not given |
Institution: |
|
| Age: |
81y 0m 9d |
Cause of death: |
Apoplexy |
| Trade/Profession: |
housekeeper |
|
|
| Industry: |
|
|
|
| Date last worked: |
|
Contributory Causes: |
Old Age |
| Birthplace City: |
unknown |
|
| Birthplace Co./St: |
Ohio |
|
| Father: |
Aaron Walterhouse |
Born: |
Pennsylvania |
|
| Mother: |
Emily Voorhees |
Born: |
Penn. |
|
| Informant: |
E. M. Vaughn |
Address: |
Jackson, Ohio |
| Burial, Cremation or Removal: |
|
Date of Burial |
Mar. 31, 1920 |
| Burial Location |
Madison, Ind |
Address: |
|
| Undertaker: |
L. H. Powell |
Address: |
Jackson, Ohio |
| Source: State of Ohio Department of Health, Division of Vital Statistics |
| NOTE: Burial date could say 8/31/1920 |
| Contributed by: |
| |
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