Certificate of Death |
|
Jackson Co., Welllston, Ohio |
|
2567 |
Full Name: |
Clarence W. Young |
Registration Dist. No.: |
644 |
Residence: |
|
Primary Reg.: Dist. No.: |
8268 |
Sex: |
Male |
Registered No. |
54 |
|
Color or Race: |
White |
Date of Death: |
Aug 13, 1931 |
| S/M/W/D: |
single |
Time of Death: |
8:20 am |
| Spouse: |
|
Served in Military: |
|
| Date of Birth: |
May 18, 1903 |
Institution: |
|
| Age: |
28yrs 2m 25d |
Cause of death: |
tuberculosis, pulmonary |
| Trade/Profession: |
Laborer |
|
|
| Industry: |
Labor |
|
|
| Date last worked: |
|
Contributory Causes: |
myocarditis, acute |
| Birthplace City: |
Wellston |
|
| Birthplace Co./St: |
|
|
| Father: |
Leander Young |
Born: |
Kentucky |
|
| Mother: |
Susan Smith |
Born: |
Indiana |
|
| Informant: |
Mrs George H. Ritchey |
Address: |
Col, Ohio |
| Burial, Cremation or Removal: |
|
Date of Burial |
Aug 16, 1931 |
| Burial Location |
Ridgewood |
|
|
| Undertaker: |
Carl L. Leach |
Address: |
Wellston, Ohio |
| Source: State of Ohio Department of Health, Division of Vital Statistics |
| NOTE: |
| Contributed by: |
|
|
