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Jackson County, Ohio
Certificate of Death


 

Certificate of Death
Place of Death:
Jackson Co., Welllston, Ohio
File No.
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: