CA1024

By cavis , 11 April 2020
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Death Certificate of Minnie Ola Bush Avis
Description/Transcription

Death Certificate of Minnie Ola Bush Avis
(C. Avis Catalog entry #1024)

TEXAS DEPARTMENT OF HEALTH
BUREAU OF VITAL STATISTICS
CERTIFICATE OF DEATH
STATE FILE NO. 36389

1.  Place of Death:  County:  Wichita.  City:  Wichita Falls,  Length of stay in this place:  67,  Address:  1318 10th Street
2.  Usual Residence:  State:  Texas, County:  Wichita, City:  Wichita Falls,  Street address:  1318 10th Street
3.  Name of Deceased:  Minnie Ola Avis
4.  Date of Death:  June 27, 1952
5.  Sex:  Female,  6. Race:  White,  7. Widowed
8.  Date of Birth:  January 22, 1865
9.  Age:  86 years, 6 months, 5 days
10.  Occupation:  Housewife
11.  Birthplace:  Parkersburg, West Virginia
12.  Father's name:  Isaac Bush    Birthplace:  W. Va.
13.  Mother's name:  Unk.    Birthplace: Unk.
16.  Informant:  Mrs. James B. Baker [signed]
17.  Cause of Death:  Hypertensive Heart Disease  Due to:  Senility
19.  Autopsy:  No
21.  I hereby certify that I attended the deceased from March 16, 1952 to June27, 1952, that I last saw the deceased alive on June 27, 1952 , and that death occurred at 7:00 pm from the causes and on the date stated above.
22.  Signature:  W. A. S. B. Halland  322 Hamilton Building  June 30, 19__
23.  Burial:   June 29, 1952  Riverside Cemetery Wichita Falls Texas
24.  Funeral Director's Signature:  Hampton Vaughan Merkle  R. M. Vaughan [signed]
25.  Registrar's File No.:  308  Received:  July 1 1952  Signed:  Paul Lee Blevins [signed]

[The informant was her daughter Ruby]

 

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