CA1448

Death Certificate of Lena Griffey Pettit Bussinger
(C. Avis Catalog entry #1448)

[found posted on FindAGrave.com, not available in county records at FamilySearch.com]


WEST VIRGINIA STATE DEPARTMENT OF HEALTH - DIVISION OF VITAL STATISTICS

CERTIFICATE OF DEATH
72 006627
Dist. No. 420
Serial No. 115

1. DECEASED - NAME    Lena G. Bussinger
2. SEX    Female
3. DATE OF DEATH        April 8, 1972
4. RACE    White
5. AGE-LAST BIRTHDAY    84
6. DATE OF BIRTH    April 4, 1888
7a. COUNTY OF DEATH    Randolph
7b. CITY, TOWN, OR LOCATION OF DEATH    Elkins
7c. INSIDE CITY LIMITS    Yes
7d. HOSPITAL OR OTHER INSTITUTION    Elkins Convalescent Hospital
8. STATE OF BIRTH    North Carolina
9. CITIZEN OF WHAT COUNTRY    U.S.A.
10. MARRIED, NEVER MARRIED, WIDOWED, DIVORCED    Widowed
11. SURVIVING SPOUSE    -
12. SOCIAL SECURITY NUMBER    163-//-////
13a. USUAL OCCUPATION    Housewife
13b. KIND OF BUSINESS OR INDUSTRY    Housewife
14a. RESIDENCE - STATE    W.Va.
14b. COUNTY    Randolph
14c. CITY, TOWN OR LOCATION    Elkins
14d. INSIDE CITY LIMITS    Yes
14e. STREET AND NUMBER    611 West Main St.

15a. FATHER-NAME    Griffey
15b. BIRTHPLACE    U.S.A.
16a. MOTHER-MAIDEN NAME    Elizabeth Chandler
16b. BIRTHPLACE    U.S.A

17a. WAS DECEASED EVER IN ARMED FORCES?    No
18a. INFORMANT-SIGNATURE    Mrs. Erna Petit Hines
18b. ADDRESS    1512 S. Henry Ave., Elkins, W.Va.

CAUSE OF DEATH
19. Part I. DEATH WAS CAUSED BY    Immediate cause:  Pneumonia
            Approximate interval between onset and death    1-2 weeks
      Part II. OTHER SIGNIFICANT CONDITIONS    Diabetes mellitus, Cerebral degeneration
20a. AUTOPSY   No     20B. Findings
21a. ACCIDENT, SUICIDE, HOMICIDE, OR UNDERMINED
21b. DATE OF INJURY
22. I attended the deceased from    Sept. 2, 1971    to    April 8, 1972    and last saw the deceased alive  on April 6, 1972
    Death occurred at    8:30 A.m. on the date stated above; and to the best of my knowledge, from the causes stated

23a. SIGNATURE    Manuel B. Gabato, M. D.
23b. ADDRESS    The Golden Clinic, 1200 Harrison Avenue, Elkins, West Virginia
23c. DATE SIGNED    April 14, 1972
24a. BURIAL, CREMATION, REMOVAL    Burial
24b. CEMETERY OR CREMATORY-NAME    Northwood Cemetery
24c. LOCATION    Cambridge, Ohio
24d. DATE    April 13, 1972    
25a. FUNERAL HOME - NAME AND ADDRESS    John W. Lohr Funeral Home 120 First St. Elkins, W. Va. 26241
25b. FUNERAL DIRECTOR'S SIGNATURE    John W. Lohr
25c. DATE SIGNED    4/8/72
26a. DATE REC'D BY LOCAL REG.    April 20 1972
26b. REGISTRAR'S SIGNATURE    Linda Morrison