Death Certificate of James F. Avis
(C. Avis Catalog entry #593)
Indiana State Board of Health
Certificate of Death
County of Hamilton
Township of Jackson
Town of Arcadia
Full Name: Fred Avis
Personal and Statistical Particulars
Sex: Male
Color: White
Date of birth: Mch 15 1838
Age: 75 years 8 months 2 days
Single, Married, Widowed or Divorced: Widowed
Name of wife: Lucinda J. Avis
Birthplace: Indiana
Name of Father: David Avis
Birthplace of Father: Unknown
Maiden Name of Mother: Unknown
Birthplace of Mother: Unknown
Occupation: Retired Wagon Maker
Informant: F. M. Wolff, Arcadia, Ind.
Burial Permit Issued By: C. C. Ray
Filed: 11/31/13
Medical Certificate of Death
Date of Death: Nov 17 1913
I hearby certify that I attended deceased from Oct 20 1913 to Nov 17 1913 and that I last saw him alive on Nov 17 1913 and that death occurred on the date stated above, at --- M. The CAUSE OF DEATH was as follows:
Cerebral Hemorrhage
Duration: 27 days
Contributory Artero-sclerosis
Duration: 1 year
Signed: C. C. Ray
11/31/13 Arcadia
Place of Burial or Removal: Arcadia, Ind
Date of Burial: Nov 20th 1913
Undertaker: Kreug & Shoffer
Number of License: 849
Address: Arcadia
Was the body embalmed? Yes