Death Certificate of Mary Avis Palmer
(C. Avis Catalog entry #419)
Texas Department of Health
Bureau of Vital Statistics
Standard Certificate of Death
Place of Death: State of Texas
County of Deaf Smith
City or Precinct No.: Hereford, Texas
Full Name of Deceased: Mary Victoria Palmer
Length of Residence Where Death Occurred: 44 years
Residence of Deceased: Hereford, Texas
Personal and Statistical Particulars
Sex: Female
Color or Race: Wh
Single, Married, Widowed or Divorced: Widowed
Date of birth: July 16, 1863
Age: 80 years 3 months 28 days
Trade, Profession or Kind of Work Done: Household Duties
Birthplace: Texas
Name of Father: Daniel Avis
Birthplace of Father: La.
Maiden Name of Mother: Martha Webb
Birthplace of Mother: Mo.
Informant: Mrs. E. H. Norton
Address: Hereford, Texas
Place of Burial:
Date: Nov. 17, 1943
Undertaker: J. M. Gilliand
Address: Hereford
Medical Particulars
Date of Death: Nov. 14, 1943
I hearby certify that I attended deceased from ___ to Nov. 14, 1943 and that I last saw her alive on Nov. 14 1943 and that death occurred on the date stated above, at 1 pm.
The Primary Cause of Death was:
Comminuted fracture of left hip
Duration: 1 week
Contributory Causes Were: Hypertatic Pneumonia
If Not Due To Disease, Specify Whether:
Accident, Suicide, or Homicide: Accident
Date of Occurrence: Nov. 4, 1943
Place of Occurrence: Home
Manner or Means: Fall
Signature: Lewis B. Barnett M.D.
Address: Hereford, Texas
File Number: 164
File Date: Nov. 16-43
Signature of Local Registrar: A. L. Thomas
Postoffice or Address: Hereford, Texas