CA777

By cavis , 8 November 2016
Image
Source Description
Death Certificate of Charles Robert Avis
Description/Transcription

Death Certificate of Charles Robert Avis
(C. Avis Catalog entry #777)


State of California
Department of Public Health
Vital Statistics
Standard Certificate of Death

Local Registered No. 388
Place of Death:  Dist. No. 1903
County of Los Angeles
City or Town of:  Long Beach
No. 2820 Linden Ave.

Full Name:  Charles Robert Avis

Personal and Statistical Particulars
Sex:  Male
Color or Race:  White
Single, Married, Widowed or Divorced:  Single
Date of birth:  Unknown
Age:  About 35
Occupation:  Unemployed
Birthplace:  Unknown
Name of Father:  A. J. Avis
Birthplace of Father:  Unknown
Maiden Name of Mother:  Unknown
Birthplace of Mother:  Unknown
Length of Residence at Place of Death:  4 years
(If non-resident, give city or town and state):  Long Beach, Cal.
In California:  4 years

Informant:  Thomas J. Taylor, Sunset Pacific Oil Co., Julian City, Calif.

Filed:  Mar. 25 '31  G. E. McDonald MD.

Coroner's Certificate of Death
Date of Death:  March 24, 1931

I hereby certify, as to the person above named and herein described That on March 24, 1931  I investigated the death officially on account of:
Death no one being in attendance
The Cause of Death was as follows:  Acute double lobal pneumonia

Signed:  Frank R. Webb M. D. and Frank A. Nance Ass't
Approved:  W. A. MacDonald Chief Deputy March 24, 1931

Place of Burial:  Wichita Falls, Texas
Date:  March 25, 1931
Undertaker:  J. J. Mottell, Inc., Long Beach, Calif.
Embalmer's License No. 1890

 

Source Type