James Hale; Death Certificate

HALE

Posted By: Jerry Hale (email)
Date: 5/19/2002 at 07:09:19

CERTIFICATE OF VITAL RECORDS
STATE OF IOWA

CERTIFICATE OF DEATH STATE OF IOWA – Department of Vital Statistics
1- County of Webster
2- Township of ???
3- City or Town of Ft. Dodge 15 W – 5 Ave N.
4- FULL NAME: James Hale
5- SEX: Male
6- COLOR: White
7- DATE OF DEATH: July 12th 1914
8- AGE: 75 Years, 8 Months, 14 Days
9- WIDOWED
10- BIRTHPLACE: Gloucester, Eng.
11- NAME OF FATHER: Aaron Hale
12- BIRTHPLACE OF FATHER: England
13- MAIDEN NAME OF MOTHER: Elizabeth Trotter
14- BIRTH PLACE OF MOTHER: England
15- OCCUPATION: ///
16- INFORMANT: Roy Hale Ft. Dodge, IA
17- I HEREBY CERTIFY: that I last saw him alive July 8th, 1914 and that death occurred on the date state above at 11:30 p.m.
18- THE CAUSE OF DEATH: Arterial Schlorosis and Renal Debility due to old age, DURATION : 2 years
19- (Signed) A. (?) Evans, M.D. 7/13/1914
20- ADDRESS: Ft. Dodge
21- SPECIAL INFORMATION: none
22- PLACE OF BURIAL: Oakland
23- DATE OF BURIAL: 7/14/1914
24- UNDERTAKER: Young 240
25- ADDRESS: Ft. Dodge