State of Iowa--Department of Public Health--Certificate of Death Decedent's Name: Wallace Winslow Trigg Sex: Male Date of Death: May 13, 1986 Race (White, Black, American Indian, etc): White Age Last Birthday: 81 Date of Birth: *Oct. 30, 1904 County of Death: Lyon City, Town or Location of Death: Rock Rapids Inside City Limits: Yes Hospital or Other Institution: Lyon Manor Care Center Hospital: Inpatient State of Birth: Minnesota Citizen of What Country: U. S. A. Marital Status: Married Surviving Spouse: Jennie Jasper Social Security Number: 483-05-8002 Usual Occupation: Laborer Kind of Business or Industry: Car Seat Factory Was Deceased ever in U. S. Armed Services: No Residence-- State: Iowa County: Lyon City, Town or Location: Rock Rapids Inside City Limits: Yes Street and Number: 1010 South Union Father's Name: Walter Trigg Mother's Maiden Name: Mary Jane Enos Informant: Jennie Trigg Mailing Address: 1010 South Union, Rock Rapids, Ia. 51 (copy runs out) Death was Caused by: Respiratory arrest Due to: Chronic obstructive pulmonary disease and bronchospasm. Autopsy: No To the best of my knowledge, death occurred at the time, date and place and due to the cause(s) stated. Signature and Title: Steven C. Ferguson, M. D. Date Signed: 5-20-86 Hour of Death: 12:10 A. M. Name and Address of Certifier: Steven C. Ferguson, M. D., 803 South Greene, Rock Rapids, IA 51246 Burial, Cremation or Removal: Burial Cemetery or Crematory Name: Hillside Cemetery Location: Doon, Iowa Date: May 16, 1986 Funeral Home: Porter Funeral Home, 1705 14th, Rock Valley, Iowa 5124(copy runs out) Funeral Director Signature: Ricard Porter F. D. License No.: 2284 Registrar Signature: LaVonne Mydland, Clerk By Jean Vande Weerd, Deputy Date Received by Local Registrar: 5-25-86 |