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Atoka Cemetery, Novice, Coleman County, Texas

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BROWN Perry Bryson

BROWN Perry Bryson

Male 1888 - 1972  (83 years)

 

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Death Certificate
BROWN Perry B.
19 October 1972

[editorial comment]

221-01-2 200-02
4109 30
Certificate of Death
State File No.: [stamp] 78821
State of Texas
1. Place of Death: a. County: Taylor
b. City or Town or Precinct No: Abilene
c. Length of Stay (in this place): 3 weeks
d. Full Name of Hospital or Institution: Hendrick Memorial Hospital
e. Is place of death inside city limits? Yes
2. Usual Residence (Where deceased lived.)
a. State: Texas
b. County: Runnels
c. City or Town: Winters
d. Street Address: 226 N. Melwood
e. Is residence inside city limits? Yes
f. Is residence a farm? No
3. Name of Deceased: Perry "B" Brown
4. Date of Death: 10-19-72
5. Sex: Male
6. Color or Race: White
7. Married, Never Married, Widowed or Divorced: Married
8. Date of Birth: 11-24-1888
9. Age, Years, Months, Days: 83 years
10a. Usual Occupation: Farmer
10b. Kinda of Industry or Business: Farmed
11. Birthplace (state or country): Texas
12. Citizen of what Country? U.S.A
13. Father's Name: No Record
14. Mother's Maiden Name: No Record
15. Was Deceased Ever in U.S. Armed Forces, (Yes, no, or unknown, If yes, give war or dates of service): No
16. Social Security No.: 564-34-0764
17. Informant's Signature: Mrs. Myrtle [KINCAID] Brown [wife]
Medical Certification
18. Cause of Death, Enter only one cause per line for a, b, c
I. Disease or Condition Directly Leading to Death *(This does not mean the mode of dying, such as heart failure, asthenia, etc. It means the disease, injury, or complication which caused death.
Immediate Cause (a) Acute Anterior myocardial Infarction, Coronary Artery Disease.
Due to (b) Gastric Ulcer. Suspected carcinoma of prostrate with metastasis
II. Other Significant Conditions, Conditions contributing to the death but not related to the disease or condition causing death.: [blank]
19. Was autopsy performed? No
20. Accident, Suicide, Homicide… [blank]
21. I hereby certify that I attended the deceased from 9-28, 1972, to 10-19, 1972, and last saw the deceased alive on 10-18, 1972. Death occurred at 12:43 A.M., on the date stated above, and to the best of my knowledge, from the causes stated.
22a. Signature:Lawrence G. Hardwicke M.D
22b. Address: 598 Westwood Drive, Abilene, Texas
22c. Date: 10-21-72
23a. Burial, Cremation, Removal: Burial
23b. Date: 10-21-72
23c. Name of Cemetery or Crematory: Atoka Cemetery
23d. Location: Novice, Texas
24. Funeral Director's Signature: Spill Funeral Home by Ted Meyer
25a. Register's File No: 735
25b. Date Rec'd by Local Registrar: Oct 25 1972
25c. Registrar's Signature: Rose Stubber
[stamp] Texas Department of Health, Rec'd Nov 6 1972, Bureau of Vital Statistics
[end]


Owner/SourceFamilySearch.org
File nameBROWNPerryBDeathCertificate.jpg
File Size484.46k
Dimensions1416 x 1284
Linked toBROWN Perry Bryson; KINCAID BROWN Myrtle "Mertie" Elizabeth

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