PENDLETON SLATE KINCAID Sarah Elizabeth Louisa (S. L.) (Sallie Louise)

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Death Certificate
KINCAID BROWN Myrtle Elizabeth
12 June 1975

[editorial comment]

200-02-2 200-02
E9209 66 90
Certificate of Death
State File No.: [stamp] 54357
State of Texas
1. Place of Death: a. County: Runnels
b. City or Town or Precinct No: Winters
c. Length of Stay (in this place): 20 years
d. Full Name of Hospital or Institution: North Runnels 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 No. Melwood
e. Is residence inside city limits? Yes
f. Is residence a farm? No
3. Name of Deceased: Myrtle Elizabeth Brown
4. Date of Death: June 12, 1875
5. Sex: Female
6. Color or Race: White
7. Married, Never Married, Widowed or Divorced: Widowed
8. Date of Birth: Feb. 10, 1895
9. Age, Years, Months, Days, If less than 1 Day Hours, Min: 80 years
10a. Usual Occupation: Housewife
10b. Kinda of Industry or Business: Home
11. Birthplace (state or country): Coleman Co., Tex
12. Citizen of what Country? U.S.A
13. Father's Name: George A. Kincaid
14. Mother's Maiden Name: Sarah Louise Pendleton
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.: 464-34-0764
17. Informant's Signature: Mrs. Roy Davis (Niece)
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) Prob. cerebrovascular accident, 8 hours
Due to (b) congestive heart failure, off & on many years
Due to (c) Infected [unable to read] both lower legs, 2 week
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 June 6, 1975, to June 12, 1975, and last saw the deceased alive on June 12, 1975. Death occurred at 11:45 P.M., on the date stated above, and to the best of my knowledge, from the causes stated.
22a. Signature: Yung Kee Lee; M.D.
22b. Address: Winters, Texas
22c. Date Signed: 6-16-75
23a. Burial, Cremation, Removal: Burial
23b. Date: 6-16-75
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: 18
25b. Date Rec'd by Local Registrar: 6-16-75
25c. Registrar's Signature: J. C. Hodnett
[stamp] Texas Department of Health, Rec'd Aug 11 1975, Bureau of Vital Statistics
[end]

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