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Atoka Cemetery, Novice, Coleman County, Texas

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Death Certificate
LAIRD PARKER Alice Ruth
06 September 1964

[editorial comment]
042-01-2 04200
1538 17
Certificate of Death
State File No.: [stamp] 61843
State of Texas
1. Place of Death: a. County: Coleman
b. City or Town or Precinct No: Coleman
c. Length of Stay (in this place): Several Days
d. Full Name of Hospital or Institution: Overall-Morris Memorial Hospital
e. Is place of death inside city limits? Yes
2. Usual Residence (Where deceased lived.)
a. State: Texas
b. County: Coleman
c. City or Town: Novice
d. Street Address: unknown
e. Is residence inside city limits? Yes
f. Is residence a farm? No
3. Name of Deceased: Alice Ruth Parker
4. Date of Death: September 6, 1964
5. Sex: Female
6. Color or Race: White
7. Married, Never Married, Widowed or Divorced: Widowed
8. Date of Birth: Sept. 2, 1899
9. Age, Years, Months, Days, If less than 1 Day Hours, Min: 65 years, months, days
10a. Usual Occupation: Housewife
10b. Kinda of Industry or Business: Household
11. Birthplace (state or country): Santa Anna, Texas
12. Citizen of what Country? U.S.A
13. Father's Name: Rufus Laird
14. Mother's Maiden Name: Nancy Kelley
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.: 464-60-9055
17. Informant's Signature: s/ Ray L. Parker [son]
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) Adenocarcinoma of colon
Interval between Onset and Death: 90 Days
Due to (b) [blank]
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 6 - 7 - 64 to 9 - 6 - 64, and last saw the deceased alive on 9 - 6 - 64. Death occurred at 6:20 P.M., on the date stated above, and to the best of my knowledge, from the causes stated.
22a. Signature: Morris D. Mann, MD
22b. Address: Coleman, Texas
22c. Date Signed: 9-17-64
23a. Burial, Cremation, Removal: Burial
23b. Date: Sept. 8, 64
23c. Name of Cemetery or Crematory: Atoka Cemetery
23d. Location: Atoka (Coleman Co.), Texas
24. Funeral Director's Signature: Stevens Funeral Home - s/ Tom Walker
25a. Register's File No: 423
25b. Date Rec'd by Local Registrar: Sept. 17, 1964
25c. Registrar's Signature: s/ Lee F. Craig
[stamp] Texas Department of Health, Rec'd Oct 26 1964 Bureau of Vital Statistics
[stamp] Texas Department of Health, Rec'd Oct 21 1964 Bureau of Vital Statistics
[end]


Owner of originalFamilySearch.org
File nameLAIRD_PARKERAliceRuthDeathCertificate.jpg
File Size772.77k
Dimensions1364 x 1236
Linked toKELLEY LAIRD Nancy Alice; LAIRD Rufus Hardin; LAIRD PARKER Alice Ruth; PARKER Ray Laird

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