I HEREBY CERTIFY, That I attended deceased from ____, 192__, to ____ 192__ that I last saw her alive on about Sept., 1922 and that death occurred, on the date stated above, at 5 A.m. The CAUSE OF DEATH was as follows; Senility
C. C. Johnson, M.D. Nov 18, 1922 Bolivar W.Va
Place of Burial or Removal
St Peters Cemetery Harpers Ferry
Date of Burial
Nov 20, 1922
J. L. Eackles, Bolivar W.Va
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