I HEREBY CERTIFY, That I attended deceased from Nov 1, 1926, to Nov. 6, 1926 that I last saw her alive on Nov 6, 1926 and that death occurred, on the date stated above, at 7 p.m. The CAUSE OF DEATH was as follows; Gastro-intestinal auto-intoxication (actute) Contributory Cardiac Insufficiency
C. C. Johnson, M.D. Nov 6, 1926 Harpers Ferry W.Va
Place of Burial or Removal
Date of Burial
Nov. 8, 1926
J. L. Eackles, Bolivar W.Va
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