Related To:
This evidence is not directly related to any people.June 28, 1944
Dist. No. | 1911 |
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Serial No. | 44 |
Place of Death | |
County | Jefferson |
Magisterial District | Charles Town |
City or Town | Charles Town |
Length of stay in hospital or inst. | |
Home (Usual Residence) of Deceased | |
State | |
County | |
City or Town | |
Street No. | |
— | |
Full Name | Daniel Lee Moler |
If veteran, name war | Spanish Americ. |
Social Security No. | — |
Sex | Male |
Color or race | White |
Single, married, widowed, or divorced. | Married |
Name of husband or wife | Florence E. Moler |
If alive, give age | 56 years |
Birth date of deceased | Mar 11- 1869 |
Age | 75 yrs. 3 ms. 17 ds. |
Birthplace | Molers Cross Roads |
Usual Occupation | Gov’t Employee |
[Father’s] Name | Geo Wm Moler |
[Father’s] Birthplace | Jeff. Co |
[Mother’s] Name | Laura F. Flanagan |
[Mother’s] Birthplace | Jeff. Co |
Informant’s Signature | Mrs. Florence E. Moler |
[Informant’s] Address | Charles Town |
Burial, Cremation, Removal | Burial |
Date Thereof | July 1, 1944 |
Cemetery | Edge Hill |
Location | Charles Town |
Funeral Director | Melvin T. Strider |
Address | |
Medical Certification | |
Date of Death | June 28, 1944 at 6:15PM |
I certify that death occurred on the date above stated; that I attended deceased from 6/2, 1944 to 6/28, 1944 and that I last saw him alive on 6/28, 1944. | |
Immediate cause of death | Cerebral Hemorrhage, Paralysis duration |
Due To | Arterial Hypertension |
Duration | 2 wks. |
Signature | G. P. Morrison |
Address | Charles Town, W.Va 6/29/44 |
Information Catalog
No evidence analysis information has been cataloged for this piece of evidence yet.
Repositories
Repository | |
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West Virginia State Archives | View This Record Online |