I HEREBY CERTIFY, That I attended deceased from Jan 26, 1925, to Jan 26, 1925 that I last saw her alive on Jan 26, 1925 and that death occurred, on the date stated above, at 2:30 p.m. The CAUSE OF DEATH was as follows; Acute obstruction of the bowel. (Duration) 4 ds.
C. C. Johnson, M.D. Jan 27, 1925 Harpers Ferry W.Va
Place of Burial or Removal
Date of Burial
Jan 28, 1925
J. L. Eackles, Bolivar W.Va
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