I HEREBY CERTIFY, That I attended deceased from —-, to —-. I last saw her dead on Sept 10, 1927, death is said to have occurred on the date stated above at 2:15 p.m. The principal cause of death and related causes of importance in order of onset were as follows: Died Suddenly — I did not attend to her before death — was dead when I saw her.
C. Johnson, Harpers Ferry, W.Va
Place of Burial or Removal
Date of Burial
Sept. 13, -27
J. L. Eackles, Bolivar W.Va
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