I HEREBY CERTIFY, That I attended deceased from Feb 7, 1931, to Feb 18, 1931. I last saw her alive on Feb 18, 1931, death is said to have occurred on the date stated above at 2 a.m. The principal cause of death and related causes of importance in order of onset were as follows: influenza + pneumonia.
C. C. Johnson, M.D. Harpers Ferry, W.Va
Place of Burial or Removal
Date of Burial
Feb. 22, 1931
J. L. Eackles, Bolivar W.Va
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