Page 10 - hb1906_docs

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1907 :u ... llWIS ee 13940
ll GI\ TU TlOII alTIFICATE OF DEATH
TO,CT IIO
h NAIi( OF DECEASE rtllS I •••l I 11 _ MIOOlC NAMt
JISSI I EUOEJII
3 5[1
llal• Caucalian Mvried
DECEDENT Y[AJIS
PERSONAL ,. USUAL OCCUPATION ltm.l!I!!.°' e, KIND or BUSINESS OR INDUSTRY 9 BIRTHPLACE u.1,'.:t.'I': ...... . 10 CITIZEN OF WHAT COUNTRY!
DATA IW~M-,0-' ~ woa••-- Lt1rlVi'tl1r9
. ,, ... DriTer 011 Truck■ l lli noi ■ u.s • .1 •
,.,..t ,. •• ,,
11 NAIi[ or FA IH[R 12 IIAIO[N NAIi[ or IIOTH[R 13 NAME Of SPOUSE u• ■lHll0 •
Thaaa■ Jetfer ■on Meweomb Sarah Bird
1& 1NrnR11ANT Martha E.hwcomb
t;~;;;•;;,~;;;,.;c",:7'!,-o'=..,;;,E.,;;.=~-="=S'="E.,,D:...,:.,:.V,.E::.,A...:1-"N'-nl',~'::.,c?~'-:.,o:,"'i't::=.~:'i:.',:~~o:::.[;;;,~~:;=;~;;;~.=~l(:i,I ,.---i 15 SOCIAL SECURITY NUIIB[R
no San Fern.and ad
17.t PLACE or DEA TH c1rv o-. row" •P ri('IL°tf ~=n,•.r1.'a.T,;\=.•
PLACE RUz-al san Fernando /-1 12 Lo
OF 1-1-70-FU_L_L_N_A_II_[ -AN- 0 ADDRESS Or- H"""o"'s"'"Pl-:-TA_L_O_R_ IN:_,S_ll_:TU""'T,::.10,-N_..!~,,,- _L ,......1._,--.,-.. ---=i=-,_..cc.!:~ .. ~• n_ot_n __ -----'-, .. ---","oce.,~~,,..-=, -=="------------
DEATH
San Fernando Road

ANT[CCO[NT U USCS
1110 C Dtf i lf Atn C.l\'I
I H BETWEEN
~ t UOU \.t l t f\1 ro '"' , \ I uvsr ,a, ,-u,1111G, 19 I< OU[ 10
cauu ,.. l r •o•
8 t a 1 11 1 &J!IO 1(11 ONSET ANO
19 11 19 II OTHER SIGNIFICANT CONDITIONS DEATH
TO n•• 011l-.SI o• C OU U \11''"- OOtM
20 ATE o r OP[R4 TION 201 IIAJOR FINDINGS OF OPERATION 21 AUTOPSY
OPERATIONS
AUTOPSY Om
22< LOCATION cmoafOW11
'""""
'" ou nu ..ou• 22r INJURY OCCURRED 22• HOW 010 INJURY OCCUR!

WI; J.J{(}8U'S

* Tbunday. Sept. 29. lMI""

.._, leweo111, di•
A heart a.Umeni of long stand-
ing was blamed fot the- death last
Wednesday night of Jesse Eugen·e
Newcomb, at his home 16826
San Fernando -road. His wife,
Mrs. Martha Newcomb was awak-·
ened about. 9 :30 p. Jn. by her
husband's complains of pain in
the .chest and difficulty in breath-
ing. After ome remedies had
proved ineffective- Dr. Innis was
summoned, but life was extintt
when he arrived. The deceased
was 73 years old a'nd had made
his home fb Newball for the past
,12 years. He was employed by
the Oil Equipment Co.
Funeral services w:ere held at
the Wee Kirk 0' The Heather
Church at 2 :30 p. m. Monday,
with cremation following. The
deceased is survived by his wife,
a daughter, Mrs. Lavender Gilli-
' land and grandson Armond B.
t'!illilantl. Unrnrr,::,rt l I