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STATE OF OHIO
STATE DEPT. OF HEALTH
DIVISION OF VITAL STATISTICS
CERTIFICATE OF DEATH
PLACE OF DEATH:
County of Hamilton
Registration District No. 494
File No. 2968
Primary Registration District No. 8227? Registered
No. 547
City of Cincinnati
2. FULL NAME: Clara Kneipp
(a) Residence. No. 6308 Desmond St.,
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PERSONAL AND STATISTICAL PARTICULARS |
MEDICAL CERTIFICATE OF DEATH |
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3. SEX: Female |
4. COLOR OR RACE
White |
5. Single, Married, Widowed or Divorced:
Widow |
16. DATE OF DEATH: April 30, 1911 |
17. I HEREBY CERTIFY, That I attended
deceased from Sep., 1924 to Jan. 29, 1920 that I last saw
her alive on Jan. 28, 1925 and that death occurred, on the
date stated above at 4 a.m.
The CAUSE OF DEATH was as follows:
Carcinomi Uter_ |
5a. If married, widowed or divorced.
HUSBAND of John J. |
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DATE OF BIRTH: Sept. 6, 1864 |
7. AGE:
60 Years |
Months:
4 |
Days:
23 |
8. OCCUPATION OF DECEASED:
Housewife |
18. Where was disease contracted if not at place of death?
(blank)
Did an operation precede death? Yes
Date of Oct. (about) 24
Was there an autopsy? No.
What test confirmed diagnosis? (blank)
(Signed) G. O. L__gh___, M. D.
1-29-1925 (Address: 6123 Madison Rd. |
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9. BIRTHPLACE: Newtown, Ohio |
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10. NAME OF FATHER: Thomas Gaddis |
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11. BIRTHPLACE OF FATHER: Newtown, Ohio |
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12. MAIDEN NAME OF MOTHER: Armstrong |
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13. BIRTHPLACE OF MOTHER: U. S. |
14. Wilber Kneipp
(Address) 6308 Desmond St. |
19. PLACE OF BURIAL or REMOVAL:
Laurel Cemetery
DATE OF BURIAL: Jan. 31st, 1925 |
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15. Filed Jan. 29, 1925 E ____ E___ |
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20. UNDERTAKER, License No.
James A. Thomas
ADDRESS: 4418 Whetsel
Madisonville, Ohio |
UNDERTAKER: H. Ihlendorf Co.
ADDRESS: Reading, O. |
