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Atoka Cemetery, Novice, Coleman County, Texas

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Death Certificate
O'NEAL James Smith
28 April 1951

[editorial comment]

242-0-0-1-042-0-0
4430
27
Texas Department of Health
Bureau of Vital Statistics
Certificate of Death
State File No.: [stamp] 17359
State of Texas
1. Place of Death: a. County: Coleman
b. City or Town or Precinct No: Rural Precinct #4
c. Length of Stay (in this place): 12 1/2 yrs
d. Full Name of Hospital or Institution: Rural - Enroute to Coleman Hospital from Novice
2. Usual Residence (Where deceased lived.)
a. State: Texas
b. County: Coleman
c. City or Town: Novice, Texas
d. Street Address: ?
3. Name of Deceased: Jim Smith O'Neal
4. Date of Death: April 28, 1951
5. Sex: Male
6. Color or Race: White
7. Married, Never Married, Widowed or Divorced: Married
8. Date of Birth: Dec. 23, 1876
9. Age, Years, Months, Days, If less than 1 Day Hours, Min: 74 years, 4 months, 5 days
10a. Usual Occupation: Farmer (retired)
10b. Kinda of Industry or Business: Farming
11. Birthplace (state or country): Texas
12. Father, Name: James O'Neal
12. Father, Birthplace: Unknown
13. Mother, Maiden Name: Elizabeth Hammond
13. Mother, Birthplace: Unknown
14. Was Deceased Ever in U.S. Armed Forces, (Yes, no, or unknown, If yes, give war or dates of service): No
15. Social Security No.: none
16. Informant's Signature: L. M. O'Neal [son, Luther Monroe O'NEAL]
17. Cause of Death, Enter only one cause per line for a, b, and c
I. Disease or Condition Directly Leading to Death *(This does not mean the mode of dying, such as heart failure, asthenia, etc. It means the disease, injury, or complication which caused death.
(a) Myocarditis
Interval between onset and death: 6 mths
Antecedent Causes, Due to (b) Hypertension
Interval between onset and death: 1 yr.
II. Other Significant Conditions, Conditions contributing to the death but not related to the disease or condition causing death.: Chronic Prostatitis
Interval between onset and death: 2 yrs.
18a. Date of Operation: [blank]
18b. Major Findings of Operation: [blank]
19. Autopsy? No
20a. Accident, Suicide, Homicide… [blank]
21. I hereby certify that I attended the deceased from 4 - 28 - 1951, to4 - 28 - 1951, xxxxx On arrival at Hosp. Died 4 - 28, 1951, and that death occurred at 11:50 A.M., from the causes and on the date stated above.
22a. Signature: s/ J. C. Young M. D.
22b. Address: Coleman, Texas
22c. Date Signed: 4 - 30 - 51
23a. Burial, Cremation, Removal: Burial
23b. Date: April 30, 1951
23c. Name of Cemetery or Crematory: Atoka Cemetery near Novice, Texas
23d. Location: Novice, Texas
24. Funeral Director's Signature: Wright's Funeral Home, s/ Mike Wright
25a. Register's File No: 39
25b. Date Rec'd by Local Registrar: May 1st, 1951
25c. Registrar's Signature: [unable to read]
[stamp] Texas Department of Health, Rec'd May 10 1951, Bureau of Vital Statistics
Note the information called for on the reverse side.
[end]


Owner of originalFamilySearch.org
File nameONEALJamesSmithDeathCertificate.jpg
File Size898.54k
Dimensions1600 x 1317
Linked toO'NEAL James Smith; O'NEAL James Wesley; O'NEAL Luther Monroe

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