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Atoka Cemetery, Novice, Coleman County, Texas

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[editorial comment]
 Dr. C. A. Watson
Texas Department of Health
Bureau of Vital Statistics
Standard Certificate of Death
Registrar's No: 15169
[stamp] 46588 / 43678
1. Place of Death: State of Texas
County of: Runnels
City or Precinct No: Crews, Texas
Street and Number: [blank]
2. Full Name of Deceased: Mrs. P. W. Pendleton
Street and No, City, County, State: [blank]
Length of Residence Where Death Occurred, Years-Months-Days: [blank]
Personal and Statistical Particulars
3. Sex: Female
4. Color or Race: White
5. Single, Married, Widowed or Divorced: Widow
5a. Husband / Wife of: [blank]
6. Date of Birth: Sept. 17, 1870
7. Age, Years, Months, Days, If less than 1 Day Hours, Min: 60 years, 5 months, 23 days
8A. Occupation, Trade, Profession or Kind of Work Done: Housewife
8B. Industry or Business in Which Engaged: [blank]
9. Birthplace (state or country): Texas
10. Father, Name: J. Oneal
11. Father, Birthplace (state or country): xx
12. Mother, Maiden Name: xx
13.  Mother, Birthplace (state or country): xx
14. Informant, Signature: L Pendleton [James Lewis PENDLETON, son]
Address: Talpa, Texas
15. Filed: April 1, 1931, s/ Roxie Floyd
Medical Particulars
16. Date of Death: Mch. 10, 1931
17. I hereby certify that I attended the deceased from March 6, 1931to March 10, 1931
that I last saw her alive on March 7, 1931
and that death occurred on the date stated Above at [blank] M.
The Cause of Death was as follows: Apoplexy
Duration: [blank]
Contributory Causes: [blank]
Duration: [blank]
18. Where was disease contracted? [blank]
If not at place of death?[blank]
Did operation precede death? [blank] Date: [blank]
Was there an autopsy? [blank]
What test confirmed diagnosis? [blank]
(Signed) s/ C. A. Watson, M. D.
March 14, 1931 (Address) Ballinger, Texas
19. Place of Burial or Removal: Atoka Cemetery
Date of Burial: 3 / 11 / 1931
20. Undertaker: Spill Bros. & Co,
Address: Winters, Texas
[no stamp] Department of Health, Texas, Bureau of Vital Statistics
[end]


Death Certificate
O'NEAL PENDLETON Polly W.
10 March 1931




Owner of originalFamilySearch.org
File nameONEAL_PENDLETONPollyWDeathCertificate.jpg
File Size854.16k
Dimensions1500 x 1347
Linked toO'NEAL James Wesley; O'NEAL PENDLETON Polly W.; PENDLETON James Lewis

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