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STATE OF OHIO
DEPARTMENT OF HEALTH
DIVISION OF VITAL STATISTICS
CERTIFICATE OF DEATH
PLACE OF DEATH:
County of Hamilton
Registration District No. 494
File No. 4921
Primary Registration District No. 8227 Registered
No. 464
City of Cincinnati
2. FULL NAME: Corrine Gribble
(a) Residence. No. 8802 Ferdinand Pl. |
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PERSONAL AND STATISTICAL PARTICULARS |
MEDICAL CERTIFICATE OF DEATH |
3. SEX:
Male |
4. COLOR OR RACE
White |
5. Single, Married, Widowed or Divorced:
Married |
16. DATE OF DEATH: Jan. 14, 1929 |
17. I HEREBY CERTIFY, That I attended
deceased from Dec. 30th, 1928 to Jan. 14th, 1929 that I
last saw her alive on Jan. 13th, 1929 and that death
occurred, on the date stated above at 5:45 a.m.
The CAUSE OF DEATH was as follows:
Pulmonary Tuberculosis
(duration) 1 yr. 6 mos. |
5a. If married, widowed or divorced.
WIFE of Lawrence Gribble |
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DATE OF BIRTH: April 16, 1899 |
7. AGE:
30 Years |
Months:
8 |
Days:
29 |
8. OCCUPATION OF DECEASED:
Housework |
18. Where was disease contracted if not at
place of death? Same.
Did an operation precede death? No
Was there an autopsy? (blank)
(Signed: F. R. Stansbury
1/14/29(1929) (Address) 3062 Madison Rd. |
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9. BIRTHPLACE: Cincinnati, Ohio |
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10. NAME OF FATHER: Michael Des |
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11. BIRTHPLACE OF FATHER: Germany |
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12. MAIDEN NAME OF MOTHER: Dora Kneipp |
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13. BIRTHPLACE OF MOTHER: Cincinnati,
Ohio |
19. PLACE OF BURIAL or REMOVAL:
Spring Grove
DATE OF BURIAL: Jan. 17, 1929 |
14. Informant: Mrs. Dora Dres.
(Address) 3800 Ferdinand Pl. |
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15. Filed Jan. 15, 1929 E ____
E___ Registrar |
20. UNDERTAKER: Witt & Co.
ADDRESS: 3026 Madison |
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20a. WAS THE BODY EMBALMED: yes
EMBALMER'S LICENSE NO. 933A |
