From the Ohio Department of Health State,
Division of Vital Statistics, Certificate of Death.
File No. 035868, Reg. Dist. No. 31, Primary Reg. Dist. No 3100,
registrar's No. 643.
Deceased - Grace R. Johnson, Female, Date of death - April 8, 1976
Race - White, Age - 88, Date of birth - Dec. 26, 1887 in Kentucky.
Death occured at Mt. Healthy Christian Home, Springfied Twp., Hamilton
County.
Citizen of USA, Widowed. SS# 319-10-5675.
Usual occupation - Teller at American Bank & Trust Co.
Resident of 1474 Clovernoll Dr, North College Hill, Hamilton, Ohio
Name of father - Faris Rice
Name of mother - Mary Jane Umstead
Informant - M. Matthews, 8097 Hamilton Aven., Cincinatti, Ohio 45231
Cause of death - Cerebrovascular Accident due to Atheroschlerotic
Cardiovascular Disease
Certified by Daniel H. Sway, M.D. who attended her from 2-16-1972 to
4-8-1976, death occured at 8:55 p.m.
Sign by Daniel H. Sway, M.D. of 6105 Hamilton Ave., Cincinnati, Ohio
45224 on 4/26/76.
Burial on 4/12/76 at New Burlington Cemetery, Hew Burlington, Hamilton
County, Ohio
Name of Emblmer - Paul R. Young (Lic. No. 5042A).
Funeral firm and address - Paul R. Young Funeral Home, 7345 Hamilton
Ave., Cincinnati, Ohio 45231
Received by local registar - 6-10-76 by Rosina Maidena
