James Edward HARRISON Death Certificate

TEXAS STATE DEPARTMENT OF HEALTH

BUREAU OF VITAL STATISTICS

STANDARD CERTIFICATE OF DEATH

Registrar's No.: 71965

1. PLACE OF DEATH

STATE OF TEXAS

COUNTY OF: Freestone

CITY OR PRECINCT NO.: 1

Length of residence in city where death occurred: 7 yrs.

How long in U. S. if fotreign born? [blank]

2. FULL NAME OF DECEASED: J. E. Harrison

PERSONAL AND STATISTICAL PARTICULARS

3. SEX: Male

4. COLOR OR RACE: White

5. Single...: Widowed

5a. If married, widowed, or divorced HUSBAND of (or) WIFE of: Sela Holaway

6. DATE OF BIRTH: June 7, 1953 [actually should be 1853]

7. AGE: 81 years, 6 months, 9 days

OCCUPATION:

8. Trade...: Retired Farmer

9. Industry or business...: [blank]

10. Date deceased last worked at this occupation: 8 years

11. Total time (years) spent in this occupation: Lifetime

12. BIRTHPLACE: Willcox Co., Ala.

FATHER:

13. NAME: Edmon Harrison

14. BIRTHPLACE: Ala.

MOTHER:

15. MAIDEN NAME: Dont Know

16. BIRTHPLACE: Dont Know

17. INFORMANT: J. D. Harrison

(Address) R# 3 Teague Tex

18. BURIAL, CREMATION, OR REMOVAL:

Place: Removal

Date: Dec. 17, 1934

19. UNDERTAKER: Burlison & Stewart<BR>

(Address) Fairfield Tex

20. FILE DATE AND SIGNATURE OF REGISTRAR: 2-21 1935 W. B. Young, J.P.

MEDICAL CERTIFICATE OF DEATH

21. DATE OF DEATH: Dec. 16, 1934

22. I HEREBY CERTIFY, That I attended deceased from 1 & 1, 1930 to Dec 16, 1934

I last saw him alive on Dec 16, 1934; death is said to have occurred on the date stated above at 10:20 P.m.

The principal cause of death and related causes of importance were as follows:

Cancer of Face and Bowels

Date of onset: 1920

Other contributory causes of importance: none

Name of operation: Amputation of Left Arm

Date of: 1925

What test confirmed diagnosis: Lab

Was there an Autopsy? No

23. If death was due to external causes (violence) fill in also the following:

Accident, suicide, or homicide? No

24. Was disease or injury in any way related to occupation of deceased? [blank]

(Signed) [blank] M.D.

(Address) [blank]