Ludie Lillian HARRISON (Bailey) Death Certificate

Ludie Lillian HARRISON (Bailey) Death Certificate

 

TEXAS DEPARTMENT OF HEALTH

BUREAU OF VITAL STATISTICS

STATE OF TEXAS 178-01-2 178-01

CERTIFICATE OF DEATH 0388 08

STATE FILE NO. 87564

 

1. PLACE OF DEATH:

a. COUNTY: Nueces

b. CITY OR TOWN: Corpus Christi

c. LENGTH OF STAY: 10 years

d. NAME OF HOSPITAL OR INSTITUTION: Spohn Hospital

e. PLACE OF DEATH INSIDE CITY LIMITS? Yes

 

2. USUAL RESIDENCE:

a. STATE: Texas

b. COUNTY: Nueces

c. CITY OR TOWN: Corpus Christi

d. STREET ADDRESS: 214 Adams

e. IS RESIDENCE INSIDE CITY LIMITS? Yes

f. IS RESIDENCE A FARM? No

 

3. NAME OF DECEASED: Ludie L. Bailey

4. DATE OF DEATH: November 10, 1973

5. SEX: Female

6. COLOR OR RACE: Caucasian

7. WIDOWED

8. DATE OF BIRTH: July 4, 1889

9. AGE: 84 years

10a. USUAL OCCUPATION: Housewife

10b. KIND OF BUSINESS OR INDUSTRY: Housewife

11. BIRTHPLACE: Texas

12. CITIZEN OF WHAT COUNTRY? U.S.A.

13. FATHER'S NAME: Edward Harrison

14. MOTHER'S NAME: Cecia Holaway

15. WAS DECEASED EVER IN U.S. ARMED FORCES? No

16. SOCIAL SECURITY NO.: 467-18-4664-D

17. INFORMANT: Mrs. Clarice Farmer by ABL

 

18. CAUSE OF DEATH:

Part I. DEATH WAS CAUSED BY:

IMMEDIATE CAUSE: Septicemia E. Coli and clostridium. C.V.A., Urinary infection Proteus Renal Insufficiency. Diabetes Mellitus, Non Union left femur fracture, Arteriosclerosis.

Part II. OTHER SIGNIFICANT CONDITIONS: [blank]

19. WAS AUTOPSY PERFORMED? No

20. INJURY [all blank]

21. I hereby certify that I attended the deceased from Dec. 16, 1966 to Nov. 10, 1973 and last saw the deceased alive Nov. 9, 1973. Death occured at 4:30 A.m. on the date stated above and to the best of my knowledge, from the causes stated.

22a. SIGNATURE: H. A. Kennedy, MD

22b. ADDRESS: 3154 Reid Dr. Corpus Christi, Tex

22c. DATE SIGNED: Nov. 20, 1973

 

23a. BURIAL, CREMATION, REMOVAL: Removal

23b. DATE: Nov. 10, 1973

23c. NAME OF CEMETERY OR CREMATORY: Cemetery Unknown

23d. LOCATION: Edinburg, Texas

24. FUNERAL DIRECTOR'S SIGNATURE: Ross Langham Mortuary, Ross B. Langham

 

25a. REGISTRAR'S FILE NO.: 1593

25b. DATE REC'D BY LOCAL REGISTRAR: Nov 23 1973

25c. REGISTRAR'S SIGNATURE: W. R. Metzger, M.D.

 

Transcription by John C. Hepner, 1999

 

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