|
a.
|
Note: N18448 Given name (Richard), middle initial (D), surname (Porter) and address (East Millsboro, Pennsylvania) in June, 1907, from Commonwealth of Pennsylvania Certificate of Death - Malinda Porter, Bureau of Vital Statistics, Registration District No. 504, Primary Registration District No. 2650, File No. 55412, Registered No. 72, June 16, 1907
--------------------
1850 (September 12) census data from the census images for Luzern Township, Fayette County, Pennsylvania (Page 361/718 - image 26 - line 17) on Ancestry.com. The census indicates that he was a 27 year old laborer. There is no listing as to the value of real estate owned. He was living with his wife, 1 son and 1 daughter. He is listed as having been born in Fayette County, Pennsylvania. His given name is listed as ÒRichardÓ in this census.
--------------------
Form V. S. No. 5-50M-8-20-07.
COMMONWEALTH OF PENNSYLVANIA.
BUREAU OF VITAL STATISTICS.
CERTIFICATE OF DEATH.
File No. __ 21517 ___
Registered No. __ 487 __
Registration District No. __ 504 __
Primary Registration District No. __ 2649 __
PLACE OF DEATH.
County of ___ Fayette ___
Township of ___ Redstone ___
or
Borough of _____-_____
or
City of _____-_____ (No. ____, __________ St.; __________ Ward)
[If death occurs away from
USUAL RESIDENCE
give facts called for under
ÒSpecial Information.Ó]
[If death occurred in a
Hospital or Institution,
give its NAME instead
of street and number.]
FULL NAME ___ Richard Porter ___
PERSONAL AND STATISTICAL PARTICULARS
SEX ___ Male ___
COLOR ___ White ___
DATE OF BIRTH ___ October ___ (Month) __ 21st __ (Day) 1 __ 822 __ (Year)
AGE __ 86 __ years, __ 5 __ months, __ 1 __ days.
SINGLE, MARRIED,
WIDOWED, OR DIVORCED ___ Widowed ___
BIRTHPLACE
(State or County) ___ Fayette Co - Pa ___
OCCUPATION ___ Carpenter ___
NAME OF FATHER ___ Armstrong ___
BIRTHPLACE
OF FATHER
(State or County) ___ Pennsylvania ___
MAIDEN NAME
OF MOTHER ___ Nancy Davis ___
BIRTHPLACE
OF MOTHER
(State or County) ___ Pennsylvania ___
THE ABOVE STATED PERSONAL PARTICULARS ARE TRUE
TO THE BEST OF MY KNOWLEDGE AND BELIEF
(Informant) ___ Hezekiah D. Porter ___
(Address) ___ West Brownsville ___
Filed ___ Mar. 23 ___ 190 _ 9 _
___ L. N. Reichard, M. D ___
Registrar
MEDICAL CERTIFICATE OF DEATH
DATE OF DEATH ___ Mar ___ (Month) __ 21 __ (Day) 190 _ 9 _ (Year)
I HEREBY CERTIFY, That I attended deceased from
___ Feb 25 ___ 190 _ 9 _ to ___ Mar 21 ___ 190 _ 9 _
that I last saw h __ im __ alive on ___ Mar 21 ___ 190 _ 9 _
and that death occurred, on the date stated above, at ___ 7:15 ___
__ P __ M. The CAUSE OF DEATH was as follows:
___ Aortic Regurgitation ___
__________
___ 202 ___
__________ (Duration) __ 10 yrs __ Days
Contributory _____- _____
_______________ (Duration) ____ Days
(Signed) ___ A McG Duff and J D Carr ___ M. D.
___ Mar 22 ___ 190 _ 9 _ (Address) ___ Merrittstown ___
SPECIAL INFORMATION only for Hospitals, Institutions, Transients, or
Recent Residents.
Former or
Usual Residence __________
How long at
Place of Death ______? Days
Where was disease contracted? __________
PLACE OF BURIAL OR REMOVAL ___ Hopewell Cemetery ___
DATE OF BURIAL ___ Mar. 24 ___ 190 _ 9 _
20. UNDERTAKER ___ Sharpnack & Conelly ___ ADDRESS ___ Brownsville Pa ___
WRITE PLAINLY, WITH UNFADING INK - THIS IS A PERMANENT RECORD.
N. B. - Every item of information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
CAUSE OF DEATH in plain terms, that it may be properly classified. The ÒSpecial InformationÓ for persons dying away
from home should be given in every instance.
|
