Name of Deceased: Annie Bost Landquist
Date of Death: August 19, 1969
Sex: Female
Color/Race: White
State of Birth: North Carolina
Date of Birth: Feb. 15, 1878
Age: 91 years
Place of Death: County: Wilkes; City: N. Wilkesboro; Name of Hospital/Institute: 505 "D" Street; Inside city limits.
Usual Resdience: State: N.C.; County: Forsyth; City: Winston-Salem; Street: 2060 Craig Street;Iinside city limits.
Widowed
Citizen of USA
Usual Occupation: Housewife
Father's Name: Martin Luther Bost
Mother's Maiden Name: Rozetta Crowell
Informant's Name & Address: Mrs. George D. Lentz, 2060 Craig Street, Winston-Salem, N.C.
Cause of Death: Arterios Aerotic Heart Disease, duration: Many years. Other significant conditions: Congestive heart failure, chronic brain syndrome
No Autopsy
I attended the deceased form Aug. 11, 1969 to Aug. 19, 1969 and last saw her alive on Aug. 18, 1969death occurred at p.m. on the date stated abovre and in my opinion, from the causes stated.
Signature of Certifier: James C. Mills, M.D.; Date 8/22/69; Address: N. Wilkerboro, N.C.
Burial: Date 8-21-69; Cemetery: Moravian Graveyard; Location: Winston-Salem, N.C.
Funeral Home: Frank Vogler and Sons, Inc,
Signature of Funeral Director: Jack L. Sparks; License No. 2192
Date Rec'd by local Reg: 8-30-69; Signature of Registrar: Stamped Wilkes county Health Dept.
Signature of Embalmer: _____ L. Phillips; License No. 1011
(Source: Transcribed from copy of original document)
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