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Death Certificate for John Beauregard Thomasson - contributed by Madena Thomason-Whitesell

Registration Dist. No: 3408

Registrar's No: 10

Birth No.:

Standard Certificate of Death

Division of Vital Statistics - State Board of Health State of South Carolina

 State File No.:  52-5057
1. PLACE OF DEATH:
(a) County:  Newberry		 2. USUAL RESIDENCE: (where deceased lived. If institution; residence before admission)

(a) State:   South Carolina   (b) County:  Newberry

(b) City or town (if outside corporate limits, write Rural and give township): Rural (c) City or town (if outside corporate limits, write Rural and give township):
(d) Full name of hospital or institution (if not in hospital or institution, give street address or location): Greenville Hwy Rt. #3 (d) Street Address (if rural, give location):
3. NAME OF DECEASED: 
a. (First)  b. (Middle)     c. (Last)

John Beauregard Thomasson

 

 4. Date of  Death  (Month, Day, Year): 3/15/52
5. Sex:  Male

6. Color or race:  White

 

 

 

 

 7. Married, never married, widowed, divorced:

Widowed

 

 

 8. Date of birth: 11/23/1859

9. Age (in years last birthday): 92

 

 

10a. Usual occupation (give kind of work done during most of working life, even if retired):  Farmer 10b. Kind of business or industry:  Farm 11. Birthplace:
South Carolina		 12. Citizen of what country?
13a. Father's name:  John B. Thomasson (should read Arnold P. Thomasson) 13b. Mother's maiden name:  Harriet Suber 14. Husband or wife's name: 

Rosanna Hogge Thomason

15. Was deceased ever in US armed forces (yes, no, unknown. If yes, give war or dates of service): NO 16. Social Security No. 17. Informant:  

Miss Lilla Mae Thomasson, Newberry

 

Medical Certification

  
18. Cause of Death:  Coronery Thrombosis 

I. Disease or condition directly leading to death

(a)

due to (b)

due to (c)

II Other significant conditions (conditions contributing to the death but not related to the disease or condition causing death)

 Interval Between Onset and Death:  4201/5
19a Date of operation: 19b: Major findings of operation: 20. Autopsy: YES            NO
21a. Accident, Suicide, Homicide: 21b. Place of injury (home, farm, factory, street, office bldg., etc.): 21c. City, Town, or Township; County; State
21d. Time of injury (Month, Day, Year, Hour): 21e. Injury occurred (while @ work, not @ work): 21f. How did injury occur?:
22. I hereby certify that I attended the deceased from ----, 1943, to 3-15, 1952 that I last saw the deceased alive on 3-15-51, and that death occurred at 9:30 a.m., from the causes and on the date stated above.
23a. Signature, Degree or Title:  V. W. Rivebart M.D. 23b. Address: Newberry, SC 23c. Date signed: 5-7-52
24a. Burial, cremation, removal:

Burial

24b. Date:  
3/16/52

24c. Name of cemetery or crematory: Rosemont

 24d. Location (city, town or county, state):  Newberry, South Carolina
Date rec'd by local registrar: 5-14-52 Registrar's signature: Mrs. A. H. Counts 25. Funeral director, address:  McSwain Funeral Home, Newberry, SC

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