Death Certificate for Martha Caroline Griffith
| Registration Dist. No.:
Registrar's No.: Birth No.: |
Standard Certificate of Death Division of Vital Statistics - State Board of Health State of South Carolina |
State File No.: 20638 | |||||||||
| 1. PLACE OF DEATH: (a) County: Saluda |
2. USUAL RESIDENCE: (where
deceased lived. If institution; residence before admission)
(a) State: South Carolina (b) County: Greenwood RFD, Greenwood Co, SC | ||||||||||
| (b) City or town (if
outside corporate limits, write Rural and give
township): Saluda Co. twp
#5 |
(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): |
(d) Street Address (if rural, give location): | ||||||||||
| 3. NAME OF DECEASED: a. (First) Martha |
b. (Middle) Caroline |
c. (Last) Griffith |
4. Date of Death (Month, Day, Year): October 26, 1919 | ||||||||
| 5. Sex: Female
|
6. Color or race: White
|
7. Married, never married, widowed, divorced: Widowed |
8. Date of birth:
|
9. Age (in years last
birthday): About 68
| |||||||
| 10a. Usual occupation (give kind of work done during most of working life, even if retired): Farmer | 10b. Kind of business or industry: | 11. Birthplace: | 12. Citizen of what country? | ||||||||
| 13a. Father's name: ? Richmond, Newberry Co., SC | 13b. Mother's maiden name: | 14. Husband or wife's name: | |||||||||
| 15. Was deceased ever in US armed forces (yes, no, unknown. If yes, give war or dates of service): | 16. Social Security No. | 17. Informant: Mrs. Henry Attaway, Chappels, Rt. | |||||||||
|
Medical Certification |
|||||||||||
| 18. Cause of Death: Old Age
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: | ||||||||||
| 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 ----, 19--, to ---, that I last saw the deceased alive on --, and that death occurred at ---, from the causes and on the date stated above. | |||||||||||
| 23a. Signature, Degree or Title: | 23b. Address: | 23c. Date signed: | |||||||||
| 24a. Burial, cremation, removal:
|
24b. Date: October 26, 1919 |
24c. Name of cemetery or crematory: |
24d. Location (city, town
or county, state): Chesnut | ||||||||
| Date rec'd by local registrar: | Registrar's signature: | 25. Funeral director, address: R. L. Ramey, Saluda, SC | |||||||||
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