VITALS: DEATH CERTIFICATE: B.C. WINDOM, 1907: BROWNSVILLE, LINN COUNTY, OREGON

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Transcribed and formatted for use in USGenWeb Archives by:DAS, Volunteer 0001015
<http://www.usgwarchives.net/~archreg/vols/00005.html#0001015> May 10, 2003
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Surnames: Windom, Kelley, Richardson, Hayes

B.C. Windom

CERTIFICATE OF DEATH [Oregon State]
Registered No. 4175

PLACE OF DEATH:
County of Linn
City of Brownsville

FULL NAME: B.C. Windom

PERSONAL AND STATISTICAL PARTICULARS:

Sex: Male
Color: White
Date of Birth: Mar 16, 1832
Age: 75 years, 3 months, 19 days.
Single, Married, Widowed, or Divorced: M
Birthplace: Ill.
Name of Father: --
Birthplace of Father: --
Name of Mother: --
Birthplace of Mother: --
Occupation: Wagon Maker

The above stated personal particulars are true to the best of my
knowledge and belief
(Informant) A.C. Windom
(Address) Brownsville

Filed: (date and registrar name are both blank)

MEDICAL CERTIFICATE OF DEATH:
Date of Death: July 5, 1907

I HEREBY CERTIFY, That I attended deceased from 3 years, 190_,
to 7/5, 1907
that I last saw him alive on 7/1, 1907
and that death occurred, on the date stated above, at 5 am.

The CAUSE OF DEATH was as follows:
Mitral Regurgitation
years (duration) --

(Signed) J.B. Kelley M.D.
7/30 1907 (Address) BrVille

Place of Burial or Removal: Brownsville
Date of Burial: 7/7 1907
Undertaker: Richardson
Address: BrVille
---------------

Contributor's note:  This is Benjamin Carroll Windom, husband of
Sybil A. Hayes Windom