Transcript:
1 Place of Death
County or
Precinct or
City / no.
/ ward
|
Weber
Ogden / 640
22nd Street (4th Ward)
|
2 Full Name
Residence No. / St.
Length
of residence in city or town where death occurred (yrs. mos. ds)
How long in U.S., if foreign birth?
|
John Ammon Taylor
640 22nd Street (4th
Ward)
4 years
|
3 Sex
|
Male
|
4 Color or Race
|
White
|
5 Single, Married,
Widowed, or Divorced
If
Married, Widowed, or divorced, Husband of (or) wife of
|
Married
Hannah Poulson
|
6 Date of Birth
|
February 18, 1846
|
7 Age
|
75 yrs. 0 mos. 1 ds.
|
8 Occupation
|
Farmer
|
9 Birthplace (City or
town)
|
Texas
|
(State or Country)
|
|
10 Name of Father
|
John Taylor
|
11 Birthplace of Father
(State or Country)
|
Pennsilvania
|
12 Maiden Name of Mother
|
Hannah Berkatt
|
13 Birthplace of Mother
(State or Country)
|
Kentucke
|
14 Informant
|
Elmer A. Taylor
|
Address
|
|
15 Filed / Registrar
|
Feb 3 1921 / R
Wilson
|
16 Date of Death
|
February 19, 1921
|
17 I hereby Certify, That I attended
deceased from Feb 9, 1921 to Feb 19, 1921 that I last saw him alive on Feb 18, 1921 and that death occurred, on the date stated above,
at 1:20 AM.
The
Cause of Death was as follows: Apoplexy
Duration: 10 ds.
|
|
18 Where was the disease
contracted if not at place of death?
Did an operation precede death?
Was there an autopsy?
What was the confirmed diagnosis?
(Signed), M.D.
Date/Address
|
No, --
No
--
(signed)
Feb 19, 1921 / Ogden, Utah
|
19 Place of Burial,
Cremation or Removal
Date of Burial
|
Plain City Cemetary
Feby 22, 1921
|
20 Undertaker
Address
|
[Ija] Lindquist
Ogden, Utah
|
21 Registered No.
|
2656
|
22 no of Burial or Removal
Permit
|
2719
|
Interesting:
- John died one day after his 75th birthday.
- Listed as married but his wife died in 1916, according to his gravestone.
- His parents birthplaces, in addition to being misspelled, are inverted, maybe. His census records list his Father from Kentucky and his mother from Pennsylvania.
- ETA - According to Midge - "Apoplexy is the same as a stroke. Test confirming diagnosis looks like paralysis. They had few tests available to them back then but paralysis either complete or one sided is classic. More of a symptom than a test but I think that is what it says."

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