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."
John Ammon Taylor was married to Martha Jane Burns when he died. It should have been her name given on the death certificate instead of Maren Johanne's, who had died in 1916.
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