title

Lorain Death Certificate

CERTIFICATE OF DEATH
STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF VITAL STATISTICS

 

Laura Elizabeth Orick
Reg. Number:  47; Reg. District: 4700
Certificate Number: 060538


Name: Laura Elizabeth Orick
Residence: Norwalk,OH
Sex: Female
Race: white
Date of Birth: 27 Oct 1887
Place of Birth: TN
Date of Death: 09 Aug 1971
Place of Death: Weber Nursing Home
Age: 83
Marital Status: Widowed
Spouse, if living: Isaac George Orick
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: none
Occupation: n/a
Industry or Business: (left blank)
Father's Full Name: unknown
Father's Birthplace: n/a
Mother's Full Maiden Name: unknown
Mother's Birthplace: n/a
Cause of Death: circulatory failure
  • Due to: cerebral hemorage
  • Other conditions: (left blank)
  • Operation?: (left blank)
  • Autopsy?: (left blank)
If death was due to external causes, fill in the following:
  • Accident, Suicide, or Homicide: (left blank)
  • Date of Occurrence: 19
  • Where did the injury occur: (left blank)
  • Did injury occur in or about home, on farm, in industrial place, in public place?: (left blank)
  • While at work: (left blank)
  • Means of Injury: (left blank)
Informant: Sarah Burger
Informant Address: 17 Willard Ave
Burial, Removal, or Cremation: Burial
Date: 21 Jul 1971
Undertaker: James M. HIle
Address: 175 Benedict Ave. Norwalk,OH
By: James M. Hile
Date Filed: 12 Aug 1971
Registrar: Pearl A. Deimling
Signature: Harry E. Hartman M.D.
Address: 136 Main st. Wellington,OH.

Submitter's Name: Sherman F.Orick
Submitter's Email: knxorick@aol.com
Relationship to the Deceased: grandson

Comments:



 


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