Name: Elvin Orick
Residence: Ohio
Sex: Male
Race: White
Date of Birth: 30 Nov 1894
Place of Birth: Tennessee
Date of Death: 14 Jul 1976
Place of Death: St. Marys, Auglaize County, Ohio
Age: 81
Marital Status: Widowed
Spouse, if living:
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: 410-01-1988
Occupation: Laborer - Miner
Industry or Business: Industry
Father's Full Name: Cummins Orick
Father's Birthplace:
Mother's Full Maiden Name: Hatfield
Mother's Birthplace:
Cause of Death: Respiratory Failure

• Due to: Pneumonia
• Other conditions: Heart Failure
• 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: Verlin Orick
Informant Address: 755 Columbia St., St. Marys, Ohio 45885
Burial, Removal, or Cremation: Burial
Date: 17 Jul 1976
Undertaker: Yoder - Longer & Folk Funeral Home
Address: 314 W. High Street. St. Marys, Ohio 45885
By: C. Richard Long
Date Filed: 20 Jul 1976
Registrar: Evelyn George
Signature:
Address:

Submitter's Name: Leigh Ann (Partin) Boyd
Submitter's Email: LPartin@aol.com
Relationship to the Deceased: Great Grand Daughter

Comments: Buried in Jellico Cemetery. This is an Ohio Department of Health Certificate of Death.