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S. A. Sale Death Certificate
Posted by: Sherry Zorzi (ID *****8657) Date: January 28, 2003 at 08:22:30
  of 1032

Louisiana State Board of Health
Bureau of Vital Statistics
Certificate of Death

1. Place of Death
Parish - Claiborne
Police Jury Ward - 3
Registration District No. - 14-5127
File No. - 6
Village - Dykesville, La.
Primary Registration District No. - blank
Registered No. - 4021
City - blank
No., St., Ward - (stamped) May 14, 1920

2. Full Name - Mr. S. A. Sale
Residence No., St., Ward - blank
Length of residence in city or town where death occurred - blank

3. Sex - Male

4. Color or Race - White

5. Single, Married, Widowed, or Divorced - Married
Husband of - Mrs. Lilla Sale

6. Date of Birth - Yr of 1843

7. Age - 87

8. Occupation of Deceased - blank

9. Birthplace - Georgia

10. Name of Father - Don't Know

11. Birthplace of Father - Don't Know

12. Maiden Name of Mother - Liza Grove

13. Birthplace of Mother - blank

14. Informant - Mrs. W. B. Warren
Address - Haynesville, La., RFD #1

15. Filed - May 6, 1920
Registrar - Mrs. Anna Norton

16. Date of Death - April 23, 1920

17. I hereby certify that I attended deceased from blank to blank, that I last saw him alive on blank, and that death occurred on the date state above at blank o'clock.
The cause of death was as follows: Paralysis.
Duration - blank
Contributory (secondary) - Cerebral hemorrhage
Duration - blank

18. Where was disease contracted if not at place of death? - blank
Did an operation precede death? - blank
Was there an autopsy? - blank
What test confirmed diagnosis? - blank
Signed - It was Dr. A. G. Worley
Address - Haynesville, La., RFD #1

19. Place of burial, cremation, or removal - Old Haynesville, La.
Date of Burial - blank
Undertaker - none
Address - blank


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