Montgomery County, Ohio death certificate of Miranda Warner Kopp

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Date: Sun, 26 Jan 2003
Darrell Warner
From: http://www.genrecords.net/emailregistry/vols/00001.html#0000008
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MONTGOMERY COUNTY, OHIO DEATH CERTIFICATE
1. Place of death
  a. County: Montgomery
  b. Township: nothing listed
  c. City: Dayton, Ohio
  d. Registration district number: 904
  e. File number: 890
  f. Primary registration district number: 8390
  g. Registered number: 24638
  h. Did deceased serve in U. S. Army or Navy: no
2a. Full name: Nancy Kopp
2b. Residence: 24 South Kilmer
3. Sex: female
4. Color or race: white
5a. Single, married, widowed or divorced: widowed
5b. Name of husband: nothing listed
6. Date of birth: March 18, 1842
7. Age: 80 years 0 month 27 days
8. Occupation of deceased: housewife
9. Birthplace: Kentucky
10. Name of father: Jonas Warner
11. Birthplace of father: Kentucky
12. Maiden name of mother: Elizabeth Clayton
13. Birthplace of mother: Kentucky
14. Informant: Adam Kopp  address: 24 South Kilmer, Dayton, Ohio
15. Date filed: April 16, 1927
16. Date of death: April 15, 1927
17a. I hereby certify, That I attended deceased from April 13, 1927 to 
April 15, 1927, that I last saw her alive on April 15, 1927, and that 
death occurred on the date stated above at 4:30 PM.
17b. The cause of death was as follows: mycarditus with contributory 
cause of chronic bronchitis.
18a. Where was disease contracted: nothing listed
18b. Did an operation precede death: no
18c. Was there an autopsy: no
18d. Signed: C. E. Burgett MD of Dayton, Ohio  date: April 21, 1927
19a. Place of burial: Owingsville, Kentucky
19b. Date of burial: April 18, 1927
20. Undertaker: L. P. Barnes of Easin, Ohio