Vitals: S. A. Sale, Death Certificate, Claiborne Parish, LA 
Submitted for the LAGenWeb Archives by: Sherry Zorzi 
Date:  Oct. 2003
Source: Louisiana State Archives



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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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