Sarah Jane McCullough, Vernon Parish Louisiana
Submitted by Bill Mccullough
Date: June 2, 2008

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Louisiana State Board Of Health
Bureau of Vital Statistics
Certificate of Death
Registration District No. 58-5570
File No. 3
Registered No. 5413

May 20 1924
1 - Place of Death
    Parish: Vernon
    Police Jury Ward: 6
    Village/City: Alco La
2 - Full Name: Sarah Jane McCullough
    Residence: Ward 6

Personal and Statistical Particulars
3. Sex: Female
4. Race: White
5. Single, Married, Widowed or Divorced: Blank
5a. Husband/Wife of: Blank 
6. Date of Birth: May 1st 1844
7. Age: 80 Years 11 Months 11 Days
8. Occupation: Blank
9. Birthplace: Georgia
10. Name of Father: Information could not be obtained
11. Birthplace of Father: Information could not be obtained
12. Name of Mother: Information could not be obtained
13. Birthplace of Mother: Information could not be obtained
14. Informant: A Simmon
15. Filed: April 12, 1924 G.S. Miller (Registar)

Medical Certificate of Death
16. Date of Death: April 11, 1924
17. I HEREBY Certify, That I attended deceased from April 6, 1924 to April 9,
    1924, that I last saw her alive on April 9, 1924 and that death occurred,
    on that date stated above, at 7 A.M.
    The Cause of Death was as follows:
    Hed been ill for some time Indigestion, general malaise but arose as normal
    and was dressing when she fell on the floor dead.
18. Did an operation precede death: No
    Was there an autopsy? X
    (Signed) J S Branch, M.D.
    (Address) Alco La
19. Place of Burial, Cremation, or Removal: Anacoco, La
    Date of Burial: April 12, 1924