Mary Olive Carruth McCullough, Vernon Parish Louisiana
Submitted by Bill McCullough
Date: June 2008

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Louisiana State Board of Health
Bureau of Vital Statistics
Certificate of Death
Registration District No.: 56-5569
File No: 33
Primary Registration District No.: Blank
Registered No.: 2453
March 17 1924

1 - Place of Death
Parish: Vernon
Police Jury Ward 5
Village: Pitkin
City: Lined Out

2 - Full Name: Mary Olive McCollough
    Residence: Blank

Personal and Statistical Particulars
3 Sex: Female
4 Color or Race: White
5 Single, Married, Widowed or Divorced: Married
5a Wife of: JB McCollough
6 Date of Birth: Dec 5, 1874
7 Age: 50 Years 2 Months 5 Days
8 Occupation of Deceased: Housekeeping
9 Birthplace: Hineston La
10 Name of Father: Doc. Carruth
11 Birthplace of Father: Miss.
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Medical Certificate of Death
16 Date of Death: Feb 10 1924
17 I Hereby Certify, That I attended deceased from Sept 1923 to Feb 7, 1924
that I last saw her alive on Feb 7, 1924 and that death occurred, on the date
stated above, at (blank) m.
The Cause Of Death was as follows: Mitral regurgitation
(duration) 5 mos
Contributory Lagrippe
18 Did an operation precede death? No
   Was there an autopsy? No
   (Signed) H R Opp???,M.D.
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