James Calvin Pollard, 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. 58-5569
File No. Blank
Primary Registration District Blank
Registered No. 3893

May 16 1921
1 - Place of Death
Parish: Vernon
Police Jury Ward: 5
Village or City: Pitkin

2 Full Name: James Calvin Pollard

Personal and Statistical Particulars
3 Sex: Male
4 Color or Race: White
5 Single, Married, Widowed or Divorced: Single
5a If married, widowed or divorced Husband of (or) Wife of: Blank
6 Date of Birth: July, 29, 1916
7 Age: 4 Years 8 Month 18 Days
8 Occupation of Deceased: Blank
9 Birthplace: Pitkin La
10 Name of Father: John Pollard
11 Birthplace of Father: Pitkin La
12 Maiden Name of Mother: Della McCollough
13 Birthplace of Mother: Pitkin La
14 Informant: James Martin
   Address: Blank
15 Filed: 4 19 1921 Lizzie Pittman (Registar)

Medical Certificate of Death
16 Date of Death: 4 8 1921
17 I Hereby Certify, That I attended deceased from
   4 7 1921 to 4 8 1921, that I last saw him alive
   on 4 8 1921 and that death occured, on the date 
   stated above, at 10 pm.
   The Cause of Death was as follows:
   Inflamation of Brain
   from high temperature
   Duration Blank
18 Where was disease contracted if not at place of death? Blank
   Did an operation precede death? Blank
   Was there an autopsy? No
   What test confirmed diagnosis? Blank
   Signed: T R Strother, M.D.
   Address: Dido La
19 Place of Burial, Cremation, or Removal: Blue Branch Cemetery
   Date of Burial: 4 18 1921
20 Undertaker: Blank