Jake Fagan (38217)

Item

Official death certificate for Jake Fagan. Identifier number 38217.

Title

Jake Fagan (38217)

Description

Death certificate for Jake Fagan. Born on unknown date. Died 12-06-1924.

Identifier

38217

County of Death

Ware

Address of Death

618 Jones St, Washington Hospital

Militia District No.

A1231

Registration District No.

1231

Registered Number

68

First Name

Jake

Middle Name or Initial

N/A

Last Name

Fagan

Residence

Haywood, Ga

Gender

Male

Color or Race

Colored

Marital Status

Single

Date of Birth

Don't Know

Age

54? years
54 years

Occupation

Laborer

Birthplace

Don't Know

Name of Father

Don't Know

Birthplace of Father

Don't Know

Maiden Name of Mother

Don't Know

Birthplace of Mother

Don't Know

Informant

Mr. Lewis

Informant Address

Haywood

Date Filed

January 16, 1925

Registrar

C. A. Witmer

Date of Death

December 6, 1924 06:00

Interval Attended

December 3, 1924 – December 6, 1924

Last Seen Alive

December 5, 1924

Cause of Death

Concussion of Skull

Contributory

Motor Car Accident (Railway)

Disease Contracted Location

Haywood, Ga

Operation Preceding Death

No

Autopsy

No

Medical Doctor

E. B. Mitchell, M.D.

Date of Doctor’s Signature

January 6, 1925

Medical Doctor Address

Waycross, Ga

Place of Burial

Red Hill Cemetery

Date of Burial

December 10, 1924

Undertaker

Jones Funeral Home

Additional Information

Age of deceased was marked with a question mark in original certificate to signify uncertainty.