Carl Olof Jansson (Death Certificate)

1978
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STATE OF NEBRASKA BUREAU OF VITAL STATISTICS 
CERTIFICATE OF DEATH # 78-03817 
NAME OF DECEASED: Carl Olaf Johnson
PLACE OF DEATH:  S.C. Community Hospital
Wahoo, Nebraska
USUAL RESIDENCE:  1259 N. Elm
Wahoo, Nebraska
SEX: Male
RACE: White
DESCENT: Swedish
CITIZEN OF WHAT COUNTRY?: U.S.A.
USUAL OCCUPATION: Carpenter
KIN OF BUSINESS: Bldg. Contractor
MARITAL STATUS: Married
DATE OF BIRTH: May 17, 1890
AGE: 87 Years
PLACE OF BIRTH: Sweden
FATHER'S NAME: Alfred Johnson
MOTHER'S MAIDEN NAME: Charlotte (unknown)
WAS DECEASED EVER IN
U.S. ARMED FORCES?:
Yes, WWI (9-5-17 thru 7-16-19)
INFORMANT:   Mrs. Edith Johnson
1259 N. Elm
Wahoo, Nebraska 68066
DATE OF DEATH: March 23, 1978
HOUR OF DEATH: 1:10 A.M.
CAUSE OF DEATH: Massive Cerebral Thrombosis
INTERVAL FROM ONSET: 72 Hours
DUE TO: Severe Cerebral Atherosclerosis
INTERVAL FROM ONSET: 10 Years
CERTIFICATION:    To the best of my knowledge, death
occurred at the time, date and
place and due to the causes stated.
PHYSICIAN:   Ivan M. French
964 N. Laurel St.
Wahoo, Nebraska 68066
PLACE OF BURIAL:  Sunrise Cemetery
Wahoo, Nebraska
DATE OF BURIAL: 3-25-78
FUNERAL HOME:   Ericson's Hult Funeral Home
911 N. Linden
Wahoo, NE 68066

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Carl Olof Jansson

Acknowledgements

Phillip Gowan

Citation

Encyclopedia Titanica (2003) Carl Olof Jansson (Death Certificate) ( ref: #21036, published 28 August 2003, generated 23rd September 2021 06:34:49 PM); URL : https://www.encyclopedia-titanica.org/death-certificate-21036-199.html