Campbell County Death Certificates

CERTIFICATE OF DEATH
STATE OF MISSOURI
BUREAU OF VITAL STATISTICS

 
Rebekah Butler
Reg. Number:  ; Reg. District:
Certificate Number:

IMAGE

Name: Rebekah Butler
Residence:
Sex: Female
Race: white
Date of Birth: 08 Sep 1844
Place of Birth: Campbell Co. Tenn
Date of Death: 30 May 1936
Place of Death: Ray Co. Missouri
Age: 91years 6 months 22 days
Marital Status: Widowed
Spouse, if living: Robert Butler
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number:
Occupation: housewife
Industry or Business: (left blank)
Father's Full Name: Hiram Richardson
Father's Birthplace: Tennessee
Mother's Full Maiden Name: unknown
Mother's Birthplace: unknown
Cause of Death: advanced arteriosclerosis & senility
  • Due to: (left blank)
  • Other conditions: (left blank)
  • Operation?: (left blank)
  • Autopsy?: (left blank)
If death was due to external causes, fill in the following:
  • Accident, Suicide, or Homicide: (left blank)
  • Date of Occurrence:
  • Where did the injury occur: (left blank)
  • Did injury occur in or about home, on farm, in industrial place, in public place?: (left blank)
  • While at work: (left blank)
  • Means of Injury: (left blank)
Informant: James Butler
Informant Address: Polo Missouri
Burial, Removal, or Cremation: burial
Date: 31 May 1936
Undertaker: C.A. & L.A. Reed
Address: Caugill Missouri
By:
Date Filed: Jul 1936
Registrar:
Signature:
Address:

Submitter's Name: Carol Woodward
Submitter's Email: carob@tc3net.com
Relationship to the Deceased: cousin

Comments: Buried at St. Paul's Chapel, Ray Co.Missouri along with husband Robert Butler.


 


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