| INDIANA STATE BOARD OF HEALTH DIVISION OF VITAL RECORDS CERTIFICATE OF DEATH # 32770 | |
| NAME OF DECEASED: | Ernest U. Pearson |
| PLACE OF DEATH: | RFD 1, Rural Porter County Indiana |
| USUAL PLACE OF RESIDENCE: | Rural Route 1 Valparaiso, Indiana |
| SEX: | Male |
| COLOR OR RACE: | White |
| MARITAL STATUS: | Widowed |
| DATE OF BIRTH: | July 29, 1886 |
| PLACE OF BIRTH: | Sweden |
| DATE OF DEATH: | October 17, 1951 |
| AGE: | 65 Years |
| USUAL OCCUPATION: | Brickmason |
| FATHER'S NAME: | -----Pearson |
| MOTHER'S NAME: | Do not know |
| INFORMANT: | Bert Pearson RFD 1 Chesterton, Indiana |
| CAUSE OF DEATH: | Cardiovascular Disease |
| INTERVAL FROM ONSET: | 1 1/2 Years |
| CERTIFICATION: | I certify that I attended the deceased from 7/16 to 10/16/ 1951 and that death occurred from causes stated and on above date. |
| PHYSICIAN: | Paul C. F. Vietzke, M.D. Valparaiso, Indiana |
| PLACE OF BURIAL: | Elmwood Cemetery Hammond, Indiana |
| DATE OF BURIAL: | October 19, 1951 |
| FUNERAL DIRECTOR: | Howard LePell |
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