Death Certificate of John Stephen Edwards
Jan. 17, 1922

death certificate of john stephen edwards
(click to enlarge)

State of Utah—Death Certificate

1. Place of Death
County: Salt Lake
City: Salt Lake
No. 1983 View Ave.

2. Full Name: John Stephen Edwards
a. Residence. No. 1983 View Ave.
Length of residence in city where death occurred: Life

Personal and Statistical Particulars

3. Sex: Male

4. Color or Race: White

5. Single, Married, Widowed, or Divorced: Married
5a. Husband of Ettie Pratt Edwards

6. Date of Birth: Jan. 1st, 1851
7. Age: 71 yrs. 0 mos. 16 ds.

8. Occupation of Deceased
a. Carpenter
b. Contractor

9. Birthplace: Salt Lake, Utah

10. Name of Father: John Edwards
11. Birthplace of Father: Wales, England
12. Maiden Name of Mother: Charlotte Stephens
13. Birthplace of Mother: England

14. Informant: Ettie Pratt Edwards
Address: 1983 View Ave.

15. Filed: Jan. 20, 1922

Medical Certificate of Death

16. Date of Death: Jan. 17, 1922

17. I Hereby Certify, That I attended deceased from Nov. 14, 1921, to Nov. 15, 1921, that I last saw him alive on Nov. 14, 1921, and that death occurred, on the date stated above, at 1 a.m. 

The cause of death was as follows:

Chr. Myocarditis
Duration: 3 yrs. 2 mos.

Contributory: not known

18. Did an operation precede death? No.
Was there an autopsy? No.

Signed: A.A. Anderson, M.D.
Jan. 18, 1922  Address: Lengleton Bldg.

19. Place of Burial, Cremation or Removal: City Cem.

20. Undertaker: Carl Eddington
Address: 1043 E. 21 S.

Return to histories of John Stephen Edwards