Death Certificate of Vaulton Merrill Pratt
Sept. 16, 1940

(click to enlarge)

State of Utah
Certificate of Death

1. Place of Death
a. County: Salt Lake
b. City or town: Salt Lake City
c. Name of hospital: Salt Lake General Hospital
d. Length of stay: In hospital: 12 days
In this community: Unknown

2. Usual Residence of Deceased
a. State: Utah
b. County: Salt Lake
c. City or town: Salt Lake City
d. Street No. 1152 South 5th East

3a. Full Name: Vaulton Merrill Pratt
3b. If veteran: no
3c. Social Security No. none

4. Sex: Male

5. Color or race: White

6a. Single, widowed, married or divorced: Widowed
6b. Name of wife: Zina Estella Jenkins Pratt
6c. Age of wife: deceased

7. Birth date of deceased: May 23, 1860

8. Age: 80 Years, 3 Months, 23 Days

9. Birthplace: Salt Lake City, Utah

10. Usual Occupation: none—retired
11. Industry or business: Formerly a penmanship teacher

12. Father Name: Orson Pratt, Sr.
13. Father Birthplace: Unknown
14. Mother Maiden Name: Mary Ann Merrill
15. Mother Birthplace: Norwalk, Conn.

16a. Informant’s own signature: Stanley W. Pratt
b. Address: Bountiful, Utah

17a. Burial
b. Date thereof: 9-19-40
c. Place: burial—Salt Lake City Cem.

18a. Mortuary: Deseret Mortuary Company
b. Signature of funeral director: George Alford Webb
c. Address: 36 E. 7th South
d. License No. 80
e. Was body embalmed? Yes

19a. Date received: Sept. 18, 1940

Medical Certification

20. Date of Death: September 16, 1940

21. I Hereby Certify, That I attended deceased from Sept. 8, 1940, to Sept. 16, 1940; last saw him alive on Sept. 16, 1940, death occurred on the date stated above at 10:40 a.m.

Immediate cause of death:

Chronic Myocardial
Degeneration
Duration: 10 yrs

(See Image)

22. If death was due to external causes, fill in the following:

23. Signature:
Sept. 17, 1940  Address: Salt Lake City

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