Death Certificate of Agnes Ure Pratt
May 25, 1949

Agnes Ure Pratt Death Certificate
(click to enlarge)

Certificate of Death

1. Place of Death:
County: Utah
City: Provo
Length of Stay: 1 yr. 10 mo.
Full Name of Hospital: Utah State Hospital

2. Usual Residence
a. State: Utah  
b. County: Salt Lake
c. City: Salt Lake City, Utah
d. Street Address: 1744 East 3045 South

3. Name of Deceased: Agnes U. Pratt

4. Date of Death: Month: 5   Day: 25   Year: 1949

5. Sex: Female

6. Color or Race: White

7. Married, Never Married, Widowed, Divorced: Widowed

8. Date of Birth:  Mo. Nov.  Day  4   Year 1870

9. Age: 79

10. Usual Occupation: Housewife

11. Birthplace: Tooele, Utah

12. Citizen of What Country?

13. Father’s Name: James U. Pratt   Birthplace:  Scotland

14. Mother’s Maiden Name: Elizabeth Jones   Birthplace: England

Husband’s or Wife’s Name: Mathoni Wood Pratt

15. Was Deceased ever in U.S. Armed Forces:

16. Social Security: No.

17. Informant: Hospital Records, Utah State Hospital

18. Cause of Death
            I. Disease or Condition Directly Leading to Death: Chronic Myocarditis
            II. Other Significant Conditions: Seniilty and general debility

20. Autopsy?  No.

22. I Hereby Certify that I attended the deceased from 7-15, 1947 to 5-25, 1949.  That I last saw the deceased alive on 5-23, 1949, and that death occurred at 5:25 a.m. from the causes and on the date stated above.

23. Signature

24. Burial, Cremation, Removal: Removal
24b. Date: 6/27/49
24c. Name of Cemetery: Wasatch Lawn
24d. Location: Salt Lake Co.

Date Rec’d by Local Reg.: 5-25-49

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