Division of Vital Statistics — Certificate of Death
State of Ohio | County of Montgomery
Document Transcript
1. Personal Information
Full Name:
Claude McCormick
Residence:
No. 105 Patterson Rd.
Sex / Color / Race:
Male / White
Marital Status:
Married
Spouse:
Anna N. McCormick
Date of Birth:
Aug 15, 1895
Age:
38 yrs, 0 mos, 14 days
2. Occupation & Birthplace
Occupation:
Traffic Officer
Industry/Business:
Oakwood Police Dept.
Birthplace:
Missouri (Mo.)
Father's Name:
Patrick McCormick
Father's Birthplace:
Ireland
Mother's Maiden Name:
Mollie Roebuck
Mother's Birthplace:
Missouri (Mo.)
3. Death & Medical Details
Date of Death:
August 29, 1933
Place of Death:
Miami Valley Hosp., Dayton, OH
Cause of Death:
Accidental Death - Skull Fracture, Hemorrhage
Contributory/Surgical:
Subtemporal Decompression
Manner of Injury:
Motorcycle accident while on duty
4. Informant & Burial Details
Informant:
Mrs. Anna McCormick (Dayton, O.)
Burial Place:
Woodlawn
Date of Burial:
Sept 2, 1933
Undertaker:
Schlientz & Sons (Dayton, O.)
File No. / Reg. No.:
47130 / 1855