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Following is a transcription from Image:ZonaLYockey.JPG, a downloaded version rotated and magnified.
The very top of the certificate was not captured in the image. The format of this transcription is approximate, and fields which do not have content have been excluded sometimes for formatting convenience.
County of ___Crawford___
Township of ___Licking Twp.___ | Standard Death Certificate
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Full Name ___Zona Louisa Yockey___
Residence No. ___Oblong Ill R#2___ |
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| Length of residence in (place) where death occurred _2_ yrs. mos. ds. | How long in U.S. if foreign born? yrs. mos. ds.
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| PERSONAL AND STATISTICAL PARTICULARS | MEDICAL CERTIFICATE OF DEATH
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Sex
__Female__ | Color/Race
__White__ | __Widowed__ | DATE OF DEATH - ___June 8, 1933___
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| Former wife of ___Jasper Yockey___ | I HEREBY CERTIFY, That I attended deceased from
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| Date of Birth ___Feb 14, 1873___ | ___June 3, 1933___ to ___June 8, 1933___
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| Age Years Months Days | that I last saw _her_ alive on ___June 8, 1933___
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| ____60__ __3__ __24___ | The CAUSE OF DEATH was as follows:
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| Occupation of Deceased | ___housewife___
___housekeeping___ | _____apoplexy_____
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| Place of occupation | ___at home___ | Duration ___5___ ds.
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| Birthplace | ___Jasper County___
___Illinois___ | WHERE WAS DISEASE CONTRACTED
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| Name of father | ___<u>Wm Downey___ | If not at place of death? ____________
Did an operation precede death? __________
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| Birthplace of father | ___Unknown___
___Indiana___ | Was there an autopsy? __________
What test confirmed diagnosis? __________
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| Maiden name of mother | ___Ann Webster___ | (signed) _____J. Wicirt(sp)_____, M.D.
Address _____Oblong Ill_____
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| Birthplace of mother | ___Unknown___
___Indiana___ | Date ___June 8, 1933___ Telephone __________
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| Informant | ___C. A. Yockey___ | PLACE OF BURIAL OR REMOVAL | DATE OF BURIAL
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| Address | ___Oblong Ill R#2___ | ___Mound Cemetery___ | ___6/9, 1933___
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| Filed | ___6/8, 1933___ ___Goran(sic) L. Barker___ | UNDERTAKER | ADDRESS
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| | registrar | ___Frank Geffs(sic)____ | ___Oblong Ill.___
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