Certificate of Death for James Pickens Walker, Jacksonville, November 19, 1960
Book 1, Page 379 ·1960
Transcription
A printed Florida State Board of Health Certificate of Death, form filed at Jacksonville and stamped with the seal of the City of Jacksonville, Department of Health, Bureau of Vital Statistics. Some entries are typewritten in capitals, others completed in ink; the photostat is somewhat faded but the principal fields can be read with care. Key entered data:
PLACE OF DEATH
County: Duval — Code No. 26-08
City, town, or location: Jacksonville
Length of stay (in this place): 26-08 [i.e., the residence code, not a stay duration]
Name of hospital or institution: 3698 Hedrick Street [i.e., home address — not an institution]
If hospital, indicate whether inpatient or outpatient: (blank)
USUAL RESIDENCE
State: Florida — County: Duval
City, town, or location: Jacksonville
Street and number: 3698 Hedrick St.
Inside city limits: Yes
NAME OF DECEASED: James Pickens Walker
DATE OF DEATH: Month Nov. — Day 19th — Year 1960
SEX: Male COLOR OR RACE: White MARRIED
DATE OF BIRTH: Apr. 27th 1883
AGE (last birthday, in years): 77
USUAL OCCUPATION: General Superintendent
KIND OF BUSINESS OR INDUSTRY: A.C.L. Ry. (Atlantic Coast Line Railroad)
BIRTHPLACE: Overfield Com., W. Va.
CITIZEN OF WHAT COUNTRY? U.S.A.
FATHER’S NAME: Samuel Cadwaller Walker
MOTHER’S MAIDEN NAME: Emma Dee Pickens
WAS DECEASED EVER IN U.S. ARMED FORCES? No
SOCIAL SECURITY NO.: (blank)
INFORMANT’S SIGNATURE: [signature — appears to read A. Walker Jr. — i.e., James Pickens Walker Jr., the decedent’s son]
Informant’s address: 3698 [Hedrick] — Jax., Fla.
CAUSE OF DEATH
Part I. Death was caused by:
Immediate cause (a): Coronary acute
Conditions, if any, which gave rise to above cause (b): (blank)
Due to ©: (blank)
Part II. Other significant conditions contributing to death but not related to the terminal disease condition given in Part I (a): (blank)
Interval between onset and death: Sudden
WAS AUTOPSY PERFORMED? No
PLACE OF INJURY: (blank — death not due to injury)
I HEREBY CERTIFY that I attended the deceased from 1953 to date, and that I last saw him alive on Nov. 19, 1960. Death occurred at 9:55 P.M. on the date stated above, and on the basis of my knowledge, from the causes stated.
22a. Signature: [signature — best reading MacKenzie Mason or similar, M.D.]
22b. Address: 2442 [Atlantic] Blvd., Jacksonville [7], Fla.
22c. Date signed: 11-21-60
BURIAL, CREMATION, REMOVAL: Removal
23b. Date: Nov. 21st 1960
23c. Name of cemetery or crematory: (blank)
23d. Location (city, town, or county): Philippi, West Virginia
24. Funeral director’s signature: Hugh L. Hardage
Address: Hardage & Sons, 517 Park St. (Jacksonville, Fla.)
25. Date recorded by Local Reg.: Nov. 21, 1960
26. Registrar’s signature: [signature]
Certified-copy stamp (bottom of form):
I hereby certify the above to be a true and correct photo copy of the record on file in this office. (Not valid unless the raised seal of the CITY HEALTH DEPARTMENT, JACKSONVILLE, FLORIDA, is affixed.)
November 22, 1960
E. R. [Smith?] Bell, M.D.
City Health Officer
Kathleen Z. Barker
Director, Division of Vital Statistics
AI Notes
An official Certificate of Death issued by the Department of Health, Bureau of Vital Statistics, City of Jacksonville, Florida, for James Pickens Walker (Sr.). Death occurred at the family residence (3698 Hedrick Street, Jacksonville) on the evening of November 19, 1960. Filed November 22, 1960; certified true-and-correct copy bears the seal of the City Health Department and signatures of the City Health Officer and the Director, Division of Vital Statistics (Kathleen Z. Barker). The cause of death is given as acute coronary, with interval between onset and death entered as ‘Sudden.’ This is the death certificate enumerated on the envelope mounted at page 378. The photostat is dim: key fields read as date of death Nov 19, date of birth Apr 27 1883, age 77, cause of death acute coronary, time of death 9:55 PM, birthplace ‘Overfield Com., W. Va.’ (i.e., Overfield Community), and mother’s maiden name Emma Dee Pickens. The attending physician’s signature is rapid and only partially legible (best reading ‘MacKenzie Mason’ or similar).
The decedent — Amy FitzSimons’s husband — was buried at Philippi, West Virginia, the West Virginia town near his birthplace (Overfield, in present-day Barbour or Greenbrier County); the body was shipped from Jacksonville two days after death. The informant’s signature, “A. Walker Jr.”, is almost certainly that of his son James Pickens Walker Jr., who lived at the same Jacksonville address.