ORIGINAL
STANDARD CERTIFICATE OF DEATH
1. In the Denison Hospital, city of Denison, the Township of Denison, in the County of Crawford, in state of Iowa, this death was number 37.
2. [The deceased name was] Albin Jarl who lived in Boyer Iowa. He had been in the hospital for about 9 hours. The document further states that he was in the United States, [33] years.
5. [Albin was a] white married male. His wife was Caroline Jarl. He was 50 years, 1 month, and 10 days old.
8. [His] occupation was as a Laborer on [a] farm.
9. [His] birthplace was Sweden.
10., 11. 12. 13. [The informant for this document] does not know his parents names, nor their birth places besides Sweden.
14. [The informant was] Mrs. Caroline Jarl, Boyer, Iowa.
15. Filed, [unreadable]
THE MEDICAL CERTIFICATE OF DEATH relates the following
16. DATE of DEATH: (month, day, and year) June 21 1924
17. I HEREBY CERTIFY, That I attended deceased from June 20 1924 to June 21 1924; that I last saw him alive on June 20, 1924, and that death occurred, on the date stated above, at 7am.
THE CAUSE OF DEATH was as follows:
Acute obstruction of the bowels (duration) 48 yrs.
CONTRIBUTORY Adhesions in abdomen [?] (duration) yrs mon...... da....
18. Where was disease contracted if not at place of death?
Did an operation precede death? No Date of...
Was there an autopsy? No.
What test confirmed diagnosis? Symptoms
(signed) Louis W. Coon, M.D.
,19 (Address) Denison Iowa
*State the disease causing death, or in deaths from violent causes, state (1) means and nature of injury, and (2) whether accidental, suicidal, or homicidal. (See reverse side for additional space.)
19 PLACE OF BURIAL, CREMATION OR REMOVAL DATE OF BURIAL Kiron, Cemetery June 24 192[4]
20 UNDERTAKER ADDRESS
Chas. Bartcher Denison
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