Death Certificate of Kittie M. Lewallen

Washington State of Board of Health, Bureau of Vital Statistics, Certificate of Death
Record Number: 22, Registered Number 5
Clarke County, City of Vancouver, St Joseph's Hospital
Full Name: Kittie M. Lewallen
White Married Female
Date of Birth May 31, 1888
Age: 30 Years, 7 Months, 4 Days
Occupation: Housewife
Birthplace: Illinois
Name of Father: Geo. Shay
Birthplace of Father: U.S.
Maiden name of Mother -------
Birthplace of Mother -------
The above is true to the best of my knowledge. (signed) J. H. Lewallen, address: Vancouver
filed Jan 8, 1919 (signed) JMP Chalwers (?) MD
Date of Death Jan 5, 1919
I HEREBY CERTIFY, That I attended deceased from Jan 2, 1919 to Jan 5, 1919, that I last saw her alive on Jan 5, 1919 and that death occurred on the date above, at 5 P.M.
The CAUSE OF DEATH was a follows: :Influenza and Bronchial Pneumonia
(signed) Chr MacCallum, MD
Jan 6th, 1919 Vancouver, WA
Length of Residence at place of death: 6 days
In the state: 2 months
Former or usual residence: Weiser, Idaho
Place of Burial: Park Hill; Date of Burial: Jan 8, 1919
Undertaker: V. H. Limber, address: Vancouver

Additional information found on the Funeral Record
funeral charged to: W. J. Hunter
clergyman: Rev. Holmes
Interment: Park Hill, Lot No. 453, Sec. A, Casket size 37; color Blk.
Price of casket $45.00; Price of Outside Box $7.50; Price of Burial suit $10.00; Underclothing $3.00; Embalming Body $10.00; Washing and Dressing $5.00; gloves $1.00; Hearse $5.00; Wagon Deliveries $1.50; Total Footing of Bill $88:00