| Dist. No. | 1911 |
|---|---|
| Serial No. | 44 |
| Place of Death | |
| County | Jefferson |
| Magisterial District | Charles Town |
| City or Town | Charles Town |
| Length of stay in hospital or inst. | |
| Home (Usual Residence) of Deceased | |
| State | |
| County | |
| City or Town | |
| Street No. | |
| — | |
| Full Name | Daniel Lee Moler |
| If veteran, name war | Spanish Americ. |
| Social Security No. | — |
| Sex | Male |
| Color or race | White |
| Single, married, widowed, or divorced. | Married |
| Name of husband or wife | Florence E. Moler |
| If alive, give age | 56 years |
| Birth date of deceased | Mar 11- 1869 |
| Age | 75 yrs. 3 ms. 17 ds. |
| Birthplace | Molers Cross Roads |
| Usual Occupation | Gov’t Employee |
| [Father’s] Name | Geo Wm Moler |
| [Father’s] Birthplace | Jeff. Co |
| [Mother’s] Name | Laura F. Flanagan |
| [Mother’s] Birthplace | Jeff. Co |
| Informant’s Signature | Mrs. Florence E. Moler |
| [Informant’s] Address | Charles Town |
| Burial, Cremation, Removal | Burial |
| Date Thereof | July 1, 1944 |
| Cemetery | Edge Hill |
| Location | Charles Town |
| Funeral Director | Melvin T. Strider |
| Address | |
| Medical Certification | |
| Date of Death | June 28, 1944 at 6:15PM |
| I certify that death occurred on the date above stated; that I attended deceased from 6/2, 1944 to 6/28, 1944 and that I last saw him alive on 6/28, 1944. | |
| Immediate cause of death | Cerebral Hemorrhage, Paralysis duration |
| Due To | Arterial Hypertension |
| Duration | 2 wks. |
| Signature | G. P. Morrison |
| Address | Charles Town, W.Va 6/29/44 |
Death Certificate: Daniel Lee Moler
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