| County | Jefferson |
|---|---|
| District | Harpers Ferry |
| Town or City | Bakerton |
| Full Name | David Henry Hetzel |
| Residence | |
| Personal and Statistical Particulars | |
| Sex | Male |
| Color or Race | White |
| Single, Married, Widowed, or Divorced | Married |
| Husband or Wife of | Anna M. Hetzel |
| Date of Birth | Sept 24, 1880 |
| Age | 51 years 10 months 25 days |
| Trade, Profession | Laborer |
| Industry or Business | Lime Plant |
| Date Deceased Last Worked | April 5th |
| Total Time (Years) Spent In This Occupation | 20 yrs. |
| Birthplace | Antietam, Md. |
| Father’s Name | John Hetzel |
| Father’s Birthplace | Antietam, Md. |
| Mother’s Maiden Name | Unknown |
| Mother’s Birthplace | Unknown |
| Informant | Mrs. Anna M. Hetzel |
| Informant’s Address | Bakerton, W.Va |
| Burial, Cremation, or Removal (Place) | Sharpsburg, Md. |
| Date | Aug 21, 1932 |
| Funeral Director | J. L. Eackles, Bolivar W.Va |
| Filed | Aug. 19, 1932 |
| Medical Certification | |
| Date of Death | Aug. 19th, 1932 |
| I HEREBY CERTIFY, That I attended deceased from about Aug 1930 to Aug. 18 1932. I last saw him alive on Aug 18, 1932, death is said to have occurred on the date stated above at 3:45P.M. | |
| Principal and Related Cause of Death | Chronic Myocarditis, onset about Aug 1930; Chronic Nephritis, onset 1931; [?] course uremia, onset Aug 14 – 32. |
| Other Contributory Causes of Importance | |
| Was there an autopsy? | No |
| Signature | C.C. Johnson, M.D. |
| Address | Harpers Ferry, W. Va. |