| Name of Deceased | Frederick Flannagan Moler |
|---|---|
| Date of Death | Feby. 19th 1953 |
| Place of Death | |
| County | Jefferson |
| City or Town | Charles Town |
| Length of Stay […] | |
| Name of Hospital or Institution | North Samuel Street |
| Usual Residence | |
| State | W. Va. |
| County | Jefferson |
| City or Town | Charles Town |
| Street Address | North Samuel Street |
| — | |
| Sex | Male |
| Color or Race | White |
| Married | Widower |
| Date of Birth | Nov. 14th 1873. |
| Age (in years last birthday) | 79 yrs. 3 m. 5 d. |
| Usual Occupation | Retired Farmer |
| Kind of Business or Industry | |
| Birthplace | Molers Cross Roads |
| Citizen of What Country? | USA |
| Father’s Name | George W. Moler, (deceased) |
| Mother’s Maiden Name | Laura Flannagan, (deceased) |
| Was Deceased Ever in Armed Forces? | —- |
| Social Security No. | —- |
| Informant | Mrs. Marshall Orndorff, (Daughter) |
| Cause of Death | |
| Immediate Cause | Essotoue Gas Poisoning, interval between onset and death 1 hour (?) |
| Due to | Depression |
| Other significant conditions contributing to death | Arteriosclerotic Cardiovascular Disease |
| Major Findings of Operation | — |
| Autopsy | No |
| Accident, Suicide, Homicide | Suicide |
| Place of Injury | Home |
| City, Town, or Township | Charles Town Jefferson W.Va. |
| I hereby certify that I attended the deceased from Feb. 14, 1946, to 2-14, 1953, that I last saw the deceased alive on 1-23, 1953, and that death occurred at 1 P.M., from the causes and on the date stated above. | |
| Signature | W. P. Wardey[?] M.D. , Charles Town, W.Va. 2/22/53 |
| — | |
| Burial, Cremation, Removal | Burial |
| Date | Feby. 21st ’53 |
| Name of Cemetery or Crematory | Edge Hill, (Chas. Town) |
| Embalmer’s Signature | E. G[?] Davis |
| Date Rec’d By Local Reg. | 2/25/53 |
Death Certificate: Frederick Flanagan Moler
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