| Dist. No. | 190 |
|---|---|
| Serial No. | 29 |
| Place of Death | |
| County | Jefferson |
| Magisterial District | Harpers Ferry |
| City or Town | Halltown |
| Length of stay in hospital or inst. | [?] |
| Home (Usual Residence) of Deceased | |
| State | W. Va. |
| County | Jefferson |
| City or Town | Halltown |
| Street No. | |
| — | |
| Full Name | Raleigh Moore |
| If veteran, name war | — |
| Social Security No. | — |
| Sex | Male |
| Color or race | White |
| Single, married, widowed, or divorced. | Married |
| Name of husband or wife | Sarah Ellen Moore |
| If alive, give age | 76 years |
| Birth date of deceased | Nov. 16th 1858. |
| Birthplace | Washington County, Maryland |
| Usual Occupation | Truck Farmer |
| [Father’s] Name | James Moore |
| [Father’s] Birthplace | Maryland |
| [Mother’s] Name | Angeline Myers |
| [Mother’s] Birthplace | Maryland |
| Informant’s Signature | Mrs. Raleigh Moore |
| [Informant’s] Address | Halltown, West Virginia |
| Burial, Cremation, Removal | Burial |
| Date Thereof | Feb. 12th ’47 |
| Cemetery | Edge Hill |
| Location | Charles Town |
| Funeral Director | Melvin T. Strider |
| Address | Charles Town, W. Va. |
| Medical Certification | |
| Date of Death | Feb. 10th, 1947 at 3:00PM |
| I certify that death occurred on the date above stated; that I attended deceased from Feb. 8, 1947 to Feb. 10, 1947 and that I last saw him alive on Feb. 10, 1947. | |
| Immediate cause of death | Myocarditis |
| Due To | Arteriosclerosis |
| Duration | 4 mos. |
| Signature | Marshall Stum |
| Address | Charles Town, W.Va 2-12-47 |
Death Certificate: Raleigh N. Moore
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