County of Washtenaw, State of Michigan, Certificate of Death Michigan Department of Health, Vital Records Section State File No. 1781 Local File No. 410 1. Place of Death a. County - Washtenaw b. City or Village - Ann Arbor Township c. Length of Stay at this place - 27 days d. Full name of hospital or institution - Veterans Administration Hospital 2. Usual Residence (Where deceased lived. If institution: residence before admission.) a. State - Michigan b. County - Muskegon c. Township, City or Village - Muskegon Heights d. Is residence within limits of city or incorporated village - Yes e. Street address - 121 West Broadway 3. Name of Deceased - Dave T. Wiggins 4. Date of Death - September 23, 1964 5. Sex - Male 6. Color or Race - White 7. Married, Never Married, Widowed, Divorced - Married 8. Date of Birth - 7-11-1897 9. Age (In years last birthday) - 67 10. a. Usual occupation - Machinist b. Kind of business or industry - Continental Motors 11. Birthplace - Wetzel, Michigan 12. Citizen of What Country - U.S.A. 13. Father's Name - Thomas Wiggins 14. Mother's Name - Sarah Valance 15. Name of Husband or Wife of Deceased - Alice Wiggins 16. Was Deceased ever in U.S. Armed Forces - Yes - World War I 17. Social Security Number - Given 18. Informant's Name - Official VA Hospital Records 19. Cause of Death - Gastro-intestinal hemorrhage - Duodenal ulcer eroding into artery Other significant conditions - Thrombosis of aortofemoral prosthesis Date of Operation - 8/31/1964 Major Findings of Operation - Bilateral A/K amputation 20. Autopsy? - Yes Burial 9/26/1964 at Mona View Cemetery, Muskegon Heights, Michigan - Lee Funeral Home, Muskegon Heights, Michigan Tonia L. Baird