Vital Documents

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Death certificate of Ernest Bernard Johnson Jr, 2004 (Montana)

State File No. 200407-005975
(note: box numbers are non-consecutive and out of order on the form)
1. Name: Ernest Bernard Johnson Jr.
2. Sex: Male
3. SSN: 516-22-7511
4. Age: 81
5. Date of birth: June 17, 1923
29. Date of death: October 07, 2004
17. County of death: Cascade
14. Place of death: Hospital, inpatient
15. Facility: Benefis Healthcare, Great Falls
6. Birthplace: Great Falls, Montana
9. Marital status: Married
10. Surviving spouse: Shirley Eloise Johnson
54. Decdent's occupation: Certified Public Accountant
55. Business/industry: Floor Covering
8. Was decdent ever in armed forces: Yes
7. Residence: Montana, Cascade, Great Falls, 209 11th Street N., 49301; inside city
51. Education: Bachelor's degree
52. Not Spanish/Hispanic/Latino
53. Race: White
11. Father's name: Ernest Bernard Johnson, Sr.
12. Mother's maiden name: Frances Davis
13. Informant: Shirley Eloise Johnson, wife, 209 11th Street N., Great Falls, Montana 59401
18. Disposition: Cremation
19. Place of disposition: Hillcrest Lawn Crematory, Great Falls, Montana
(funeral and disposition info omitted)
24. Date pronounced dead: October 07, 2004
25. Time: 3:20
32. Cause of death: Pneumonia, 1 week; Pulmonary Fibrosis, years; Chronic aspiration, years
other significant conditions contributing to death: Parkinson's Disease

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