Reg. Dist. No. 494
Primary Reg. Dist. No. _227 |
OHIO DEPARTMENT OF
HEALTH
COLUMBUS
CERTIFICATE OF DEATH
Department of Commerce - Bureau of
the Census |
State File No. 68679
Registrar's No. 6529 |
|
1. PLACE OF DEATH:
(a) County Hamilton
(b) Cincinnati
(c) Name of hospital or institution
2723 Jefferson Ave.
(d) Length of stay: In hospital or institution
In this community 50
(Years, months
or days) |
2. USUAL RESIDENCE OF DECEASED:
(a) State: Ohio (b) County: Hamilton
(c) City: Cincinnati
(d) Street No. 2723 Jefferson Ave. |
MEDICAL CERTIFICATION:
20. Date of death: Nov. 27, 1944 at 9:30 a.m.
21. I hereby certify that I attended the deceased from
about Nov. 1, 1938 in Nov. 26, 1944, that I last saw her
alive on Nov. 26, 1944 and that death occurred on the date
and hour stated above.
Immediate cause of death:
Cerebral Hemorrhage - Duration 1 day
Due to Hypertension and Diabetes mellitus
Other conditions: Chronic Arthritis
Duration 7 years
22. (blank)
23. Signature of Doctor or Osteopath:
Edwin W. Eng, M. D.
Address: Vine & Findlay, Cinti, O. -
Date signed Nov. 30/ 44 |
3. FULL NAME:
Elizabeth M. Gerhold |
4. Sex. F 5. Color: W 6. (a)
Widowed
6(b) Name of Husband: Louis H.
7. Birth date of deceased: Dec. 7th 1870 |
|
8. Age: 73 yrs. |
9. Birthplace: Cincinnati, O.
10. Usual occupation: Housewife
11. Industry or business: (blank)
12. Father's Name: Martin Schwartz
13. Father's birthplace: Ger.
14. Mother's Maiden name: Elizabeth Deibel
15. Mothers birthplace: Ger.
16. (a) Informant's signature: Arthur Gerhold
(b) Address: 3261 Bishop St.
17. (a) Burial, cremation or other:
(b) Date: Nov. 29th, 44
(c) Place: Walnut Hills
(d) Embalmer: Cletus Homen - Lic#31809
18. (a) Funeral Director: Paul C. Frederick
Lic. No. 1947
(b) Address: 18 Calhoun
19. (a) Nov. 30, 1944
(Date received local retistrar)
(b) Jos. Back? |
