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 | William Williams (1859-1927) - Certificate of Death (Illinois Deaths and Stillbirths, 1916-1947)
State of Illinois – Certificate of Death
1) Place of death: 3907 N. St. Louis Ave, Chicago, Cook County
2) Full name: William Williams, Residence: 3907 N. St. Louis Ave
Personal and statistical particulars
3) Sex: Male
4) Color or race: White
5) Marital Status: Married, If married, widowed, or divorced, wife of: Anna Williams
6) Date of Birth: Apr 7, 1859
7) Age: 67 Years, 10 Months, 14 Days
8) Occupation
a)Trade, profession or particilar kind of work done: Retired
b) General nature of indutry, business in which work was done: Awning hanger
c) Name of employer: T. William ???
9) Birthplace: Egersund, Norway
Parents
- 10) Name of father: Tengsary
- 11) Birthplace of father: Egersund, Norway
- 12) Maiden name of Mother: not known
- 13) Birthplace of mother: not known, Norway
14) Informant: Mrs. Jane Johnson, 3936 N. Kostner Ave
15) Filed: 1927 Feb 26, 11:21 AM
Medical certificate of death
16) Date of Death: Feb. 24, 1927
17) I hereby certify, That I attended deceased from Jan 27th, 1927 to Feb. 21th, 1927, that I last wa saw him alive on Feb. 21st, 1927; and that death occured on the date stated above, at 3:15 P.M.
*The Cause of death was as follows:
Cerebral Hemorrhage, Duration: Instantaneous
Contributory (Secondary) causes: ???
18) Where was disease contracted:
- Did an operation precede death? No
- Was there an autopsy? No
- What test confirmed diagnosis? ???
19) Place of burial or removal: Acacia Park
21) Date of Burial: 2/26, 1927 |
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