BOROUGH OF BROOKLYN CERTIFICATE OF DEATH
| DIVISION OF RECORDS DEPARTMENT OF HEALTH BOROUGH OF BROOKLYN CERTIFICATE OF DEATH # 156-63-326117 |
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| NAME OF DECEASED: | Anna Bolton |
| PLACE OF DEATH: | 1020 Ocean Pkwy. Brooklyn, New York |
| USUAL RESIDENCE: | 39 Turner Place Brooklyn, Kings County |
| LENGTH OF RESIDENCE: | 30 Years |
| SEX: | Female |
| MARITAL STATUS: | Widowed |
| DATE OF BIRTH: | (not given) |
| AGE: | 80 Years |
| USUAL OCCUPATION: | Housewife |
| BIRTHPLACE: | Russia |
| CITIZEN OF WHAT COUNTRY: | USA |
| FATHER'S NAME: | Mitchel Warshaw |
| MOTHER'S MAIDEN NAME: | Dianah Jaffe |
| INFORMANT: | Tessie Bolton, daughter 39 Turner Place |
| DATE OF DEATH: | December 22, 1963 (P.M.) |
| CAUSE OF DEATH: | Arteriosclerotic cardiovascular disease |
| CERTIFICATION: | I hereby certify that in accordance with the provisions of law, I took charge of the dead body at 1152 Coney Island Hospital this 24th day of December 1963.I further certify from the investigation and post mortem examination without autopsy that, in my opinion, death occurred on the date and at the hour stated above and resulted from natural causes. |
| PLACE OF BURIAL: | New Montefiore Cemetery Pinelawn, New York |
| DATE OF BURIAL: | December 24, 1963 |
| FUNERAL DIRECTOR: | Kirschenbaum Bros. Inc. 1153 Coney Island Avenue |
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