Ada Balls Death Certificate

Maryland State Department of Health : Certificate of Death

MARYLAND STATE DEPARTMENT OF HEALTH 
CERTIFICATE OF DEATH # 13582     
NAME OF DECEASED: Ada E. Perine
PLACE OF DEATH:  Masonic Homes Bonnie Blink
Cockeysville, Maryland
LENGTH OF STAY: 14 Years
USUAL RESIDENCE:  Narragansett Ave. 58.3
Pittsfield, Massachusetts
SEX: Female
COLOR OR RACE: White
MARITAL STATUS: Widowed
USUAL OCCUPATION: Housewife
DATE OF BIRTH: May 9, 1875
PLACE OF BIRTH: London, England
AGE: 92 Years
CITIZEN OF WHAT COUNTRY:? USA
FATHER'S NAME: William Hall
MOTHER'S MAIDEN NAME: Laura M. Powel
INFORMANT:  Masonic Home
Cockeysville, Maryland
DATE OF DEATH: October 1, 1967
CAUSE OF DEATH: Chronic Monolytal Leukemia
CONTRIBUTORY CAUSE: Broncho-pneumonia
CONTRIBUTORY CAUSE:  Chronic Brain Syndrome
Cerebral arteriosclerosis
CERTIFICATION:            I certify that I attended the
deceased from August 15, 1965
to Sep. 30, 1967, that I last
saw the deceased alive on Sep
30, 1967, and that death
occurred at 2:45 P.M. from
causes and on the date above.
PHYSICIAN:  Jamshid Hamed, MD
Masonic Home
PLACE OF BURIAL:  Oak Lawn Cemetery
Baltimore, Maryland
DATE OF BURIAL: October 4, 1967
FUNERAL DIRECTOR:    William Cook-Brooks Towson
1050 York Road
Towson, Maryland

Related Biographies:

Ada E. Balls

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Copyright © 1996-2019 Encyclopedia Titanica (www.encyclopedia-titanica.org) and third parties (ref: #136, published 1 August 2003, generated 15th September 2019 01:45:17 PM)
URL : https://www.encyclopedia-titanica.org/ada-balls-death-certificate.html