| STATE OF NEW YORK DEPARTMENT OF HEALTH OF THE CITY OF NEW YORKBUREAU OF RECORDS STANDARD CERTIFICATE OF DEATH # 29552 |
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| NAME OF DECEASED: | Dorothy Annan Harder |
| PLACE OF DEATH: | 510 Park Ave. Manhattan |
| CHARACTER OF PREMISE: | Apartment |
| SEX: | Female |
| COLOR OR RACE: | White |
| MARITAL STATUS: | Married |
| AGE: | 36 Years |
| OCCUPATION: | Housewife |
| BIRTHPLACE: | New York City |
| HOW LONG IN CITY?: | Life |
| NAME OF FATHER: | Eduard Annan, Jr. |
| FATHER'S BIRTHPLACE: | U.S. |
| MAIDEN NAME OF MOTHER: | Maud Earle |
| MOTHER'S BIRTHPLACE: | U.S. |
| DATE OF DEATH: | December 1, 1926 |
| CERTIFICATION: | I hereby certify that the foregoing particulars are correct as near as the same can be ascertained, and I further certify that I attended the deceased from August 28, 1926 to December 1, 1926, that I last saw her alive on the 1st day of Dec. 1926, that death occurred on on the date stated above at 4:30 P.M. and that the cause of death was as follows: URAEMIA |
| CONTRIBUTORY CAUSES: | Chronic Endocarditis Chronic Nephritis |
| DURATION: | 7 Years |
| PHYSICIAN: | Francis J. Murray, M.D. |
| PLACE OF BURIAL: | Greenwood Cemetery |
| DATE OF BURIAL: | December 3rd, 1926 |
| UNDERTAKER: | Fairchild Sons, Inc. 86 Leffert St. |
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