| STATE OF CALIFORNIA DEPARTMENT OF HEALTH SERVICES STANDARD CERTIFICATE OF DEATH # 19-017629 | |
| NAME OF DECEASED: | Daisy Minahan |
| PLACE OF DEATH: | 1811 N. Berendo Los Angeles |
| SEX: | Female |
| COLOR OR RACE: | White |
| MARITAL STATUS: | Single |
| DATE OF BIRTH: | January 9, 1879 |
| AGE: | 40 Years, 3 Months, 21 Days |
| BIRTHPLACE: | Wisconsin |
| NAME OF FATHER: | William B. Minahan |
| FATHER'S BIRTHPLACE: | Ireland |
| MAIDEN NAME OF MOTHER: | Mary Shaughnessy |
| MOTHER'S BIRTHPLACE: | Ireland |
| LENGTH OF RESIDENCE AT PLACE OF DEATH: | 1 Year |
| INFORMANT: | Mrs. Grace Phillips 1811 N. Berendo St. Los Angeles |
| DATE OF DEATH: | April 30, 1919 |
| CAUSE OF DEATH: | Chronic Pulmonary Tuberculosis |
| DURATION: | 9 Years, 6 Months |
| CONTRIBUTORY CAUSE: | Tuberculous Laryngitis |
| DURATION: | 3 Months |
| CERTIFICATION: | I hereby certify that I attended deceased from Sept. 11, 1918 to Apr. 30, 1919, that I last saw her alive on April 29, 1919 and that death occurred on the date stated above at 4 A.M. |
| PHYSICIAN: | W. James Barlow, M.D. 616 Leewick Bldg. |
| PLACE OF BURIAL: | Calvary Cemetery |
| DATE OF BURIAL: | May 2, 1919 |
| UNDERTAKER: | Robert Sharp & Son |
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