MINNESOTA DEPARTMENT OF HEALTH SECTION OF VITAL STATISTICS CERTIFICATE OF DEATH | |
NAME OF DECEASED: | Alice Munger Patrick |
PLACE OF DEATH: | St. Mary's Hospital Duluth, St. Louis County, MN |
USUAL RESIDENCE: | 2514 E. Superior St. Duluth, Minnesota |
SEX: | Female |
COLOR OR RACE: | White |
MARITAL STATUS: | Widow |
USUAL OCCUPATION: | At Home |
DATE OF BIRTH: | October 19, 1872 |
BIRTHPLACE: | Duluth, Minnesota |
AGE: | 85 |
FATHER'S NAME: | Roger S. Munger |
MOTHER'S MAIDEN NAME: | Olive Gray |
SPOUSE'S NAME: | Richard S. Patrick |
INFORMANT: | W. W. Crawford Duluth, Minnesota |
DATE OF DEATH: | May 2, 1958 |
CAUSE OF DEATH: | Septicemia (Organism not known) |
INTERVAL FROM ONSET: | 5 days |
DUE TO: | Pyelonephritis |
INTERVAL FROM ONSET: | 7 Days |
SIGNIFICANT CONDITION: | Unreverted Cancer-Sigmoid Colon |
CERTIFICATION: | I certify that I attended the deceased from 1957 to 5/1/58 and that I last saw the deceased alive on 5/1/58 and that death occurred at 4 AM on the date stated above and to the best of my knowledge from the causes stated. |
PHYSICIAN: | William B. Martin, MD Duluth, Minnesota |
PLACE OF BURIAL: | Forest Hill Cemetery Duluth, Minnesota |
DATE OF BURIAL: | 5/5/58 |
FUNERAL DIRECTOR: | W. W. Munford Duluth |