| 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 |
