Fridtjof Arne Madsen (Death Certificate)

DEPARTMENT OF HEALTH 
CITY OF NEW YORK
CERTIFICATE OF DEATH # 72-301748 
NAME OF DECEASED: Fred Matson
PLACE OF DEATH:  Lutheran Medical Center
Borough of Brooklyn
SEX: Male
MARITAL STATUS: Married
NAME OF SPOUSE: Louise Stokke
USUAL RESIDENCE:  8805 3rd Avenue
Brooklyn, Kings, New York
LENGTH OF RESIDENCE: 60 Years
OCCUPATION: Carpenter
DATE OF BIRTH: March 17, 1888
PLACE OF BIRTH: Norway
CITIZENSHIP: USA
AGE: 83 Years
NAME OF FATHER: Fridtjof Madsen
MOTHER'S MAIDEN NAME: Anna Larsen
INFORMANT:   Louise Matson, wife
8805 3RD Ave.
Brooklyn, NY
DATE OF DEATH: January 23, 1972
CERTIFICATION:            I hereby certify that a staff
physician of this institution
(Dr. Stousland) attended the
deceased from 1/3/1972 to 1/23/
1972 and last saw him alive at
8:40 PM on Jan 23, 1972. I
further certify that traumatic
injury or poisoning DID NOT play
any part in causing death, and
that death did not occur in any
unusual manner and was due
entirely to NATURAL CAUSES.
PHYSICIAN:   L. Harisiadis
4520 4th Ave.
Brooklyn, New York
NAME OF CEMETERY:  Greenwood Cemetery
Brooklyn, New York
DATE OF BURIAL: January 26, 1972
FUNERAL DIRECTOR:   Edw. C. Halvorsen Inc.
5310 8th Avenue
Brooklyn, NY 1056

Related Biographies:

Fridtjof Arne Madsen

Acknowledgements

Phillip Gowan

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Copyright © 1996-2019 Encyclopedia Titanica (www.encyclopedia-titanica.org) and third parties (ref: #21043, published 28 August 2003, generated 12th July 2019 11:44:01 AM)
URL : https://www.encyclopedia-titanica.org/death-certificate-21043-205.html