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DISTRICT NO. Z950 ~UCOU~~ REGISTERED NO. .
Name of Deceased ___F~~ DEVINE
Date of Deat~+ ~~CCh 15th, 19b2 _~X Male Color or Race_~ite
Place of Death Meadowbrook 8ospital, East Meadow, New Y„rk
Usual Residence 160 Mdple Ave. , Smithtowrl, NeW YOrk
Single, Monisd Married Name of Husbond ~rqaret Horion
Widowed w Divorced -(or) Wife
IF UNDE! 1 YR. IF UNOEt 24 HRS_
` Date of Birth Febru_ ary 4th, 1901 p9e 61 Y~ "~O~"~` °an N°~"`
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` g~rthP~Qa Scotland _ whor~co ntry? U.S? .A
! Industry
; usuol Occ~pat~o•+ Welder «~;~~u Iron Works
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~ Father's Name UI]~CnOWn M~ci~ ~sName Margaret Unknown
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~ Evsr in U. S. ~10~ 074-O1-0094
j Armed fwce:2 Yes W. W. I I Securiry No
7 PRONO CED
~ CAUSE OF DEATH: Time of Deot6 4 s~ am
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< (A)... CQRONARY_ OCCLUS.I~~i... . _ . . . . . _ . . . .
~ ARTERIOSCLEROTIC HEART DZSEASE
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~ E.V. Mc Goldrick M.D. Address N.C. Dep. *!led. Examiner
~ Certified by
~o~ ~ L . I . National Cem.
~ Pinelawn New York March 19th, 1962
= w Crornatioti ~ Qate of Burial
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3 Undertaker O R Davis F_H_ Address Smithtown, New Yozk _
I do hereby certify that the above is a tronsuipt of a death record of
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as contained in the official records of the Registrar of Vito) Statistia of the Tawn of Hempstead, Nassau
County, New York _
Ft~EO ?h'~ aECORDED
57.1UC1E GOUNTT fL~-
RGGE~ 40~TRAS L ~N TESTIMONY WHER~OF,~ have ~Ierounto set my hand
= ~~R~ yERif EO COURZ
~E~o and affixed the o{fiiciat'ssq~ a~ the'~own vf Hempstead,
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- 2 2S ~~Z ` this 29th. ~ ~io~ve~er. - . 1971 .
3 at Hempstead, ~ew Y~t. . - .
- N° 6'7'7'74 _ - ~ ~ , . . - .
~~(js A. ~C COSTANZO
~ror of Vital Statistics
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P Registror, De or Sub-Registror
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