HomeMy WebLinkAbout2717 `TC q ~ 11, `
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UItITFD STJ1T~ OF A~RICi
COPY OF RECQRD OF DEATH ~2~ ;
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- Town oE Notfolk~ Massachuxtts '
I. d~e undersigned~ hereby certity that I am cierk of the Town of Noriotk that as such I have
custody of the r~oords of death requircd by law to be Icept in my office; tl~at among such reoords is one ~ a
relatin~ w the death of ~
~aymond ~John Gault
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and that the follo~ving is a true rnpy of so much oi said rea~~d as rCiatr~ w aai~ ~leath. na~arly; ~ `
Date of Dath. I3ovember 24~ t
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Place of Death Pondville Nospital, ,~urfulic, .Zla;~. t
Ra,ymond : John ,~sult ~
Name . . . . . . _ _ . . . . _ -
lt ~icaoaar! a a:wr::ad. w.~J0:1I Ot 1JICY[a' U~. on•rn. Ci~~ also maiden n+me ~+d n~~ ol hML~ad. ~
W}1~t9 ~
StX.-----•-- - D1A_19.... . _ COIOT - - :
t
E At~~~ E
Single~ riarried. Widowcd or Divorced ~r~~ ~E G U r
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~L F rQ~
7 ' 24 c~~sK c~~+~~iT ~fi ~
~Se------....__.._........_.. Y~ars.--...__65...--~~-~----.. Months DaYs~~-~--------AEC-~~~cR?cl p ~
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~ Foxboro, I~ass. ~ pu qC
€ ~ Residenct ~ ~~r?t ~t~l
f Oceupation r'.achinest _ _ - _ _
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~ U. S. War Veteran ._no. . . . . . . . °
llpee.fe w.r . ~
~ Place of Birth ......_Grenth~r~~._.•:'~.: ~i. . • ~
FATHER MOTNER ;
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~ Nsme Jerome Gault . . ~taiden Name _.._......Fannie__Rus_sel~,--------......._._ ~ :
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~ ~rantham, 'ri. ~nfield. ' . K. ' ' s
. Plaae of Birth ' . . . . . . Place o( Birth . . . . . . . . _ _ . - ~ - . f
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~ Causeof Ue~t,rr, pronchopneumonie, Fibrosarcot?w. ~f phar~rxix
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'1 {.:c •
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~ , - ! " • k..~.... - - - . Cem. . _ _ . . Ci y or Town . . _ _ ~~1s~.81d.~... ....L~....__._...._._....._. . .
Plaoe o~8ur~~~St~- 0'~ reye 'c
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t • . . • ~ ecember t , ~ _ . . . _ _ . . . . . . . . . . . ~ +
:.y~.;: .D . ` ~
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~ 's`~ ,~j.'t~ And I do hereby cerufy that the foregoing is a true copy from said reo~rds
~ : \wf ~ • - • • ~ : . . ~
: . ~i • 'i ~ ~ ~{ttttBB my hand and seal of said Town of Norfolk
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~ - ~ th a r
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~ ~ N~~ S d Ja 19
~ -.=.,cr~ ` - on tbis . . y oi . . n. . - ~ -~---75
~ Year .---~-y=?~"t~ ~ - i ~
~ Vol. 4 ~ ~ _
~ ~ . ~i~. ` ~-CA.?S:e?' i Cltrt .
~ P~~ . _ 05 ~ . . .
~ No. ' 95 y .
~a
~ 80
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