HomeMy WebLinkAbout1948 44f UEi1 s7 - -
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NEr JERSEY STATE DEPARTMENT OF MEAf`TN • - -
~oul~FrEttluw[w CERTIFICATE OF DEATH sTwtEnECtttweER ~ ~J~ •
srACES 1. NAME. OF (F~rst1 1 M.ll/r/ /Lest) 2. Sta DA7 E OF DEATH
bE~o• FOR DECEASED ^v~~+ TT ~p Male JU ].2 1 •
siATE Ys[ (Type w Pnrt) ~C[7n.GL Er ~lyp
oNar ~ ! S~3
?ewCE Colw or Race S. Ase Its yrs Il under 1 Yr U trader 2t Hr:. 6. Date as Butb 7. ras deceased fret is U.S. Artaed FaceaJ
fast brrtb/o,l Mwrls eys Norrs M.a rPes, ro, or relrowr/ ll/ yea„ silo wr w l•Iea o/+erw/_
Idhite 60 7 U?I7 2
0. Bin place /law a /o?erp coagtry/ Citieen d that country 10. Martied~; Nerer Muritd L, 11. Social SeeutNy Na
Pate: son, i~lr J. U. S. A° fidorc0~ Di.«ced[~ 1!!h 03 7ot19
REflOEr/C[ 2. PLACE OF DEATH l;. USUAL RESWE\YE (U iastitutitaa: tesidcoce belae adoisai.sn)
Ctwny R(: @n a. Ssate 2t. ~T • a County Berg,@n .
a City (Check bo: and sire astae) e. City (Check bwa and Aire tart)
Toro[ Hackensack ~
~ ~ FairLlNn . =
e. r~amc eor ss spha) ar iasurotion sire stria ess) d. Swett Address (11 real, P.O. Address)
IlasFrtal as Hackensack Hos ,ita 7-25 iwnor Avenue
4lsrnuioa
t Usual Occupatan (Grvr lrwl o/ ro.l Irwr lanes /rose o/ rorlus /r/t, et+rs iJ ttmrll N. b. Kind of 8rsiaess a Industry
Textile Printer Dyeing & ~infa Cow
IS. fat?ct's Nast 1(>L Mother's Maidta N.tae j,
Michael Bogle ;;'•r '
Ellen . ~ ,
7. IrJrteant'a Name and Address _ tt~~••~r sr•oare~~ 'i
a ~ ca .a~yw .i-
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,ors r aEnes Boyle (wire) S me as #13 ~a - , ~ a; ,
CavSE (e, PART 1 DEATH sAS CAUSED BY Eatn os/y owe ceusr Per l.er /w pL ~ r' • ~1~}tt iotRral betrte~ .
~ ' t • ~ .:r ~ ~ dew
Irrrediate Cause ~ 1 ~C ( ~ dlf rt' s/
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corlr,iors.:/.ry, ra:c~ cD R F!~ Ij/~ ~-A ~ /0 G L-E'/~G~J~ ~ ~
sp» rue to about crrse Due ro fb1 l l`' ~~Li ~
Te/'. smears the awlen 1 •rea .bey, o: •.y
Cawt.era rew- lyres case lest Due tofc/ • t _ YI raaria• - ~ .
- M war rrlatd PART 11 OTNkR SiGNIFKA.rT CQ\DIf10WS '
<«?o. r~~NQVf Y~~/fl~pl4'C /fi,F~l~(~!/i1~ ~t ~Qf ~ rforver! veer (indinss coasideted
pe y - sw deters:ains cause of deufl
' Ycs(-j No Yes Ao C1
ewer o• 20r. Accidrnt Suicide Hosidde 2fib• Datt and How of la- 20c. Hut rn'ur Occurred /Fern set~rr o w w it Perl 1 e. If /tee /sL
acaoar• [7 C7 L7 tw1 t y / I y o/
to for brat o/ ny 4raa/r1 r. bl.
20d. 4ajury Occurred 20e. Plxe of (nlutr /r s rs a ab..•r bunt. 201. City, Torn or Locatiow Count Stue
wile at N.x [Ailt /arw_ /arts sAeet. of/rtt b/ls • rlc.) '
Cork at Qork _
e cross e~ass. 21. I (atanded, ttaaiacd) the deceased (from, oa) to
and last sat (Are, hey) dive or c L
Oforb occrrrrd a! a for lab sterrJ about; asl to for brst of ny lso~Ir/se. /roar tit ceases stare!.
1r1MaCt 22a. A[tendrns Phys_ Mrd. Esau. Cot:ot Ph s.
[J r , [7 11b] Address ~ ~f 22e• Da:C SiRoed
F Sibnutrc i~/~ C.~,~1,~-t/J ~ /3~ ~J`~ L[b~ / / / rG~fi ~4 ~3
23a. Bwial• Cttmatior• Rcaora) 2)b. Century a Crcwaatwy Name 2)c. location City State
i (fPr<r/yl
! Burial Holy Se .Ilcn:-e CFme ~e Tot zra Ro: ot1~?h, K. J.
1 2)d. Bwul Date Mo. Day Yr. 21a. Funeral Florae Diane I/b. Funeral Hose Address ,
~ 1b~19 3 Scullion tc Son _ 267 Park Avenue • Paterson, PJ. J.
2/C. .rtrrral !).rector ~ nar f N. J icease No. 2Sa.'Rt~isu r~ssum~Per.sij - Siyeutue J)h. Date Reed. by Local
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sac. to ,C• -1 i - 1953 ,1, f
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f~,, ~ ~s ReRi chat 3 i973s_
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