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Acte de décès d'Elise Fromentier

1 PLACE OF DEATH
County Bexar
City San Antonio, Texas
P.& S.Hospital
2 FULL NAME Elise Stevens
RESIDENCE. NO. 130 St., Rusk Str.



PERSONAL AND STATISTICAL PARTICULARS
3 SEX Female
4 COLOR OR RACE White
5 SINGLE, MARRIED, WIDOWED OR DIVORCED Widowed
6 DATE OF BIRTH January,28,1838
7 AGE 87 yrs. 3 mos. 7 ds.
8 OCCUPATION Housework
9 BIRTHPLACE Paris,France
10 NAME OF FATHER RENNE Fromantese
11 BIRTHPLACE OF FATHER France
12 MAIDEN NAME OF MOTHER Louise Caillot
13 BIRTHPLACE OF MOTHER France
14 THE ABOVE IS TRUE
(Informant) Mrs. Dave Jones
(Address) 213 Water Str.,


MEDICAL PARTICULARS
16 DATE OF DEATH May, 5, 1925
17 I HEREBY CERTIFY, That I attended deceased from May 4, 1925, to May 5, 1925 and that death occurred on the date stated above, at 10A.m.
The CAUSE OF DEATH* was as follows:
Aortic and Mitral Inempetency
Do not know

Contributory (Secondary) Senility
18 Where was disease contracted if not at place if death?
Did an operation precede death? No Date of
Was there an autopsy? No
What test confirmed diagnosis?


Source ou propriétairePierre Dierickx
Nom de fichierfromentier_elise.jpg
Taille du fichier186.82k
Taille800 x 625
Lié àSan Antonio, Texas; Famille: Fromentier/Caillot (F381); Elise Fromentier (Décès)

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