Id | 12 | |
Collection | Firth | |
Date | 1935-12-23 | |
Description | Christopher Eden Firth Death Certificate | |
Source | Niagara County Records | |
Text | Registered No. 621
No. 1158 Haeberle Ave 2 Full Name: Christopher Eden Firth 3 Residence no. 1158 Haeberle ave 4 Length of residence in city or town where death occured: 45 years 5 How long in U.S., if of foreign birth: 45 years Personal and Statistical Particulars 6 Sex: Male 7 Color or Race: White 8 Single, Married, Widowed, or Divorced: Married 8a If Married or Divorced, wife of: Laura Hiame Firth 9 Date of Birth: Dec-3-1866 10 Age: 69 years, 20 days Occupation 11 Trade, profiession: Vice President & Foreman 12 Industry or business in which work was done: Haeberle Lumber Co. 13 Date deceased last worked at this occupation: Oct. 12-1935 14 Total time spent in this occupation: 45 years Birthplace: York, England Father 16 Name: Christopher Firth 17 Birthplace: England Mother 18 Maiden Name: Elizabeth Humphries 19 Birthplace: England 20 The above is true to the best of my knowledge Signature of informant: Laura B. Firth Address: 1158 Haeberle Ave. 21 Place of Purial Cremation, or Removal: Memorial Park, Cemetary Date of Burial: December 26 1935 22 Undertaker: Cornece and Daggett Address: 1517 Main St. 23 Filed: Dec. 26, 1935 Registrar: [illegible] Medical Certificate of Death 24 Date of Death: December 23, 1935 25 I Hereby Certify, That I attended deceased from Sept 20, 1935 to Dec. 22, 1935. I last saw him alive on Dec. 23, 1935. To the best of my knoledge, death occured on the date stated above, at 6:30 p.m. Cause of Death: Chronic Myocarditis, Duration of Condition: 1 year Contributary Causes Obstruction bileary tract, Duration of Condition: 4 months Severe anemia, Duration of Condition: 1 month (Cause of obstruction unknown) 26 Where was disease contracted, or injury sustained: Niagara Falls, N.Y. 27 Name of operation, if any: None 28 What laboratory test assited diagnosis: blood test 29 Was thre an autopsy: No Signed: Edward Stebbens, Dec 26, 1935 Niagara Falls, NY 1/21/36 Burial or Transit Permit issued by: [illegible] Date of issue: Dec 26, 1935 |