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Alice E. Keach Slater Death Certificate

Alice E. Keach Slater Death Certificate

Posted: 24 Feb 2008 2:06AM GMT
Classification: Death
Surnames: Keach, Slater, Smith
I received this from the Norwich Town Hall. It is stamped, "Connecticut State Department of Health, Bureau of Vital Statistics - Hartford, Connecticut, U.S.A.

1. PLACE OF DEATH:

(a) State of Connecticut (b) County: New London (c) Town: Preston (d) Length of stay in town: ______________
(e) Name of Hospital or Institution: Norwich State Hosp.

2. USUAL RESIDENCE OF DECEASED:

(a) State: CONN (b) County: Windham (c) Town: Brooklyn
(d) City or Borough ____________ (e) Street Number _________

3. NAME OF DECEASED: Alice E. Slater

4. SOCIAL SECURITY NUMBER: _______________________

5. SEX: Female

6. RACE: White

7. SINGLE, WIDOWED, MARRIED, DIVORCED

8. IF MARRIED, WIDOWED OR DIVORCED, GIVE NAME OF WIFE OR HUSBAND: William A. Slater

9. DATE OF DEATH: August 1, 1951

10. DATE OF BIRTH: 1-4-88
/ AGE: 63 years, 6 months, 18 days

11. BIRTHPLACE: Killingly, CONN

12. USUAL OCCUPATION: Housekeeper

13. WAS DECEASED A VETERAN? No

14. FATHER'S NAME: Wm. A. Keach
15. FATHER'S BIRTHPLACE: Scituate, R.I.

16. MOTHER'S MAIDEN NAME: Fannie B. Smith
17. MOTHER'S BIRTHPLACE: Killingly, CONN

18. INFORMANTS NAME: Hospital Records Preston CONN

19. BURIAL, CREMATION OR REMOVAL Date: Aug. 2, 1951
Cemetery or crematory: Westfield Cemetery
Place: Danielson, CONN

20. NAME OF EMBALMER IF BODY WAS EMBALMED: W.E. Tillinghast - License number: 908

21:SIGNATURE:

22. CAUSE OF DEATH:
(a) DISEASE OR CONDITION DIRECTLY LEADING TO DEATH:

(looks like) generalized Arteriosilerosis
senile arterios clerotic kidneys

22. OTHER SIGNIFICANT CONDITIONS: (looks like) cholelethiasis




27. SIGNATURE OF PHYSICAN: Hannah Pierson
Address: Norw. State Hosp. Date: 8-2-1951
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