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Death Certificate of
Cecelia Anne (Hughes) Mullen
(1869 - 1951)![]()
Birth No. _____ Registrar�s No. 1182
KANSAS STATE BOARD OF HEALTH
Division of Vital StatisticsCERTIFICATE OF DEATH 51 012723
1. PLACE OF DEATH
a. County Wyandotte
b. City or Town (If outside corporate limits, write RURAL and give township) Kansas City
c. Length of Stay (in this place) 23 Years
d. Full Name of Hospital or Institution (If not in hospital or institution, give street address or location) 437 North 17th. K.C.K.
2. Usual Residence (Where deceased lived. If institution: residence before admission).
a. State Kansas
b. County Wyandotte 1052
c. City or Town (If outside corporate limits, write RURAL and give township) Kansas City 1052
d. Street Address (If rural, give location) 437 North 17th. Street.
3. NAME OF DECEASED
a. (First) Cecelia b. (Middle) Anne c. (Last) Mullen
4. Date of Death (Month, Day, Year) August 6, 1951
5. SEX Female
6. COLOR OR RACE White
7. MARRIED, NEVER MARRIED, WIDOWED, DIVORCED (Specify) Married
8. DATE OF BIRTH June 19-1869
9. Age (In years last birthday) 82-1-17
10 a. Usual Occupation (Give kind of work done during most of working life, even if retired) Homework
b. Kind of Business or Industry At Home
11. BIRTHPLACE (State or foreign country) Council Bluffs, Iowa
12. Citizen of What Country? U.S.A.
13.FATHER�S NAME Martin D. Hughes Ireland
14. MOTHER�S MAIDEN NAME Mary Wickham Ireland
15. Was Deceased Ever in U.S. Armed Forces? (Yes, no, or unknown) No
(If yes, give war or dates of service) No
16. Social Security No. None
17. INFORMANT John M. Mullen Sr. 437 No. 17th. K.C.K.
MEDICAL CERTIFICATION
18. Cause of Death
Enter only one cause per line for (a), (b), and (c)
I. DISEASE OR CONDITION DIRECTLY LEADING TO DEATH *
* This does not mean the mode of dying, such as heart failure, asthenia, etc. It means the disease, injury, or complication which caused death.
(a) Uremic Coma 1 INTERVAL BETWEEN ONSET AND DEATH 2 da.
ANTECEDENT CAUSES Morbid conditions, if any, giving rise to the above cause (a) stating the underlying cause last.
DUE TO (b) Gen. arteriosclerosis  
chr. Interstitial Nephritis  2 INTERVAL BETWEEN ONSET AND DEATH Several yrs
DUE TO (c) ___________ INTERVAL BETWEEN ONSET AND DEATH _____
II. OTHER SIGNIFICANT CONDITIONS
Conditions contributing to the death but not related to the disease or condition causing death.
Senility INTERVAL BETWEEN ONSET AND DEATH _______
19 a. Date of Operation ________
b. MAJOR FINDINGS OF OPERATION _________
20. AUTOPSY? Yes ___ No XX
21 a. ACCIDENT, SUICIDE, HOMICIDE (Specify) _________
b.Place of Injury (e.g., in or about home, farm, factory, street, office bldg., etc.) _____
c. (CITY, TOWN, OR TOWNSHIP) ________ (COUNTY)________ (STATE) ________
d. Time of Injury (Month, Day, Year, Hour) _________
e. Injury Occurred while at work ___ while not at work ___
f. HOW DID INJURY OCCURR? __________
22. I hereby certify that I attended the deceased from Jan , 19 51 , to Aug. , 19 51
that I last saw the deceased alive on Aug. 6 , 19 51 ,
and that death occurred at 3:15A m., from the causes and on the date stated above.
23 a. SIGNATURE A.J. Rettenmaier (Degree or title) MD
b. ADDRESS Kansas City, Kansas
c. Date Signed 8/7/51
24 a. Burial, Cremation, Removal (Specify) Burial
b. Date Aug/8/1951
c. Name of Cemetery or Crematory Mt. Calvary Cemetery
d. Location (City, town, or country) (State) Kansas City, Kansas
25. FUNERAL DIRECTOR Jos. A. Butler�s Sons ADDRESS Kansas City, Kansas
Date Rec�d by Local Reg. [??] 7 [??]
REGISTRAR�S SIGNATURE Howard Payne
1 Uremic coma can occur in the later stages of uremic syndrome (uremia), a serious complication of renal (kidney) failure. It can cause severe nausea, confusion, psychosis, irregular heart beats, and pulmonary edema (fluid in lungs). Uremia is caused by the accumulation in the blood of nitrogen-bearing waste products (urea) that are usually excreted in the urine. Urea is toxic to the body and can affect all the major organs including the brain. Symptoms usually only appear when kidney function falls to less than 10 percent of normal. Kidney failure can be chronic or acute. It can be caused by a variety of different things. The most common are diabetes, high blood pressure and inflammation or obstuction of the kidney.
2 Chronic interstitial nephritis is a kidney disorder caused by inflammation of the tubules and the spaces between the tubules and the glomeruli, which results in a reduction in kidney function.
| Transcribed by Erica DeCoursey
© 2002 |
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