• back to BMD •
Mary A. (Murray) Crowley
(1850 - 1914)
STATE OF OHIO
DIVISION OF VITAL STATISTICS
CERTIFICATE OF DEATH
1. PLACE OF DEATH
County of Cuyahoga
Township of __________ Registration District No. 8?116 File No. 48872
or Village of __________ Primary Registration District No. ______ Registered No. 6254
or City of Cleveland (No. 883 , East 76 St., 23 Ward)
(If death occurred in a hospital or institution, give its NAME instead of street and number.)
2. FULL NAME Mary A Crowley
PERSONAL AND STATISTICAL PARTICULARS
3. SEX Female
4. COLOR OR RACE White
5. Single, Married, Widowed or Divorced (write the word) married
6. DATE OF BIRTH (Month, Day, Year) March 5 , 1 850
7. AGE 64 yrs. 5 mos. 2 ds.
8. OCCUPATION
(a) Trade, profession, or particular kind of work House wife
(b) General nature of industry, business or establishment in which employed (or employer) _________
9. BIRTHPLACE (State or country) U.S.A.
PARENTS
10. NAME OF FATHER Michael Murray
11. BIRTHPLACE OF FATHER (State or country) Ireland
12. MAIDEN NAME OF MOTHER Ann McBride
13. BIRTHPLACE OF MOTHER (State or country) Ireland
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) Grover G Crowley 1
(Address) 883 E 76th St
15. Filed SEP 3 - 1914 CG Moland? Registrar
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH (Month, Day, Year) Sept. 2 , 191 4
17. I HEREBY CERTIFY, That I attended deceased from Jan. 10 , 191 3 , to Sept. 2 , 191 4 , that I last saw h er alive on Aug. 24 , 191 4 , and that death occurred, on the date stated above, at 7 A. m.
The CAUSE OF DEATH* was as follows:
Carcinoma of Rectum (Duration) 2 yrs. ___mos. ___ds.
Contributory (Secondary) __________ (Duration) ___yrs. ___mos. ___ds.
(Signed) H. A. Herkner , M.D. 9 - 3 , 191 4 (Address) 928 E 79 St
* State the DISEASE CAUSING DEATH, or in deaths from VIOLENT CAUSES, state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCIDENTAL, SUICIDAL, or HOMICIDAL. (See reverse side for additional space.)18. LENGTH OF RESIDENCE (For Hospitals, Institutions, Transients, or Recent Residents)
At place of death ___yrs. ___mos. ___ds. In the State ___yrs. ___mos. ___ds.
Where was disease contracted, if not at place of death? __________
Former or usual residence _________
19. PLACE OF BURIAL OR REMOVAL Calvary Cemetery
DATE OF BURIAL 9/4 , 191 4
20. UNDERTAKER The Flynn-Froelk Co ADDRESS 5309 Superior
1 Grover Crowley is Mary's son.
