The following is my transcription of the death certificate of Marieanne T. Bourgeois while trying to remain as true to the original form as possible.
The State of New Hampshire
This is to certify that the following is a true copy of facts recorded on the death record of the individual named hereon, said record being filed according to law.
NAME OF DECEASED: Marieanne T. Bourgeois
DATE OF DEATH: September 7, 1973
AGE (In Years, Last Birthday): 82
DATE OF DEATH: 7-26-91
PLACE OF DEATH, CITY OR TOWN: Manchester, N.H.
BIRTHPLACE (State or Foreign Country): Canada
(Marital Status): Widowed
SURVIVING SPOUSE OR WIFE:
SOC. SEC. NO.: 003 03 1700
RESIDENCE: State: N.H., County: Hills, City or Town: Manchester
CAUSE OF DEATH:
Part 1, Death was caused by:
Immediate Cause (A) Cardiac Arrest
Due to (B) ASHD
Due to (C)
Medical Certification [?] By: L. A. Perron; Title: MD; Address: Manchester N.H.; Date Signed: 9-10-73
Place of Burial (Name of Cemetery): Mt. Calvary
Location: City or Town: Manchester, State: N.H.
SUPPLEMENTAL INFORMATION IF DEATH WERE DUE TO EXTERNAL CAUSES
_ Accident _ Suicide _ Homicide
Place of Injury: City or Town: State:
Time of Injury: Month: Day: Year: Hour:
Means of Injury:
By: C. R. Stout
Clerk of: Manchester N.H.
Date of Issue: 9-10-73
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