BRON: Bylaag A12-Death Notice-Catharina Wilhelmina Marneweck.pdf
METODE: OCR
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[Bladsy 1]
eee SS RAS

PURSUANT TO THE PROVISIONS CONTAINED IN SECTION 9, ORDINANCE No. 104.

BYLAAG A12

‘Be. mie nga fpr —

%. Birthplace of the Decewsed of gp La Lae

8. Names of the mae} Father
of the Deceased. {tower

4. Age of the Deceased Le-PLeLe eta

5. Condition in life (occupation) _ secgerenscge B 7
§. Married or nes a JE Za Liasnsecet

Widower or Widow

(a) Name of Surviving Spouse . . RR pe aR RTE emery

(2) Name or names and approximate date of (
death of previous Spouse or Spouses (

7. The day of the decease: on _ a OO a

8. At what House or where the person died ~

9. Names of Children of Deceased, and )
whether majors or minors 5)

(Stating separately those born of different
marriages,

10, Whether Deceased has left =r} Pritt ha-

. Property, and of what kind

The ws left i JS

Dated at_

me
this Z x wp Ae. A 4

State in what