Thursday, January 31, 2013

Missouri Department of Health Certificate of Death Jasper L Maxwell

aunt Minerva collection....
Jasper L. Maxwell Male date of death April 3 1999
social security number 500-36-1242
age 73
date of birth June 18 1925
birthplace Brimson MO
was decendent ever in US ARMED FORCES? yes.
place of death ER/outpatient
faciilty name RESEARCH MEDICAL CENTER, KANSAS CITY, MO, Jackson County
married surviving spouse GLADYS A ALFORD (if yes, give full maiden name)
descendents usual occupatoin CARPENTER
kind of business or industry CONSTRUCTION
residence 1122 East 76th Terrace, Kansas City , Jackson County, Missouri, 64131.
inside city limits yes,
years at present address 20 or more.
was decendant of Hispanic origin? no
race WHITE
decendents education 12
fathers name James Maxwell
mothers name maiden Alma Arney
informants name Gladys A Maxwell, 1122 East 76th Terrace Kansas City Missouri 64131
burial, date of disposition Apirl 8 1999
place of disposition Springer Cemetery, Brimson MO.
name and address of facility Muehleback Funeral Home 6800 Troost Kansas City MO 64131
funeral establishment liscence number 126
immediate cause Dilated cardiomyopathy
sequentially list conditions, if any, leading to immediate causes.: coronary artery disease, diabetes.
no autopsy
manner of death natural
certifying physician David Wilt M.D. 4/6/99 time of death 427
date rec'd by local registrar April 8 1999

No comments: