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Registration district Sub-district |
HASTINGS HASTINGS |
Administrative
area
COUNTY BOROUGH OF HASTINGS |
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1. Date and place of death |
Nineteenth May, 1969. |
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St. Helens Hospital,
Hastings. |
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4. |
Maiden surname
of woman who
has married |
------ |
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5. Date and place of birth |
14th August, 1920. |
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Islington, London. |
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6. Occupation and usual
address |
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Technical Manager,
General Post Office,
50 Glenthorne Road,
Friern Barnet, London, N.11.
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7. (a) Name and surname of
informant |
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Olive Edith HAGGER |
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(b) Qualification |
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Widow of deceased.
Present at the death. |
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(c) Usual
address |
50 Glenthorne Road, |
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Friern Barnet,
London, N.11. |
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8. Cause of
death |
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1a.
b.
c.
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Left
ventricular failure.
Pulmonary embolism.
Myocardial infarction.
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Certified by
A.U. Khan. M.B. |
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9. I certify
that the particulars given by me are true to the best of my knowledge and belief |
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_____________________________O.E. Hagger.________________________________ |
Signature
of informant |
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