|
Registration district Sub-district |
Enfield
Enfield |
Administrative
area
London Borough of
Enfield
|
|
|
1. Date and place of death |
|
Nineteenth May
1999
North Middlesex Hospital, Edmonton |
|
|
|
|
|
4. |
Maiden surname
of woman who
has married |
------ |
|
|
5. Date and place of birth |
|
2nd September 1922 Islington |
|
|
6. Occupation and usual
address |
|
Building Manager
(retired)
5 The Crescent,
Friern Barnet, N11
|
|
|
7. (a) Name and surname of
informant |
|
Irene Evelyn HAGGER |
|
|
(b) Qualification |
|
Widow of deceased
Present at the death |
|
|
(c) Usual
address |
|
|
5 The Crescent,
Friern Barnet, N11 |
|
|
8. Cause of
death |
|
1(a)
(b)
(c)
|
Cerebrovascular
Accident
Congestive Cardiac Failure
Ischaemic Heart Disease
|
|
|
Certified by
P Rybinski MB |
|
|
9. I certify
that the particulars given by me are true to the best of my knowledge and belief |
|
Irene Hagger |
Signature
of informant |
|