Standard Certificate of Death
Place of Death: Worcester County, Mass.; Winchendon (110 Summer St.)
Full Name: Catherine Elizabeth (Wheeler) Clark
Residence: 110 Summer St.
How long residence: 47 years
Sex: F.; Color: W.; Condition: Widowed
Husband: George D. Clark
Date of Birth: Feb. 6, 1831
Age: 88 y. 7 m. 29 d.
Occupation: At home
Birthplace: Orange, Mass.
Name of Father: Wilson Wheeler
Birthplace of Father:: Not learned
Maiden Name of Mother: Catherine H. Warden
Birthplace of Mother: Worcester, Mass.
Informant: Mary C. Clark / Winchendon
Date of Death: Oct. 5, 1919
Cause: Arterio-sclerosis
Place of Burial: Riverside Cem. Winchendon; Date of Burial: Oct. 7, 1919