CERTIFIED TRANSCRIPT OF DEATH
STATE OF NEW YORK
DEPARTMENT OF HEALTH
NAME: CHARLES OLMSTEAD
SEX: MALE
DATE OF DEATH: 7-22-1913
DISTRICT NO. 3622
PLACE OF DEATH: (Street & No.) MEDINA HOSPITAL
INDEX NO. 2039
PLACE OF BIRTH: NEW YORK STATE
SERVED IN US ARMED FORCES (Years):
MARITAL STATUS: DIVORCED
OCCUPATION: LABORER
FATHER'S NAME: GEORGE OLMSTEAD, BIRTHPLACE: IRELAND
MOTHER'S MAIDEN NAME: RASNA GOODENOUGH, BIRTHPLACE: NEW YORK STATE
CERTIFYING PHYSICIAN OR CORONER: C.H. TURNER
MANNER OF DEATH: EXHAUSTION A RESULT OF PARISIS
FUNERAL HOME: N/A
PLACE OF BURIAL: BOXWOOD CEMETERY
DATE FILED: 7/24/1913
This is to certify that the information concerning the death of the above named person is a true and accurate transcription of the information recorded on the original local certificate of death on file with the local registrar of MEDINA, New York.
E. Margaret Crawley (Signature of Local Registrar)
DATE: MARCH 5, 2010
