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- 1a FIRST NAME: Marguerite
1b MIDDLE NAME: T.
1c LAST NAME: Munroe
1d JR etc.: (blank)
2 DATE OF DEATH (Mo, Dy, Yr): Sept. 10, 1998
3 SEX: F
4 SOCIAL SECURITY NUMBER: 016-30-2473
5a AGE (Yrs): 81
5b UNDER 1 YEAR: (blank)
5c UNDER 1 DAY: (blank)
6 DATE OF BIRTH (Mo, Dy, Yr): July 31, 1917
7 BIRTHPLACE (City and State or Foreign Countery): East Jeffrey, NH (sic)
8 WAS DECEDENT EVER IN US ARMED FORCES?: No
9 PLACE OF DEATH: Residence
10 FACILITY (If not institution, give street and number): Cadigan Lodge, The Highlands
11 COUNTY OF DEATH: Sagadahoc
12 CITY OR TOWN OF DEATH: Topsham
13 MARITAL STATUS: Widowed
14 MOST RECENT SPOUSE: Richard G. Munroe, deceased
15 DECEDENT'S USUAL OCCUPATION: Homemaker
16 KIND OF BUSINESS/INDUSTRY: At Home
17 DECEDENT'S EDUCATION
Elementary/Secondary (0-12): 12
College (1-4 or 5+ years): 2
18 ANCESTRY: Scottish, English
19 RACE: White
20 RESIDENCE STATE: Maine
21 RESIDENCE COUNTY: Sagadahoc
22 RESIDENCE CITY OR TOWN: Topsham
23 RESIDENCE STREET AND NUMBER: Cadigan Lodge, The Highlands
24a FATHER'S FIRST NAME: Spencer
24b FATHER'S MIDDLE NAME: (blank)
24c FATHER'S LAST NAME: Taylor
24d JR etc: (blank)
25a MOTHER'S FIRST NAME: Catherine
25b MOTHER'S MIDDLE NAME: (blank)
25c MOTHER'S MAIDEN SURNAME: Copland
26 INFORMANT NAME: Ms. Jan Munroe
27 INFORMANT MAILING ADDRESS: PO Box 89, East Vassalboro, Maine 04935
28 METHOD OF DISPOSITION: Cremation
29 WAS BODY EMBALMED: No
30a PLACE OF DISPOSITION: Laurel Hill Crematory
30b LOCATION: Saco, Maine
30c DATE OF DISPOSITION: Sept. 14, 1998
31a SIGNATURE OF FUNERAl PRACTITIONER OR AUTHORIZED PERSON: [signed] Peter W Ladner
31b LICENSEE NUMBER: PR136
32a NAME AND ADDRESS OF FACILITY OR AUTHORIZED PERSON: Peter W. Ladner, Brackett Funeral Home
29 Federal Street, Brunswick, Maine 04011
32b FUNERAL ESTABLISHMENT LICENSE NUMBER: 09167
33 CERTIFYING PHYSICIAN: [signed] Judith Chamberlain, MD
34 DATE SIGNED: 9/11/98
35 VIEWED BODY AFTER DEATH?: No
36a NAME OF ATTENDING PHYSICIAN IF OTHER THAN CERTIFIER: (blank)
36b NAME AND ADDRESS OF CERTIFIER: Judith Chamberland, MD, Bowdoin Medical Group, Brunswick, Maine 04011
37 TIME OF DEATH: 10 pm
38 REGISTRAR'S SIGNATURE: [signed] Carol A. Edwards, Deputy Clerk
39 DATE FILED: 9-14-98
40 WAS AN AUTOPSY PERFORMED?: No
41 WERE AUTOPSY FINDINGS AVAILABLE PRIOR TO COMPLETION OF CAUSE OF DEATH?: (blank)
42 MANNER OF DEATH: Natural
43 PART I Enter the diseases, injuries, or complications which caused the death.: Osteoporosis with compression fractures
43 PART II Other significant conditions contributing to death but not resulting in the underlying cause given in Part I: Diabetes
DATE ISSUED: 9-14-98
ATTEST: Carol A. Edwards, Dep. Clerk
TOWN OF: Topsham
CERTIFICATE NUMBER (on back): 01284125
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