| STATE DEPARTMENT OF HEALTH OF NEW JERSEY CERTIFICATE OF DEATH # 52213 | |
| NAME OF DECEASED: | Charles Joughin |
| PLACE OF DEATH: | Barnert Hospital Paterson, Passaic County |
| USUAL RESIDENCE: | 574 E. 23rd Street Paterson, New Jersey |
| SEX: | Male |
| COLOR OR RACE: | White |
| MARITAL STATUS: | Widower |
| USUAL OCCUPATION: | Baker on the Titanic |
| SOCIAL SECURITY #: | 086-12-5127 |
| DATE OF BIRTH: | August 3, 1878 |
| AGE: | 78 Years |
| BIRTHPLACE: | Liverpool, England |
| CITIZEN OF WHAT COUNTRY?: | USA |
| FATHER'S NAME: | Unknown Joughin |
| MOTHER'S MAIDEN NAME: | Unknown |
| INFORMANT: | Mrs. Rose Stoehr |
| DATE OF DEATH: | December 9, 1956 |
| CERTIFICATION: | I hereby certify that I attended the deceased from 12/6/1956 to 12/7/1956, that I last saw the deceased alive on 12/7/1956, and that death occurred at 2:00 AM on the date stated above. |
| PHYSICIAN: | A. F. Depetino, MD 30 Boulevard East Paterson, New Jersey |
| PLACE OF BURIAL: | Cedar Lawn Cemetery Paterson, New Jersey |
| DATE OF BURIAL: | 12/11/1956 |
| FUNERAL DIRECTOR: | Charles W. Legg 384 B'Way Paterson, New Jersey |
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