| THE COMMONWEALTH OF MASSACHUSETTS DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH # A678448 | |
| NAME OF DECEASED: | Mary C. (Lines) Wellman |
| PLACE OF DEATH: | 103 Salem Road Topsfield, Essex County |
| USUAL ADDRESS: | 103 Salem Road Topsfield, Mass. 01983 |
| SEX: | Female |
| COLOR: | White |
| MARITAL STATUS: | Widowed |
| HUSBAND'S NAME: | Sargent H. Wellman |
| USUAL OCCUPATION: | Housewife |
| INDUSTRY OR BUSINESS: | At Home |
| AGE: | 80 Years, 3 Months, 24 Days [Note: Massachusetts Death records do not request dates of birth - Mary Lines Wellman was born July 27, 1895] |
| PLACE OF BIRTH: | Mt. Vernon, New York |
| NAME OF FATHER: | Ernest H. Lines |
| FATHER'S BIRTHPLACE: | USA |
| MAIDEN NAME OF MOTHER: | Elizabeth James |
| MOTHER'S BIRTHPLACE: | USA |
| INFORMANT: | Mrs. Bradford Wellman Bangor, Maine |
| DATE OF DEATH: | November 23, 1975 |
| CAUSE OF DEATH: | Cerebral Hemorrhage |
| INTERVAL FROM ONSET: | 3 Days |
| DUE TO: | Arteriosclerosis |
| SIGNIFICANT CONDITION: | Cancer of Breast |
| TEST CONFIRMING DIAGNOSIS: | Clinical |
| CERTIFICATION: | I hereby certify that I attended deceased from Nov. 5 1975 to Nov. 23, 1975. I last saw her alive on Nov. 23 1975. Death is said to have occurred on the date stated above, at 11:55 AM. |
| PHYSICIAN: | Cornelius J. Driscoll, MD 5 Alden St. Danvers, Massachusetts |
| PLACE OF BURIAL: | Pine Grove Cemetery Topsfield, Massachusetts |
| DATE OF BURIAL: | November 26, 1975 |
| FUNERAL DIRECTOR: | Robert A. Peterson 167 Maple St. Danvers, Massachusetts |
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