| STATE OF MONTANA CERTIFICATE OF DEATH # 55-120162 |
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|---|---|
| NAME OF DECEASED: | William DeMessemaker |
| PLACE OF DEATH: | Montana State Hospital Warm Springs Township Deer Lodge County, Montana |
| USUAL RESIDENCE: | Glasgow, Valley County |
| SEX: | Male |
| COLOR OR RACE: | White |
| MARITAL STATUS: | Married |
| USUAL OCCUPATION: | Farmer |
| KIND OF BUSINESS: | Agriculture |
| DATE OF BIRTH: | December 31, 1875 |
| PLACE OF BIRTH: | Belgium |
| AGE: | 79 Years |
| NAME OF SPOUSE: | Marie DeMessemaker |
| FATHER'S NAME: | William DeMessemaker |
| MOTHER'S MAIDEN NAME: | Therese Poels |
| INFORMANT: | Hospital Records |
| DATE OF DEATH: | June 5, 1955 |
| CAUSE OF DEATH: | Arteriosclerotic Heart Disease |
| CERTIFICATION: | I hereby certify that I attended the deceased from April 7, 1954 to June 5, 1955, that I last saw the deceased alive on June 5, 1955, and that death occurred at 4:45 P.M. from the causes and on the date stated above. |
| NAME OF CEMETERY: | No record Glasgow, Montana |
| DATE OF REMOVAL: | 6-6-55 |
| FUNERAL DIRECTOR: | Duggan-Merrill Mortuary Butte, Montana Holland & Penland Funeral Home Glasgow, Montana |
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