CERTIFICATE OF DEATH


STATE OF CALIFORNIA-DEPARTMENT OF PUBLIC HEALTH
NAME OF DECEASED

Percy

MIDDLE NAME

William

LAST NAME

Kilbride

DATE OF DEATH

December 11,1964

Hour

12:05 AM

SEX

Male

COLOR OF RACE

Cauc.

BIRTHPLACE

California

DATE OF BIRTH

July 16,1888

AGE

76

NAME AND BIRTHPLACE OF FATHER

Owen Kilbride, Canada

MAIDEN NAME AND BIRTHPLACE OF MOTHER

Elizabeth Kelly, Maryland

CITIZEN OF WHAT COUNTRY

U.S.A.

SOCIAL SECURITY NUMBER

340-01-7082

LAST OCCUPATION

Actor

NUMBER OF YEARS IN THIS OCCUPATION

50

NAME OF LAST EMPLOYING COMPANY OR FIRM

Universal Studio

KIND OF INDUSTRY OR BUSINESS

Movie

IF DECEASED WAS EVER IN U.S. ARMED FORCES GIVE WAR OR DATES OF SERVICE

WW I

SPECIFY MARRIED NEVER MARRIED WIDOWED DIVORCID

Never Married

NAME OF PRESENT SPOUSE

None

PRESENT OR LAST OCCUPATION OF SPOUSE

None

PLACE OF DEATH-NAME OF HOSPITAL

Chase Rest Home

STREET ADDRESS-PLACE OF DEATH

1032 W. 18th Street

CITY OR TOWN-PLACE OF DEATH

Los Angeles

COUNTY

Los Angeles

LENGTH OF STAY IN COUNTY OF DEATH

76 Years

LENGTH OF STAY IN CALIFORNIA

76 Years

LAST USUAL RESIDENCE

6650 Franklin Avenue

NAME OF INFORMANT OF OTHER THAN SPOUSE

Maude Crawley

CITY OR TOWN

(Hollywood) Los Angeles

COUNTY

Los Angeles

STATE

California

ADDRESS OF INFORMANT

838 S. Grapd Ave., L.A.

SPECIFY BURIAL INFORMATION OR CREMATION

Cremation

DATE

12-14-64

NAME OF CEMETERY OR CREMATORY

Chapel of the Pines

NAME OF FUNERAL DIRECTOR

Armstrong Family

CAUSE OF DEATH-PART I

Hypostatic pneumonia
Cerebral Contusion, Slight

PART II OTHER SIGNIFICANT CONDITION CONTRIBUTING TO DEATH BUT NOT RELATED TO THE TERMINAL DISESE CONTION GIVEN IN PART I

Alzheimer's Disease

OPERATION

Operation Performed- Findings used in determining above stated causes of death

DATE OF OPERATION

11/11/64

AUTOPSY

Autopsy Performed- Gross findings used in of termining above stated causes of death

SPECIFY ACCIDENT,SUICIDE OR HOMICIDE

Accident

DESCRIBE HOW INJURY OCCURRED

Auto vs ped

TIME OF INJURY

9:10 P.M. 9/21/64

INJURY OCCURRED

Not while at work

PLACE OF INJURY

Street

PLACE OF INJURY-CITY,COUNTRY,STATE

Los Angeles Los Angeles Calif.

PHYSICIAN

J.S. Woodard M.D.


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