Grace Heels Death Certificate
Production date
2nd October 1984
Object number
2014.296
Physical Description
Death certificate for Grace Heels
Associated Organisation
St Matthew's Hospital (Featured)
Associated Person
Associated Place
Material
Paper
Dimension
Width (Whole): 210mm
Height (Whole): 285mm
Height (Whole): 285mm
On display?
No
Inscription
D. Cert.
R.B.D.
CAUTION—It is an offence to falsify a certificate or to make or knowingly use a false certificate or a copy of a false certificate intending it to be accepted as genuine to the prejudice of any person, or to possess a certificate knowing it to be false without lawful authority.
CERTIFIED COPY OF AN ENTRY
Pursuant to the Births and Deaths Registration Act 1953
DEATH
Entry No. 50
Registration district Administrative area
Sub-district HACKNEY LONDON BOROUGH OF HACKNEY
HACKNEY
1. Date and place of death
First October 1984
St. Matthews Hospital Shoreditch
2. Name and surname
Grace Salome Heels.
3. Sex
Female
4. Maiden surname of woman who has married —
5. Date and place of birth
14th January 1895 Hackney
6. Occupation and usual address
Clerical officer (retired)
St. Matthews Hospital. Shepherdess Walk. N1
7. (A) Name and surname of informant
Gladys Joan Radcliffe
(B) Qualification
Niece.
(C) Usual address
125A Main Street Balderton. Newark. Notts.
8. Cause of death
Bronchopneumonia
Congestive Cardiac Failure
Ischaemic Heart Disease
11. Diabetes Mellitus
Certified by S. Gupta MBBS
9. I certify that the particulars given by me above are true to the best of my knowledge and belief.
Gladys J. Radcliffe Signature of informant
10. Date of registration
Second October 1984
11. Signature of registrar
Registrar
Certified to be a true copy of an entry in a register in my custody.
Registrar 2.10.1984 Date IV 335558
R.B.D.
CAUTION—It is an offence to falsify a certificate or to make or knowingly use a false certificate or a copy of a false certificate intending it to be accepted as genuine to the prejudice of any person, or to possess a certificate knowing it to be false without lawful authority.
CERTIFIED COPY OF AN ENTRY
Pursuant to the Births and Deaths Registration Act 1953
DEATH
Entry No. 50
Registration district Administrative area
Sub-district HACKNEY LONDON BOROUGH OF HACKNEY
HACKNEY
1. Date and place of death
First October 1984
St. Matthews Hospital Shoreditch
2. Name and surname
Grace Salome Heels.
3. Sex
Female
4. Maiden surname of woman who has married —
5. Date and place of birth
14th January 1895 Hackney
6. Occupation and usual address
Clerical officer (retired)
St. Matthews Hospital. Shepherdess Walk. N1
7. (A) Name and surname of informant
Gladys Joan Radcliffe
(B) Qualification
Niece.
(C) Usual address
125A Main Street Balderton. Newark. Notts.
8. Cause of death
Bronchopneumonia
Congestive Cardiac Failure
Ischaemic Heart Disease
11. Diabetes Mellitus
Certified by S. Gupta MBBS
9. I certify that the particulars given by me above are true to the best of my knowledge and belief.
Gladys J. Radcliffe Signature of informant
10. Date of registration
Second October 1984
11. Signature of registrar
Registrar
Certified to be a true copy of an entry in a register in my custody.
Registrar 2.10.1984 Date IV 335558