STATE OF GEORGIA DEPARTMENT OF PUBUC HEALTH T. F. ABERCROMBIE, M.D., DIRECTOR ATLANTA CERTIFIED COPY CERTIFICATE OF DEATH GEORGIA DEPARTMENT OF PUBLIC HEALTH 1. Place of Death (a) County Meriwether (b) City or Town Warm Springs 2. Usual Residence of Deceased (c) City or Town Washington D.C. 3. Full Name Franklin Delano Roosevelt 4. Sex Male 5. Race White 6. Marital status M 7. If Married or Widowed Give Name of Spouse Eleanor Roosevelt 8. Age Years 63 9. Date of Birth 1-30-82 10. Usual Occupation President of United States of America Father 12. Name James Roosevelt 13. Birthplace Hyde Park, NY. Mother 14. Maiden Name Sarah Delano 15. Birth Place Newburgh, NY. 16. Informants Own Signature F W Palterson 17. Informants P.O. Address 1020 Spring St. N.W. 18. Burial, Cremation or Removal Burial (a) Date April 15, 1945 19. P.O. Address of Place of Burial Hyde Park, N.Y. 20. Signature of Person Burying Body H.M. Patterson & Son [text illegible] Bowen 21. P.O. Address of Undertaker Atlanta, Ga. Date Filed with L. R. April 17, 1945 22. Registrar's Own Signature Richard Brewer 23. Date of Death April 12 1945 Time 3 35 PM 24. I hereby certify that I attended the deceased who died on the above date. I last saw Him Alive on April 12 1945 Primary Cause of Death Cerebral Hemorrhage Duration 2 1/2 hrs. Contributory Causes Arteriosclerosis Operation none Diagnosis: Clinical Was Autopsy Performed: no 26. Physician's Own Signature Howard G. Bruenn Physician's P.O. Address U.S.N.H. Bethesda, Md. Date Signed 4/13/45 THIS IS TO CERTIFY THAT THE ABOVE IS A TRUE AND CORRECT COPY OF THE ORIGINAL CERTIFICATE, WHICH HAS BECOME A PERPETUAL RECORD IN THE ARCHIVES OF THE GEORGIA STATE DEPARTMENT OF PUBLIC HEALTH. (NOT VALID UNLESS COUNTERSIGNED IN THE DIVISION OF INFORMATION AND STATISTICS.) DATE 4-18-1945 T. F. Abercrombie DIRECTOR, GEORGIA DEPARTMENT OF PUBLIC HEALTH Richard Brewer DIVISION OF INFORMATION AND STATISTICS |