Queensland Death Certificate
DEATH in the District of Blackall
1920 Registered by C. Burchill, District Registrar
1920 Registered by C. Burchill, District Registrar
in the State of Queensland
Number
1920/004182 000059
DECEASED
Name and surname
Occupation
Sex and Age
Date of Death
Place of Death
Where born and, if not born in Australia,
period of residence in Australia
Name and surname
Occupation
Sex and Age
Date of Death
Place of Death
Where born and, if not born in Australia,
period of residence in Australia
Mary Ellen BARRY
Housewife
Female, 66 years
14 November 1920
Aqua Street, Blackall
Wexford, Ireland
48 years, Queensland
PARENTS
Name and surname of father
Occupation
Name and maiden surname of mother
Name and surname of father
Occupation
Name and maiden surname of mother
Daniel LEE
Labourer
Margaret CARROLL
MARRIAGE(S)
Where, at what age and to whom deceased was married
Where, at what age and to whom deceased was married
CHILDREN
Names and ages
Deceased number and sex
Names and ages
Deceased number and sex
Patrick John 40 years, William 38 years
2 males (Michael d: 1915 - AIF Egypt, Francis d: 1917)
2 females (Mary Ellen d: 1886, Margaret Ann d: 1903)
MEDICAL
Cause of death
Duration of last illness
Medical attendant by whom certified
When he/she last saw deceased
Cause of death
Duration of last illness
Medical attendant by whom certified
When he/she last saw deceased
1. Myocardial degeneration 2. Heart Failure
1. Indefinite 2. sudden death
Robert A. G. MALCOLM
14 November 1920
BURIAL or CREMATION Registered
When and where buried or cremated
By whom certified
Name and religion of minister, and/or
names of two witnesses of burial or cremation
When and where buried or cremated
By whom certified
Name and religion of minister, and/or
names of two witnesses of burial or cremation
14 November 1920, Blackall Cemetery
Fred J. GREEN
Francis H. MASTERSON, Roman Catholic
Wm. H. TYNDALL, F. MALONE
INFORMANT
Name, description or relationship,
and residence
Name, description or relationship,
and residence
REGISTRAR
Name, date and place of registration
Name, date and place of registration
C. BURCHILL, 20 November 1920, Blackall
NOTES (if any)
