Vital Documents

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Death certificate of Harold Vogt Gould (1955, Illinois)

State File No. 10400, Dist. No. 16.10
1. Place of death: Illinois, Cook County, Chicago / Length of stay in this place: 64 years
Full name of hospital or institution: Ravenswood Hospital Association
2. Usual residence: Illinois, Cook County, Chicago, 5303 N. Magnolia
3. Name of deceased: Harold Vogt Gould
4. Date of death: Feb. 22, 1955
5. Male
6. White
7. Married
8. Date of birth: April 18, 1889
9. Age: 65 years
10. Usual occupation: Physician, self-employed
11. Birthplace: Buffalo, N.Y.
12. Citizenship: U.S.A.
13. Father's name: Cassius Gould
14. Mother's maiden name: Clara Vogt
15. Not a veteran
16. No SSN
17. Informant: Marguerite Harmon, 1931 Wilson Avenue, Hospital Records
18. Cause of death: massive gastro-intestinal hemorrhage, 24 hours
antecedant causes: ruptured esophageal varices, 24 hours
20. Autopsy performed
22. I hereby certify that I attended the deceased from Feb 21, 1955 to Feb 22, 1955, that I last saw the deceased alive on Feb 22, 1955 and that death occurred at 2:40 pm from the causes and on the date stated above. (signature of attending doctor)
Burial: Feb 25, 1955, Rosehill Cemetery, Chicago, Illinois
Received for filing 1955 Feb 24, 2:30 PM

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