Gy BNE DEPARTMENT OF STATE REPORT OF THE DEATH OF AN AMERICAN CITIZEN ‘American Consulate General, Ducsseldort, Germany, October 25, 1963 _ ‘acs _——Owupation __Howsewife _ Manivear naturalized ——————___— in the United States Detroit, Michigan 0 Date of death —Eepruary 16... 26245 1963 ___ Age__86 _ —— Last known address SS) an aT ey isi wa gis Martenctios rchen-Buer, Germany Place of death — Scr acah o toaiat ae + Share nics Cause of death .. ——Gertitied ty Dr. rues, of the MariaacHospi.tal,. to_ be. nyeloblast batch resulting trom a chronic myeloid Leukaemia, Disposition of the remains Interred.in the Heuptfriedhof ot Gelsenkizchen= Bust, Eigld 2. WG, Stelle 26. Local lw as fo dsinterring romaine — jive or legal Dison fh eta Saba ate Tena owing iia death on March 3, Person or official responsible Informed by telogram: “— & -Bnvhime upon request of. tive of estate (Copy of this report sent Jie, Gharles Hebert, gu.edtorg pliant en ae 207 Crapo St. son oe ‘Traveling or residing abroad with relatives orfeiende as fellows: & ‘This information and data concerning an inventory of the effects, accounts, ete,, have been placed ‘under File 234 in the correspondence of this office. Remarks: The deceased_was. {ncluded in _hez_busbende-pananant 3592649 , 1e4, to the ao tobS ~ fini on Peverse if neoesdary.) [seat] [No fee preveribed.Attached to the original of this report are? Medical, Death Certificate; The deceased received Social Security, checks together with her husband, Fred Hebert — Claim No. 373-12-9365.Amerikanische Staatsangehdrige. Go Sterbeurkunde (Standesomt Gelsenkirchen +B Elisabeth Hebert gebor! katholisch wohnhoft in _Gelsenkirchen=Buer, Hagenstrafe—29--—— istom 16. Februar 1963 - - - -vm 16 Uhr 45 Minuten Gelsenkirchen —; » den p1963-= = = == = Der Standesbeamte In Vertyetun, Fate. wee Dr. med. P. Paul Bris « Four fr ler Medlin 23. 9. 1965 Chet der ineren Abellng des ‘StoMarientospitale Arztliche Bescheinigung Prau Elisabeth Hebert , geb. am 23. 3. 1876, befand sich vom 1, 10, 1962 bis zum 16. 2, 1963 wegen einer chroni- schen myeloischen Leukaemie in meiner Behandlung. Frau H. verstarb am 16. 2. 1963 an den Folgen eines llyeloblastenschubes. (br. Brits, Chh}arst) il