(Death Certificate Transcription)
Santa Clara County
Transcribing from a poor copy - this is what I think I saw
Rachael E. SEELY, Female, White,Widowed
Father: Jacob Leland born Canada
Mother: Mary Evans born Canada
DOD: 5 May 1922
Age 91 years 1 month 18 days
DOB: 27 March 1831 Canada
Retired
Residence 135 S. 17 San Jose, Santa Clara County
Stay in Santa Clara County: 2 years; Stay in California: 15 years
Informant: Mrs. D.S. Andrews
Cause of Death: Myocarditis, hypostatic pneumonia, fracture of Left Femur
Burial: 05/17/1922 Oakland
Funeral Director: San Jose Undertaking