(Death Certificate Transcription)
Riverside County Filed: 23 Apr 1981 Book # 1981 Page # 1926 Record #1911
Ada Idaha SEELY, Caucasian Female, Widowed
Father: John Matthews, born Illinois
Mother: Mary C. Wood, born Illinois
DOD: 22 April 1981 @ 8:45 am
Deathplace: Orangetree Convalescent Hospital
Address: 4000 Harrison, Riverside, CA
DOB: 17 October 1893, born Idaho
Age: 87 y/o
Residence: 6374 Wineville Rd., Mira Loma, CA
Occupation/Yrs: Housewife
Citizen: USA
Soc. Sec.#: 548-30-6064
Informant: Jinks Seely, Daughter-in-law
Address: 8841 California Ave., Riverside, CA 92503
Cause of Death: Cardiac Arrest > 5 mins
D/T: Arteriosclerosis > 2 yrs
Treated- to/from: 22 May 1975 - 22 Apr 1981
Last seen alive: 20 Apr 1981
Physician: John Coles, MD
Address: 4440 Brockton, Riverside, CA
Burial 24 Apr 1981, Crestlawn Memorial Park
Address: 1150 Arlington Ave., Riverside, Ca
Funeral Director: Crestlawn Mortuary
Notes: See James Herbert SEELY, son