Citation
  • "Certificate of Death: Clara Elizabeth (Mayer) Loebach".
Data
  • Category: Original
Detail
  • Submitter: William D. Forsythe
  • Submission Date: 2000
Photos
Clara (Mayer) Loebach, Death Certificate, April 26, 1983
Content
  • Text: Certificate of Death

    1. Name of Deceased - Clara Elizabeth Loebach
    2. Sex: Female
    3. Date of Death: 4-26-1983
    4. Race: Caucasian
    5. Was the decedent of Spanish Origin: No
    6. Date of Birth: 6-3-1900
    7. Age: 82
    8. Place of Death - County: Tarrant, City: North Richland Hills, Name of Hospital or Institution: Glenview Hospital. Inside City Limits: Yes
    9. Widowed
    10. Birthplace: Illinois
    11. Citizen of What County: USA
    12. Was decedent ever in the armed forces: No
    13. Surviving Spouse: None
    14. SSN: 349-60-4712.
    15. Usual Occupation: Housewife, Kind of business: Homeaker
    16. Residance - State: Texas, County: Tarrant, City: Richland Hills, Address: 7616 Richland Road, Inside City Limits: Yes
    17. Father's name: Gerhard Mayer
    18. Mother's maiden name: Margaret Dahn
    19. Signature of Informant: Doris Forsythe
    20. Conditions, if any, which gave rise to the immediate cause stating the underlying cause last: Immediate cause: Respiratory failure due to: Metabolic acidosis and dehydration Interval between onset and death 36 hours due to: Diabetic ketoacidosis Interval between onset and death 36 hours. Other significant conditions contributing to death, but not relating to cause: Senilic dementia.
    21. Autopsy: No
    22. [blank]
    23. Signed: James L. Atteberry... M.D.
    24. Date signed: 4/26/83, Hour of Death: 5:07 A.M.
    25. Removal date: 4-26-1983, Name of Cemetery: Saint Joseph Cemetery, Location: Chicago, Cook County, Illinois.
    26. Signature of funeral director: Allen Griffin, Lucas Funeral Homes.
    27. Regestrants File No. 83-76, Date rec'd by local registrar: 4-27-1983. Signature of local registrar: Juanette Moore.
Personal Names
PersonClaimDetailEvidence
Clara Elizabeth MayerNameClara Elizabeth Loebach [S4]
primary
Margaretha DahmNameMargaret Dahn [S4] [N126]
primary
Relationships
PersonClaimDetailEvidence
Doris Marie LoebachMotherClara Elizabeth Mayer (1900-1983) [S2] [S4] [S6:118] [S428] [S2875]
dna
Clara Elizabeth MayerFatherGerhard Mayer (1864-1949) [S4] [S258] [S486] [S1794] [S2890:19490209]
dna
Clara Elizabeth MayerMotherMargaretha Dahm (1872-1958) [S4] [S258] [S486] [S1794] [S2890:19490209]
dna
Events & Attributes
PersonClaimDateDetailAgeEvidence
Clara Elizabeth MayerBirthJun 3, 1900Chicago, Cook, Illinois, United States [S4] [S238] [S258] [S428] [S769] [S819] [S1790] [S1794] [S2956]
primary
Clara Elizabeth MayerResidenceApr 26, 19837616 Richland Rd. in Richland Hills, Tarrant, Texas, United States [S4]
primary
Clara Elizabeth MayerDeathApr 26, 1983Glenview Hospital, North Richland Hills, Tarrant, Texas, United States [S4] [S10] [S238] [S769] [S818] [S819] [S2915:83]
Respitory failure due to Metabolic acidosis and dehydration
82y
primary
Clara Elizabeth MayerSocial Security Number349-60-4712 [S4]
primary
Clara Elizabeth MayerBurialSt. Joseph Cemetery, River Grover, Cook, Illinois, United States [S4] [S818]
primary