Death Certificate Carl Ernest RYDEN (LARSON), 1966 Cook County, Illinois ------------------------------------------------------------------------------------ Information contributed for use in Cook County ILGenWeb by Julia Ryden , June 1999 ====================================================================== State of Illinois State File Number: 64679 Decedent's Birth No. ----- Medical Certificate of Death Registration District No 16.10 Registered Number ---- Place of Death a. State: ILLINOIS b. County: COOK c. Inside: CHICAGO Usual Residence a. State: ILLINOIS b. County: COOK c. Inside: CHICAGO Length of Residence at above: 25 years Name of Hospital or Institution: Presbyterian-St. Luke's Hosp. Length of stay: 2 days Residence address: 1649 North Springfield Avenue Did decedent reside on a farm? No Name of Deceased : Carl RYDEN (aka Carl Ernest LARSON)* Sex: M Race: W Date of Death: 8 September 1966 Marital State: Married Date of Birth: March 5, 1911 Birth Place Chicago, Illinois Citizen of what country? USA Age in years last birthday: 55 Usual Occupation: Carpenter Kind of Business or Industry: Medical Center Comm. Father's Full Name: Ernest Larson Mother's Full Maiden Name: Anna Soderstrom Was deceased ever in U S Armed Forces? No Social Security Number: 345-1?-0743 Informant's Signature: (Mary J. C?e?ge) Clerk of Hospital Address: 1753 W. Congress Parkway Medical Cause of Death: Intra cerebral hemorrhage secondary to Metastic tumor Underlying Cause: Malignent Melanomia Interval between onset and death: Unknown Autopsy: Yes Physican Statememt: I hereby certify that I attended the deceased from 9/6/1966 to September 8, 1966, that I last saw the deceased alive on 9/8/66 and death occured 7:30 am from the causes and on the date stated above. Signature (Frank O. Becker) M.D. Date signed: 9/8/66 Illinois License No. 35667 Address: 1753 W. Congress Parkway Chicago, Illinois Phone Se-8-4411 Disposition: Cremation Date: 9/12/66 Cemetery Acacia Park Location: Norwood Township, Illinois Funeral Director: Signature: (E. Miller) Address: 4133 West North Avenue, Chicago Illinois 60639 Illinois License No. 210 Received for filing Sep 9, 1966 Samuel L. Andelman, M.D. Local Registrar =============================================================================== Sidebar Note: State of Illinois ) County of Cook ) ss SEP. 9, 1966 City of Chicago ) I, Samuel L. Andelman, M.D., Local Registrar of Vital Statistics of the City of Chicago, do hereby certify that I am the keeper of the records of births, stillbirths and deaths of the City of Chicago by virtue of the laws of the State of Illinois and the ordinances of the City of Chicago; that the accompanying certificate on this sheet is a true copy of a record kept by me in pursuance of said laws and ordinances. ================================================================================ *Note: Carl's father died when he was about a year old. When Carl's mother remarried, the step-father, Axel Ryden, said, "That boy does not enter my house unless he uses my name." Carl thus became a RYDEN. ------------------------------------------------------------------------- COPYRIGHT NOTICE: These electronic pages may NOT be reproduced in any format for profit or presentation by other organization or persons. Persons or organizations desiring to use this material, must obtain the written consent of the submitter or their legal representative, and must contact the listed Cook County ILGenWeb Coordinator(s) with proof of this consent. ------------------------------------------------------------------------ Contact Angel Jacobsen-Shweika (CookILGW@jacobsen-shweika.com). ©1998,1999, Angel Jacobsen-Shweika