CERTIFICATE OF DEATH

STATE OF CALIFORNIA-DEPARTMENT OF PUBLIC HEALTH

NAME OF DECEASED Percy	MIDDLE NAME William	LAST NAME Kilbride	DATE OF DEATH December 11,1964	Hour 12:05 AM
SEX Male	COLOR OF RACE Cauc.	BIRTHPLACE California	DATE OF BIRTH July 16,1888	AGE 76
NAME AND BIRTHPLACE OF FATHER Owen Kilbride, Canada	MAIDEN NAME AND BIRTHPLACE OF MOTHER Elizabeth Kelly, Maryland	CITIZEN OF WHAT COUNTRY U.S.A.	SOCIAL SECURITY NUMBER 340-01-7082
LAST OCCUPATION Actor	NUMBER OF YEARS IN THIS OCCUPATION 50	NAME OF LAST EMPLOYING COMPANY OR FIRM Universal Studio	KIND OF INDUSTRY OR BUSINESS Movie
IF DECEASED WAS EVER IN U.S. ARMED FORCES GIVE WAR OR DATES OF SERVICE WW I	SPECIFY MARRIED NEVER MARRIED WIDOWED DIVORCID Never Married	NAME OF PRESENT SPOUSE None	PRESENT OR LAST OCCUPATION OF SPOUSE None
PLACE OF DEATH-NAME OF HOSPITAL Chase Rest Home	STREET ADDRESS-PLACE OF DEATH 1032 W. 18th Street	CITY OR TOWN-PLACE OF DEATH Los Angeles	COUNTY Los Angeles
LENGTH OF STAY IN COUNTY OF DEATH 76 Years	LENGTH OF STAY IN CALIFORNIA 76 Years	LAST USUAL RESIDENCE 6650 Franklin Avenue	NAME OF INFORMANT OF OTHER THAN SPOUSE Maude Crawley
CITY OR TOWN (Hollywood) Los Angeles	COUNTY Los Angeles	STATE California	ADDRESS OF INFORMANT 838 S. Grapd Ave., L.A.
SPECIFY BURIAL INFORMATION OR CREMATION Cremation	DATE 12-14-64	NAME OF CEMETERY OR CREMATORY Chapel of the Pines	NAME OF FUNERAL DIRECTOR Armstrong Family
CAUSE OF DEATH-PART I Hypostatic pneumonia Cerebral Contusion, Slight	PART II OTHER SIGNIFICANT CONDITION CONTRIBUTING TO DEATH BUT NOT RELATED TO THE TERMINAL DISESE CONTION GIVEN IN PART I Alzheimer's Disease	OPERATION Operation Performed- Findings used in determining above stated causes of death	DATE OF OPERATION 11/11/64
AUTOPSY Autopsy Performed- Gross findings used in of termining above stated causes of death	SPECIFY ACCIDENT,SUICIDE OR HOMICIDE Accident	DESCRIBE HOW INJURY OCCURRED Auto vs ped	TIME OF INJURY 9:10 P.M. 9/21/64
INJURY OCCURRED Not while at work	PLACE OF INJURY Street	PLACE OF INJURY-CITY,COUNTRY,STATE Los Angeles Los Angeles Calif.	PHYSICIAN J.S. Woodard M.D.

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