Death Certificate of Mary M SIMMS, Peoria County, Illinois Contributed for use in the USGenWeb Archives Copyright 1999 Annabelle O'Neill Certificate of Death State of Illinois, Peoria County - No 36368, (also written number shown - 839) Full Name of Deceased MARY M. SIMMS Sex - F Color W Age 91Years 5 Months 22 Days Place of Birth Virginia Lived in Illinois 75 years Occupation - Widow Died on the 15th day of Aug 1909 at about 7:30PM Place of Death 113 Ayers Place of Burial - Springdale Date of Burial - Aug 18 1909 Name of Undertaker - H E Haefer Address - 416 S. Adams Cause of Death - Adrenal (illegible) Duration - 15 days Contributory Cause or Complication - Senility Signature J C (?) Roberts Address - Peoria, Ill Witness my hand this 16 day of Aug 1909 ------------------------------------------------------------------ USGENWEB NOTICE: These electronic pages may NOT be reproduced in any format for profit or presentation by other organiza- tions or persons. Persons or organizations desiring to use this material, must obtain the written consent of the contri- butor, or the legal representative of the submitter, and contact the listed USGenWeb archivist with proof of this consent. ----------------------------------------------------------------- File contributed for use in USGenWeb Archives by: Annabelle O'Neill