Vital Records

Death Certificate

Name:

Lucy Van Dussn SHAVER

Date of Date:

March 23, 1902

Place of Death:

Fenner, Madison, New York

Age:

Date of Birth:

Place of Birth:

Syracuse, New York

Sex:

Marital Status:	Widowed	Spouse:
Occupation:	Domestic	Business:

Address:

Fenner, New York

Father:	Jacob Van Dussn	Birthplace:
Mother:	Mary Scott VanDussn	Birthplace:

Immediate Cause:	Cerebral Apoplexy
Contributory:

New York State Dept. of Health, Albany, Certificate # 11313