CERTIFICATE NUMBER: 10035 1937 (County)
NAME: Henry Albert FORGER
SEX: M
RACE: White
ETHNICITY: <Blank>
BIRTH: 05 Apr 1858 in Pittsburgh, PA
DEATH: 13 Oct 1937
NAME AND BIRTHPLACE OF FATHER: John FORGER - Germany
NAME AND BIRTHPLACE OF MOTHER: Elizabeth DEITRICK - Germany
CITIZENSHIP: <Blank>
SSN: <Blank>

MARITAL STATUS: Married
NAME OF SURVIVING SPOUSE: Clara Frances FORGER
OCCUPATION OF SURVIVING SPOUSE: <Blank>

PRIMARY OCCUPATION: Glass Moulder
NUMBER OF YEARS: 15 (Last Employed Oct 1937)
EMPLOYER: <Blank>
KIND OF INDUSTRY: Glass Factory

USUAL RESIDENCE: 8117 State Street South Gate, CA

LENGTH OF STAY IN COUNTY OF DEATH: 12 yrs
LENGTH OF STAY IN CALIFORNIA: 20 yrs

PLACE OF DEATH: 8117 State Street South Gate, CA

NAME AND ADDRESS OF INFORMANT: AHH. FORGER 8121 State Street South Gate, CA

RELATIONSHIP OF INFORMANT TO DECEDENT: <Blank>
CAUSE(S) OF DEATH:
            (1) Interstitial Nephritis
            (2)
            (3)

AUTOPSY PERFORMED?: No
OTHER SIGNIFICANT CONDITIONS CONTRIBUTING TO DEATH, BUT NOT RELATED TO CAUSES:
             (1) Anemia

DISPOSITION: Burial
DATE: 15 Oct 1937
NAME AND ADDRESS OF CEMETERY: Inglewood Park Cemetery (Sexton Pr)

NAME OF FUNERAL DIRECTOR: Wheat-Halverson Funeral Home Huntington Park, CA