Be it Remembered, That on the day to-wit the Twentieth of November in th eyear of our Lord One Thousand Nine Hundred & Seventeen adn the one Hundred and 43 of the independence of the United States of America, before me WM. H. ROBIN, M.D., Chairman Board of Health and Ex-Officio Recorder of Births, Deaths and Marriages in and for the Parish of Orleans, personally appeared Preau an undertaker, native of this city residing at No. 1192 N. Rampart Street, who hereby declares that Marie Petitpain, Widow of F. Leonce Fazende (Wid) a native of New Orleans, La., aged 73 yrs 9 mos and 19 days departed this life yesterday (19 Nov 1917) at No 140 S. St. Claude Street in this city. Cause of Death Chronic Bronchitics Gruppe. Certificate of Dr. A. Rocquit, Birth place of paines father France, Mother S.C. Thus done at New Orleans, in the presence of the foresaid P.J. Lanauze & K Jures both of this city, witnesses by me requested so to be, who haave hereto set their hands together with me after reading thereof this day month and years first above written. M.H. Robin MD
