Full Name: George Jury

Residence No. Sauqoit, Town of Paris, N.Y.

Male, white, widowed. Name of spouse: Florence Foxhall Jury

Date of Birth, 73 years, 5 months, 29 days.

Mill Worker Retired.

Birthplace: Canada

Name of Father: George Jury

Birthplace: Canada

Maiden Name of Mother: Unknown

Birthplace: Canada

The above is true to the best of my knowledge: Arthur Jury, Floyd, NY

Place of Burial, Cremation, or Removal: Sauquoit Valley.

Date: Apr 21, 1948

Undertaker: Warren W. Fisk. License No. 5080 of Chadwicks, N.Y.

Filed 4-20, 1948, Julia Moulton, Register. Burial or Transit Permit issued by Julia Maulton.

Medical Cetificate of Death

Date of Death: April 19th, 1948

I hereby Certify, that I attended deceased from (blank) I last saw (blank) alive on (blank) To the best of my knowledge, death occurred on the date stated above at about 2:30 a.m.

Cause of Death: Coronary Thrombosis

Signed: Thomas A. Cox Coroner, M.D. 4-19-1948, Address: Rome, NY

Date of Issue: 4-20-1948