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CITY OF SALEM - ASSESSORS' DEPARTMENT
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COUNTY OF EssEX: SALEM January 12, 1978
I, City Clerk of Salem, Massachusetts, do hereby certify that the follom ina is a true extract
from the records of deaths in said city which are in my custody.
Name of Deceased Alphonse Pelletier
Date of Death January 8, 1978
'Place of Death Salem Hospital, Salem, Mass,
Sex S.M.W. or D. Male - Widowed
To Whom Married Elise Morest
Aee 84 Years 9 Months 20 Days
Occupation Loom Fixer - Retired
Residence 26 Leavitt St. , Salem, Mass.
Birthplace Canada
Cause of Death Basilar artea thrombosis.
Name of Father Joseph Pelletier
Birthplace of Father Canada
Name of Mother (maiden name) Elise Lambert
Birthplace of Mother Canada
Place of Burial St. Mary's Cemetery, Salem, Mass.
Witness my hand and the seal of the City of Salem, Massachusetts, on the day and year
above written.
Attest:
City Clerk, Salem, Massachusetts