Form C. STATE OF MAINE. CERTIFICATE OF DEATH No. of Record, Name, Helen E Jackson Place of Death, Tumont Street, No Ward Date of Death : Year, 1919Month Jerry Day, 9 Age : Years, 29 Months, I Days, 7 Place of Birth, Tremont Sex, Kx or Married, Single, Color, Widowed, or Single Divorced. Occupation, L Name of Father Maiden Name of Mother, Ellen Benson Birthplace of Father, V. Birthplace of Mother, Tremont Occupation of Father; merchand Deceased was wife of Widow of [OVER]