England, death certificate (certified copy) for Mary Brookes, died 2 December 1912; registered 3 December 1912. West Bromwich district, West Bromwich South West Sub-district, County of West Bromwich; General Register Office, Southport.

Text from source:

CERTIFIED COPY OF AN ENTRY OF DEATH GIVEN AT THE GENERAL REGISTER OFFICE
Registration district West bromwich
1912 Death in the sub-district of West Bromwich South West in the County of West Bromwich
No. When and where died Name and Surname Sex Age Occupation Cause of death Signature, description and residence of informant When registered Signature of registrar
342 2 Dec 1912 9 Victoria Street West Bromwich UD Mary Brookes Female 73 Widow of Samuel Brookes a pawnbroker (1) Heart Failure Certified G Sansom MRCS Mary Brookes Daughter present at the death 9 Victoria Street, West Bromwich 3 Dec 1912