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HomeMy WebLinkAbout1003 - - ! 94 i ~ f . LV~~E COUNT . • f . . . . p VcRIF1E i j ~ (~erttfteb ~Certtftca~te of NORTH CAROLINA, 5~ ~Q ' S9 OFFICE OF RE(~IS~ ~~DEEDB 6S o _e Caunty nf Montgo~erl------- ~ 4 . :toc._F: ~•u~~c~H 11RT_ Thia is to ccri~ fy that --~1~11iam_ Jeruting_s _ I!Iooi'e RCtfi-~-~ _ E K__~ Ser ~e---. Race , waa born the - 20th ~ 0 1~a~e~~' 1~- y f - - aad died the ~1~ . day ~f - --~'-Y------ . 19__~. at tht agt oI --67- ~ in ----~~X-------------- - TownahiP, Mont$omsr~--------- - County, 3tate o f ~ North Carol~na, D.S.A. Cauac of doath _______Aaute__I+~ocardial Infarction 1lnried in ---flQ~ -.tiill.- Cemefery, the ---a.ll~ day vf ----~~e---.----- ~s.- 66 ~Ya»~e of FaEher Unlmo~xn----------------~___ 11~'ame of Mother _ Unkriotal-------- - ~ Goer e H. A stron M. Mt. Gilead N.C. - - Attending Phya~eutn ~------------r~------------~t- ~ddreas T ~ ~ Regishalion District No- ------~AO-----------------• Certifieate No. _---bb----- _.__Ceorge_ H. _Armstrong~__Ii.D.____-_____ ~ Filed lq~------------------, 19~---• According. to Becorda o~ Yital Statistica of fhis Office Go~-a! Regiatrar. . - . - : ~ ~ - - - - - v.. • - = - - _ . . . ! r .r _ . . ` : ~ . .'^J . . ~ ` 8' " ~end aad o~ June 19 ~ ' ' ~ ' ~ _ ficial aeal, thia the ~h-- day - • - • -3 . . . , . - C. . . . - . , . • .s , : ~ ` • by Aaaf , . ; 'l'/' " Ci rQ~ ~ ~ ~ = : ~a~ : - ~ a - ?had ran St,~~s.~c-~-~- - - ~ ~ ?i o:'~~~~~~~ - Regiater of Deeda. ~ ' • r ~ . . Montg ' J . 4 ~.l.•', ~ Ci - ~i01{7L~1/~ ~rOT~~i ~iaTO~ll10. . f ~ , w..,~ ~'a ~e~ CertlOed CertSflcate ol DeaB?-1(xc~ QO~~~~ Ralel~b. I~j,~~ 7is s J't F^•U'° ~ i° v_ ~;'i"~ _ -a ~ -AC y ~ _ ' i~,