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OIIIC< O~ VITAL sTATiSTICi~
CERTIFICATE OF' DEATH ~ 9S
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Guilford Friendship qrs. '~"n N.C. ~0001~ Guilford
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~ . Greensboro ~ ? » ~ ~'~?M Greensboro ,..~j L7S p ..O
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5705 Pine Haven Road «~~Ka 5705 Pine Haven Road
NAM[ OF !'rM MiM4 Irt OJ1T6 M~M? Da Yrr
OECEI1fE0 01
~ ~ ~r,'.. r+w? Homer Ra Cam bell ~*g Ma 8, 1967
i. !Sx QOI~OR OR ~11CE t. MARRISD ~ N6t6R MAtR1ED DATE Of e1Rt1! AOwe,~~ +w Irt w enw 1~ i~U~n~ Yia
~ Hale I White ~nuoweo p a~atc~o O 4-20-1903 64 ~ ~
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~ C~erk - Duke PoWer Comuanv Randolph Co., N.C. US
1~. FA7UBR~ NAIIt 1~. M07'B~R~ 11A1061f NAMS NAM6 QI IltldsAND Ot wlF6
o~~ ~Iilliam I. Campbell ~ Nary Henson I Blanche Hoore
is. wAiD~CSASBD IN .8.AUM6D ` N. . IL MIi0111MNT IMME -
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N. CAY~E OF 0[ATN-IIITEi ONLY ON[ CAWE !ER UN! /'OR W. W~ W. INTERYAI. i~i'%i 'r.Es7I
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F nk Greensboro N.C. 5-8-67
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; 5-8-67 E.H.S11inWOOd M.D. -b Hanes-Lineberry, Greensboro, N.C.
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1 HEREBY-~ER~tFY THAT THIS IS A TRUE AND ACCURATE CdPY WHICH APPEARS.
ON RECOf~Q~, l N~'~'i~E'OFFI CE Of E REG1 ST OF ~EEDS Of
GUI IFOR~ COUNTY, . ;
NORTH CIFROL I NA~ 1 M B00lE~ PAG E . ~ ;
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WITN6SS"~I~ -HAND. ~ND S,E~'~~}{~S ~HE DAY OF ~Y 16 1967. ° ;
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~ . ,.~j:"~ MARK STEM T~ REGISTER OF DEEDS 't
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