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HomeMy WebLinkAbout2384 t . ~ 1'?'~0~933 ~ F,~LS"T ORANGE DEPAF~'I'MFKT OF H^aALTH Cb~ F,AS'1' ORANGE, NEW JIy'RSEY ~Under oqr hand aad Dspartment Seal Z certi~r that this is a tru~ ~ ~ -r photas~atic reproductioa tram an imag~@ oi ~ha ariginal reaord. _ ~ f ~•~,F ~ ~ _ _ ' " *'C t~ ' ' ~ILED AN0 RECORDEO • ~ ' _ .~y: ST. LUCIE G~OUNTY. FLA. JUN 19 1~8 ,r' . 8obert~ ~ ~ ~~u. . ~ . ~~RF"~~D~V~RIFtEO Reg3.strar :o~l~i~ St~ti±~~i 1'7aKl33 : . . ~DO NOT ACC~T TH7S TRANSCRIPT DNLESS T~ ~ ~ , : ` _ . . , ~ '68 _ (1rT 2 AM Q : 3 T ~m SEAL OF THE CTTY HEALTH DTPABTI~'Yl' . ~ ~ : ' ~ :~r ' , zs ~~n ~,-•aN. ~"~t ~ . - .4 , . _=t•_. ~ . ftOGER POlTRAS > ~ ;M~.~ : , Cl RK I+~DICIIL O~~/i~"Y~~ir~ ' . ' Y.'r•aea0a v~ ..~`i NEM JERSEY SUTE DEPAR7YENT OF HEALTN 'j`Q _ L06At/1LtMYwae p~.~IID CERT1RICATE OP DEATM ~TATtI1ltNYM~~11 ~A sPRCES 1. h1ANE OF (First) f J1iJJ1~? (L~stl 2. Se: '3. .~,~1T~:. ATH , se~o~roe pECEASED sT"" rrr~ ~ pri~~ ROB~T WILISAM SAU~R Male June 1 1 68 v ~~RU 4. Ce1er er R~es S. Aae (6. r•s. If voder l Yr If under 24 Hn. 6. Dace of BiaL 7. ru deee~sed e~er ia U.S. M~ed F«ees) lsst iiMiJry) s Oqs Ho~vs Mi~. (Ysa. ~q, a aL~or~1 (!f y~s. sirt wr w ruts o/ ss?w) White 6 8irt?plaee (Svte or /oreisr cowlry) 9. Cieirea of r6ac ooYOeqr? • 10. Mcrried Alefer Married ~ 11. Soti~l Seeuricr No. Ne~r York U.s.a. •:~x~o DirorcedO 063-01-3520 ~ESw[Mts 2. PLACE OF DEATH 13. (3SUAL RESIDENCE (1f iosacutim: resideoce be(are ~d~is~ioe) co..~~ ~ s~~~Ne c~,~,xr b. Ciq (C6eek bo: ~ad s:~e ~a~e) c. C;cr (Cheek boz aad ai~e aa~e) ra°`° T. Oravi e r«'v Parsi e. woc a ~pKa or ~~stit~cw~ ~~ve wea ~dd~e~• d. Sveet Addres~ (it ar~l. P.O. Addersa) i~;'~ Veterans Administration Hos tal Parsi Road A t. 2C - a wal Occ~p~tie~ ive li la~s i~~ ~ott o w?4i~s /i s. ews i nrirdl I~. b. 1Cid ef BYSiasra ar hdwar - Shi C e ~ IS. ~t?er t Nye ' !G, lroiber'~ M~ides Nye rJacob Sauer Ann~ Gut,~an 7. I.faa...t•. t~h.s ..a Aaare., ~ Veterans Administrat.~on Hospital Records, VA Hosp3tal, Orange, N.J. t~~ 1~. PAIIT 1 DEATH ~AS CAt1SED SY Eatn wlr we c~rs~ /Kr ltN /a (i) w! (e) Approzi~ate iaen~l bet~ren p1LIalO Hab0118a1 B~la't6r8~. MBBS~vA oe.« ~nd de.~4 ~..~a~.K c.... t•~ c..~inw.. t/.q. ~td ~we ~ta u ~Mv eua~ b~s a LY~r'. ~Mti~ 1ir ~w Crn~iN~w~ aM~ y~ CNt1 ~t1 u11! q~t) , i ~riiyriq M /M* h,~ ~y~~ PAAT p OTHER SiGNIFICAKt CONDITIONS ~ I18S'~ 1 19a. ro ~rcopq 19b. [t ~e~. ~erc fi~diss~ ewsidetid ~ ~ pte(oe~edl i~ detet~iwies e~wt d dt~t?1 esv~~. ~ • ~lo Ye~ NO ~ e i o? - Acc' S~iei~e ~0l. Dne ad Herc d'pry 20e. f~ Isy~r Qccrrad (SW~r wtrrr n~ jvr O~ 1 r 1/ Ia~ 1 ~ccw~w~ ~ if ~J~ ~ " W ~oA. Mjir~ Oeerreed 70a Pl~ce ot bjrry i~ a~1o.t Io~~. ]O!. Ciry~, T~ u l.ee~i~w Coreer StKe fAile ~t Q Net !?ilf ~rr. ~C'!e7'• tWtf, e//ie~ ilJ~.. ~te.) , w~ • . clloii tLAN. =I. (V'M~ M) ~ M ; O~ri ~ec~.rrJ ~iQ~ w. M t~r Jite it~td si~sw: w1 te ~e L~st e/ wr 4wonfd~e. /row ti~ cy~i~s iat~+f. ~ . etisus 2~ At ie . C~rtr P1r. ~ Tlb. Adde~M I2t. D~te Si TMeer ' • ~ ' A Hospit~l, B. Orange, K.J. 6-13 1).. s.;.~. u..~cio.. R.n..4 23b. CesetM « w.. 13t. c.«~ti.. eih, &~c. • ~s'"~''~ 8uvci~l G~?ts o! Heav~an Cdnet,ai'? H4a4v~sr, l~• J• 7!~ ~rid DMt M~. O~q Y.. =M. i~t.slli~.e Dh.t _ 3w. E.~ard 1b.~ Ad~w 6f3,7 68 Par-?roy I~aerel floa~ ~ . ~ Pas~ippa~t, 8. J. ifs. r ~r N j t~t.. ri.. 11ep.a.s tsw+y .~e 2S?. D... ltec yr i . ~ ` ~ ~p~ - ~ a ~ .i ' . - _ _ _ _ ~ ~