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HomeMy WebLinkAbout2397 . ~~~7`~l~i ~Y .a~.~ ~~\f MYV![• • ~9`~ ~ ` CERTI~ ~CAT~ O a~ ~A7H st~rs •~~s Muuscw ~.OtClAf[O-NAMt ~~AST VOOt~ wT Z•fE~ 7.~AT~ O/ OtATN VOhTN o~• Herbert Blgise Herold Male l~~rch 18, 1967 ~r us• . ,•r taAO! K~» T IN~DEtONEtiE4a:•UMOEtpr:f0~ 1.OATE Of NliN yOMTM o~• r~~~ ~.iAC!,~y sKt~~• a QOUNiT TO~tAt2N r~ r u~ ~~ruT~a ~arch 16, 1899 T~~1~ti8. ~7tr~. J,!Vuis _ W ~.IOCATlOlIO~DlATM ~~T~•~ ~ ri~ ~-".~.~:°;'~;'~'."".'t 7~.NOSlITA? Ot OiNU WSiliYT10N-NAME ~i ~MC~rMt~, an~ - D~tluth ~ Yes 3t. Marys Hospital - ~tTNrIAC! a~a~~aM ~ouNrw~1 .C~iIaENOf WHAt ~0.MAtR~EO NEVE~I MwR~lED. 11.fWYft - NAME St. Paul, ~'Iinnesot `~SA 1Karried cE~ s~~G" do ce Z~ioy Herold ~ 1t.WAf OECEA EO EVER W U.S. ~3. fOC1Al ~ICYtlTYHUA/~tt t~.1lfNAlOtCY~ATION tOw[ awo o? wo~a H U H R W Y t!t ~~"~°~°`~~C~ 2 4..Yes 469-30-8789 A 1~"anager=`8"~er`~`""•`•'"`°~ 1 ve m nuf curi ~ is..ataocKtt - st~rt s? couNn sc. ~n. . M;~~; ~Iinnesota ' St. Louis. ~ ~ Duluth - ~ _ ~ Yes ~ •~IATNt!-NAME ~~.NRTHKACE s~~T~a~a~~~ .ADOt! f OF OtGlOENT sr~t[t ~no Mu~~cw rosr Ori~cc Joseph Herold - Austr~aTM~ 5201 London ad Duluth t~.MOMR- NWOEN N~ME WiM?IACE Isr•TC o~ ro~us ?OLIAIINT- HAMt bo~cas = cow~r~r 1 ~ , Duluth, ~Minn • V " . Catherine ~ Germany N`>>t: ' ~-t~ W 0. MtT t- O[ATN WAS CAYSlO tT llNTEt ONIT ONE CAUSE ~ER LWE 1A1. 10 wND ~Ca~/ IF Ou?GN06~tOUE1tRE0 ~~MOauurc ~~issvw~ ~ n. w~u?EDIwiE CAUSE - - cMCtR wa s~~ cw orscr a¦o ; • . :~:7~Vr'~L , ~ - M L/ ' O - _ L OYE TO. OR Af A ' • - ~ - COrfSEOUENC! OF ~ ~{3r~;' Y~i.r ~ Y /~~I ` ' ' ~ ~ ' 2 . + ' ~ ~ f~ N C.OY! TO OR AS A- ~ ~L ~ C~NSECUtNCE Os • ,tt~ ~ ~ ~ ~ Z ~AtT ~ OTMtR fIGNItICANT COtl01TIONS ~ • ~-A t~ ~t+~ ° ° ~•SIT Y. , ~ ~ . ~.~......a ~w,. a a.~. ~ ~ et~'`~ < YlaAC~OEN~fY1G0l,MOMiGOlORUNOETtRlWNiO ~.OATEOfW R VOM~ p~r •tww Mou~ c• JU llt s~cc~?~ rts owro ~I V s~c-»r ( If ~EFElREO ~ tKt~ Ws • ~ M' R~C i WJU !~T ~.0~[.f~rr,iTR[tT,F~CT0~1~.0I/K[ e.~ ATION iT~[[T Ow ~/O Mw~U CR~.vtLi?6t OwwSrw C *T• 3? ~ waona ctu W u J 7!L M0~1/INJURtOCGU~REO lcMtsw ~ut~~c o~ ~wuwr ~w ~w~~ ~ ow ~nwr n. ~itr 20! ~ u ~ . 0 2]aC6f1i1WT10N-~NTL AH w~ a" ?.C[liY1CAT10N - MEDICAL EIAIWN[t O! COROHEI W 1~~~~cwa~i iaw~~M l~`~M ~i~"t~~ O~ ~?s ~as:s ~f ae a~rwi~qee d ~w b~dy ~~d/« ~M i~~~aiy~i«~ i~ m~ ~~i~:s~ 1eM ~ ~ y~i• Ms tl MM sr tiiiw/~r ire r ~ ~t41.1~/ ~M .:~.r N~ MJ~ ~tlee ie~ll? ~ce~w~A N ru. ~w ~M ~ae ed A~ M M~ cw~s~s a~at~/ ~be~e. TM d~c~der ~ nw~~ w~ ~ar Q~d asw~~ i M r W yl~ce ~ 6w~e ~id ~ ~eM a~Nr ~le~t w N M~ /~w~~sc~d ~w~ M r M. M ~sst~wql.~..Iel~~l.~Md~~cwsessw~l. i]a/1( y ATU~ ~.MLDICA~ QAMWtt O~ CO~ONEt-SIGNAtUtE ~ \ ~ ' t3aRN.LGIAN-NA E t**~t ow ~w~~n MEOIGALEIAMWE~IORGOROnER-NAME t*v~c ow M~MTI - ' r"* ~ • Ci a t ~ K i }lru~ithG wO~RE/ii'~ ~MTfIC1Al/. M(DIC~I~ ['`i'~AY1M(R OR COAOM[A `DATESIGNEO 7 ~ / ~ W ~ ~i I'1~'I IYV~rsv~ lA ` ~ ~ - MOIriM ' OAT T[~/ I ~ L~.~- ~,c ~ ~ 4 7~• WYALCtlJrlAilON,llMOVAL I~?ClMEiElTOlC~EMATOlT-HAME c-LOCATIOH tt~Tr, r1~~CE O~ COUwir) IiiniU > • fKq/~ ; ~rial Oneota Duluth, Minnesota - W t I~~-W?ROF~uqA4dEM/?110H OR 1Sa/YN[lALNOM[-NAME ?.itlNERAINOME-ADORESS ~ ~ ~aTd~~21,~~~9~TM Fred Olson Mortuary 110 T~est lst St. Duluth, Minn. o ~ •~.CATEii~D~TIOCAItEGfitA! ~I?. At tEGISTlAt-SIGNAi{J[ . MOtTI Ot /UNE~AL DtlE~TQ!-f10HAitlRE t l4ir'.~"23 °i~E7 - ~ ~ ~ . - e ~ - - _ - ~ 3tate oiMlnnesota - . - - - - - . - - - _ . - . ~ 1 1'~' C p - County oi SL Louis U~r Henr S dstrom 1..._.._ ...Y_...~ Clerk t~J D'utsict Court in and jor asid Count,y ond State qfortsatd, ` ~ Death ' do l~ereby uertify t/aot t1~s o6ooe L a true and cwrect oopr qf tl~e oat~iostt of - ~ f.` +,~f~.._. H1IIiBl~Y BIdISE A380I~D ~ _ . ees~e snd ojr~oord in y~iee. . ~ m -.r * ~:j 1111 TESTI.1lONY R'HEREOF, 1 has~e t~creunto att ns hsnd ~nd r ~fised eks aea~ ~~ald oourt ~t : .:t~ r ? . » 6$ . ~ ~ ..~11111Lh_._..._-----------__~_____... eltn,ie ckt,....~tb ~ - ' ` . S ' ~ s ~7' 4/ , . . ~ ~ a ~ ~ - _~~I~BX..~~P~~Q~ d~ ,~u~ ` cle. t?.e tr:c: Cou.t ~ ' - - r ~ - , ~ _ ey... - . , ~ . • ~u~ ~ FILED AND RECOROED ; ST. LUC~~ COUNTY, FLa. ~ ~ • - ^ri RiF!~ D ; ~ ~ ~se e~T 2 P~ 0 7 1'70942 r•.o~r~ ~=O~TRAS ~ CLERK CIRCUIT COURT F r ; eocK 1~ r - _ _ . ~v__ ~ . _ _ _ - - v-~~