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HomeMy WebLinkAbout2889 ~ -l7'S14i. n~n o ~a~na ~usrna n a ~aw ~ ~ ' . _ 3s- _ . . . . w~ecr.~. • wr~wawrr~art - . ' CERi~fIG1TE Of O~A1M ~ ' - - - . . . . . .RN,. HCRt[~l~ N fT~T! /R[ ~NM• .t KNt ~.KC[~ft~•M! t~tlT Wl! Wt Ltli ~ ~.M1lNKA?~NMMM~.tLY1 ~ ~ ; a ~.~err ~'J - /96 ~ . . L~K! •/MTl. ~lM~, Y! NM~, Wl N Nlt~ ~~lu II~Ka : M~ L Mtt N Mt PM~M Nt. t[YI /~,~Tf ' t t1t.1V~CrT1 Mt R N.M~. M1~ 1C.rf. ~ - . ~ . . . . . _ ' . . - ~ ~ ' W ~ brange a.......... m...i K. .i..,. ~..K.n.~ «.,.u n . a » . u.. «......i. K., - M dd o 12 da 1?Ziddletown State Hos ital . ~.li11/[MM~t~1lrNiq~.iJ.~M! RCIf1Il~MtitCM~rn KVtfK~.~l1Il~W~1[~.~»Q~l~. ILNlwiNf?Ml~?Kt.r~lr~l~M~l1 1!-t%YLKCM~TfM'--«tlYt~•--i ~.ec ~na ~ G J C LI~ . • ~~~New York USA ~K~~~~~~ n ~ T ~~.~e. r o. nw~ «cw•nw w.c ar~ •m ~ M/f N~M~N l~Il. a¦ r urrin U~, a~ M ~sf~ttf M MIIiTt1 ~M..aare.a • s~~~e o,~~~.~ s~a:~~ .,P New Yor IN. CMR I~t. 1~ ~r. pit M wltAK ~~Vl~T~rtt M~K l~at{ IN. ft~tlT w~1rR~ . Oran e - Wa~.den : no ~ RD Box 191 ~ ~ - • ~ 1!. I~1~l~ - Y 1OT ~Mll Uf/ ~L 110T~! - M~l~ ~ ~ ~ ~ ~ ~ un~n ~ ~ . i . • ~ ~ f / I ~~.~rMWT. O( P~.YR~c~N~tftarHt 11l-h4i~MMr.sr~tt.Zlh . ~ Box 14 Middleto~vn N. Y. 10940 ' nurt ~ ann ~~t nrtt~ r? a~~c~ an~ Me e~~se rc~ uc re~ ta M.+w ~n ~er~.~cu ~ritwt~'i~ } ~a wiwrc . `t,• ~ ~C'tt-~~ tG . . t s M~ : ~ pt t~ Y Y A CO~YNIK! M . . . . ~ . _ . ce~n*ro+~f r~n.~.c~ c..i ~.u ~o~.ewrc c,vu m no~t va ~wcn•.s c.~se wr wc r. • ~ ~~.u ' . ' rur a~no t~cw~wr cw~i~wf: ta~MTws cMnuMt~~ r~ ~un wr .a nufe~ 1~ u.n c~rc~ a rur ~ a Nno?s.nuw ~~~~~rv~ M ~ Psychosis with Cerebral Arteriosclerosis - ~ . ~ }U_ ~t[I~t~~. NKr[. ~O~t1~l. M 1N. Mtt M~l~~f M~ M1.1U M- ~M~ 1M.1~ ~tJK~ ~CMIt~ t~tt~ YiM[ M~1Nf 1~ IYi ~ M?Vi 1~ Ii(t ~p _ MO[ltt1N[~ IVlC~Ifi . • . ~ ~ ~ M. ~l1N~ ~Ml tM. KNt M IUMf. ~t ~011l. /~M, ~iq~l. ~K~Mi. !N. aK~tIM 61~tti M~1.~. N~ qlt M TN~ ft 7(1 a?ttrf Tlf M NI K/t~ ~lN..l*C.Ol~tl/tl - ~ - - i ' I jii l?~ ~T~~- \~4 V fK~~C ~(T~[ rIrt7KW MR~ ~[LMI ~tiLYt ~tl~. 1A. MT• t~. IM. M/ YL !r i ft.~ w~~t~ ~'W t• iN ~1i1 M~t Y~LIN[ M[ T~ T~! C11~1eW~ . f ~ °r~c~ t~u ttnrt~ ~ ~ _ _ n~rc~ wa , ~ L va ich I~~ ;11-6-6$*• _ 11-11-6$ 1: P.M. ~ w. cur+K~,~o. • rcwca~ tu~+c~ M cw.~c w tia wa r~c au~~~~r nc ~r ~w.~a ~rc inresnM*~. r~c~n aa nc r~a~ut.~s nw~wcu ~w r ~ ~1 w M~~M. ~Ut~ KdMt~ M t~L MT[ AM Ml t~ M f~ ~ M~i~ Mf ~W M~ f «.T.K. ~ y: 3s 1' : ~ 1- t~ G S' 1' 3S I"~ ~ t ry?. u••ra~ - wa mn • NTl f1CQ~ N.. M?..u ~ Ro~,elio.~,~,. Ron~al NID . . ~ t -t i -6~ ; ~ ».~.,-u, M A~iddleto.~~~ N.,..~. 109~b Box 1453 ' ~ ~/WIM~, t1[Mi10~. M~lM~L IMtC1IT1 7~ ?lK! N 1.. ~IIN IM. M tl !K. lKJ IOti M TM~. fiATG . . ~~~P~. ~-~e.e C.~/~~s7'`g,e ~?Qu- ~ . ; IN_ Yil PO~T~, MT. t[l1q N[ Y M11[ 11y ~M OTMtt M~JJ. ¦ T~, ~t[. r, v~ ty. !l4{~ VT1A M. ; _ ~ /i ~ .~a~ s~ ~~°~he~,~ , ~'~o ,g C - 3i>> ; " _ ~utut . «[~1 C1M-Liu~lllt[ N1.~lM1TYnMN.-~wl4lM~tCf 7S~.tl -fKa~tllt ' G • ~-o~ d°~ 3 . g ~MT[ rRt~ l~ (MTM M1. ~tJ . ilf~~l - 1-{fR/ ff 7{~. MT! M . Nt. flYf ~ ~_v ~ t~ I~Af / ~ ~ ~ V g . • ~ . • - :<r ~ , ~ ~ . • - . . - ~ . . , . _ . " " ' " . t ti~ ~ l.'~'„~.. . . _ _ . ~~~y~ y - ~ ~ I hereby certify that the above is a true transcript _froi~ ~~h~?° ~ ~ f . - - ~ Register of Deaths as kept in the Middletown State Hosp~~~rf~; . ~ , ~ ,o; . ~ y : Middletoxn~ Orange ~ounty~ New ~ r- j~:; ' ~ • ' ~ eb~ :-•i~~ t ~ 1: ~ _ • ~ i ~ S~t ~ ~~~4~~~~ . Date: or eputy egistrar ~~9L ,~r.~~~ ~ i ~ . • ri ~.104 - •~ij ~ ir 7r..y,'~. ; . A.tenti on: Do not accept the above as a true transcript unle~s'~: ~=?~~U ,'~ND REGORDE~e raised seal of the Registrar appear$ on it. - Si. LUCIE COUNTY. FI.A ~ RECORQ VERIFiE~? ~ 1 ~s14~. . : . . ~ 1~69 FEd ~~i PM !2: ~ 3 ~ ~ n~ ~E~; ,~~~t~-r~:~,~ ~ 8~1'~ ~2885 ; . : RK `i~~ 1 ~-j ~ - - - - _ ~ ~_~-~~.~~-~~-K.~.s>_ -