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Home My WebLink About1611 MORM CAROIINA S1A1E dOABp pf HEAtTH - -.a..~:_ 186'~~'~j OFFICE OF VITA1 S?ATISTICS . - ~ CERTIFICATE OF DEATH . ~l R~]!taTl7N ,.~c. w - 3i:Q.Q_ tock ?a _.:s:i ^ic a ~ait av , a , ~ELk`BR Ol~~t~p lKiK ~ Annie ~~n :~~t?faj'~ L ~n,~• ~~F~ ~tl O~ ~AG! STAI! d MM ~f r O~Tf O! l711 - x. :~`S ..~•eA"~ •~~sn u~ t N~/~*A rN~N Wh rK ,:~~al~ White , tvorth Carol ~na . Ju?~e 9 19tJ4 ~ 59 R.ae .x w,.tM us..~+ nsd,e~Tc!''~ aw.,t :n.. , a.~.....~..~. . :Ql~i7 F TO ~ S7A1't ' CO~Am 'A" S~anl w ~al~~-~ 9. jlort`} Ca~~~lf~a o. S~anly Kscc cm wwu urt oe ~ - 'C'QRY Ot ercN ~ Ot «0 70MM . ~~SiAl1K7~1 !~I1~.~ LQ ~ ~ ~d ~~~1 !1 ~S . ^ a h ~o r.~ .a.s wueo. swvwr+c srouse r~ ~ooeess oe irn a. ~.~s.,~ un iwrts W[S'NEO D~KyC~ n.e a wa ' ''~~.p~ r~ t~. 1~..~ T .'^l~Q iS ~'Gi:tP G ~t t ~N q w~YT G017NiM SOCLY SfCUlfi~ KrNB U51:~11 OCCUfwtqN ~~o W+~:~ co~ a.~o ros~ K5t0 Of WS7~lSS Oi 1t~1b7f7 'Y O a .w..o ue rw+ ~ ~~a - ' ~ 245-05-??~2 ~b ~:~us~~.v:~p . +~'HS NU{` ~t~OR+E7S MA.6EN ?iAME -~-~tf: /~••i1V..~:l tA .i;.:i'n :f~:~:i~l~ r~F~MAhTS rMME ADOfFSS - : Rogers, F:OlliE' ~~kc~r~, +•J• OfATA CAIJYD e...v va~ oy :..a~ ro u~a roe t .,-.c.....~~ ..,wr } v-~er~ o.se~ ..o a.~w V v ' ~ _ ~ ~~~e= -_~ec ~~rc.in.~~at~c:~ I =.t.» . , ..e ex v t~ ? ae ro a.~ ._o.aewece ~,'.e', C~:1: ~'Ic3 va:: o' i. ' J:^. :j ~t? 3?S _~,n~ ~ - ' - - ~aa ~+c :~x ..s~ - L o~r .c o~ ~ : ~.s~oue~t~ .ti •~Ji ~i'El Kif~~71T ~Q~ITIQl6 ~-a`rM'tK. K.` :4~~ M`~ 6~tt q c.h/H Ci~Aw ti iYT ~ •llT~Sh Y~$ ~H! ~~L+f'~I CCMOftlD ~ . . . ~ . . . _ . . +O p ~p o!'~wi0 fw.1~! O~ 041M . . . 'a _ .9h l~:i.'_ lit - . ~:OENT SJCO! MOMKDE. O~ WOETEfwue~ED MOw !Wf OCCL~tED r+~ I..e~ w?~~. a~.tt ~ q r~ a.~r ~a ancw, TJa 71 '~E CJ ~A ~ar .eM ~w~ A7 +~Glt Qi NN[T a~ s~f~. Oi~ Ol l3D. C.01JNir STATE . N~~ ~r¢w ~ o~ .o .~wv ~c. oc ontsn 3 ~3 1t L i- '~,~,~rryyp~y,k ..-rrso xn.sm.er SQ~:.__11;. _Sli~. cElt~s+UtKY~-x[DKw~ Uuwr+ft Oe ~CSn+G r~E01UU E[wKr~Et :~d ~ ~zJ[.~ 13. ~{jZ_ ~IO lYf L~ ~b+ ~ff .4M OI A~ 0[~IY ? 1rY~f O~ Ml~~~'40 ~00~ MO W NNSNC.~TIy~ N Y~ Owud~ Of • ~~S Ofl[ M~7 ~~v n il r,~i { i u. n v.no uae ~.O w~I ~1wef• A?r L/V7H ir~r10. 12 :rYL i~~rb ~v! ~e OIfiMN ~a! wP10v4i~ 0l~O ~t r Or SC~w(UE Ci CBr~i!! ~~oe ~~we DATE SK*[D ADORESS - - - i.. ?.7cLeod ~t. 7. ~.2-14-b9 ,x. F. G. Box 38 `akboro l~;.C. .a.~. c~r~r+o.~ ona owre ~w~e os c~r o~ c~ruron tounoa •o~••~ a• p•~ ~ :r ::I~ a ~ 2~ ~ 14-69_ - ` t ~ ` '~i " J~d i °~"'f . n n~ or r+~ru orEC~oR uoasc e+o- ~ ?ar:sell, Albe r'~e%'L`' ~ r " Hartsell 1271 ss ••t• r. ..r :[iv R coGU REG tEGts1W S+Gt4ttuE Of fwuM9 UCEr6E rY~. ~ ~ ~-::,-~9 r !.1. J. ~a:`sell 47~J ~~~s ~s to certify that ttie fore~o+n¢._.IZ~h_C.~rti t,~~ ~N~ RECOROED -••~..:~a true ~nd correct capy of tr,e ~-^e ~s r^c~r~'~d in th~. ~~~~E ~OUPJTY. FLA. ~ ~~~~~~,r_c, ~ .1 Y b.~ ~ r ~ : . v ~~L~Jj~ .o~ t~e R~:~'ster of Llee"s far S'a~',~ ^'y. ,.~rth : ~i f= ' ; F ~ ~ 1$6 _ ~ 6~3 ~~:t~~h,y hand and off+ciat seai this---------.+.-r~-.__r~ay of ~ : I~ . ° ~De ce mb e r ~ ,19~.._ :69 flE~ 9 (1 : 3 8 . . ~ `:i ,4i~r: • ~ /~n ~ ~ . : , ~ r , /-~„r ~ S : ' f x• ( ~e~(1 -`1~,,l~i i? ~ . ~'r v - 'ti~".• d D~i~ S~lR~? ~Ol~ CLERiC~CIRCUt7 COURT ~ . ~ ~ ~ . !~~~I:;.~~ . _ ~:.ti4 ' = ~ ~_~Y~'~ • a~ '~I~;j:~ •..~•...•~!~~V• ~ a . •'f~_ p..; :.s ~ , , ` ' ~ . aQOK1~1 PACf 1611 ~ - x. _ Y_~ ~ _ _ _ :