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Home My WebLink About2560 t»} 11ECO~D[D O~ST11iCT NEW YORK STATE ~ •-k ,-^^B~" 2` O~~ ~ BU EA U OFNVI AL RECORDS :..~~~s s~a. 4 - - o'Y's'o" ¦«,S*E~ ~~~M.~~ CERTIFICATE OF DEATH ~ 5 TYPE ALL ENTRIES OR f'RINT IN PERMANENT BIACK lNK. 1- NAME FIRST MIODLE l.AST 2 5[~ i3A_Gt~.'. C• OE~TH 3B. NO~/A M.~lf fEt~~lr r . . • S'~CAI D~STA~CT ! v' ' ~ . . - Charles W. Arden x ~ ` 4r -70- i5 :30P. ; 4, 11A~E' lwH~7E, VEGwC. S. ?G! ~s •~rDEU 1?R. ~s u~:DER 1 DA. 6A vETCN~N O~ U~S. AA~~EC ~GACi'. t3 ~-EC•~~ 1bAA, ?ME~1iCAM 'ND1AA, ETC.~ MON~HS DAVS HOURS Mt~:l. ~ "~TES C~ SfRV'CE ~ ~ ~ rE5 NO ~v~tiow? ~ vhit~ 57 5 ;lk ~ i ~d '~l II . VRS. ~ J ~ 2 ~ W 7A. COJ\~Y iNVSI 178. TOW1 ' 1C. Ct~• OI~ VIlLA4C ~ 7Q. LEMG7M OF STl~1 1N ~7E. NOSVIT.~L OR pT..rq ~ ~ ( ~ ~ TOW4. CIT~ OR VILIAGE~ ~ii hF:~nro, :~/E ~ j '.C. ; f W Ontario ' Na les ' ' 4 days ~ Clement Rd. ~ _ B.SiATE O~ O~R~M 9. OECEDEV( ~OA~ ~0. CITIZEN O~ NM~T ~1. MARiTA~ S~~T~S ~ ~Z. S,:4v~Y~~: '~+Y'~~', 'Ai=E4 r~~'=.1 + ~ (CG'v~1TP+_tiliiOrUS• 410VTM DA~ vCAR CO.:NTAY~ i NeW Yo~k 2;~3 1913 U.S.4. married ~ IIeanora Schreib ; 13A. _S.~4L OCCJDA!10\ fEVEV :F RE~~RE71 138. ~:VD Of BJS~NE55 OA ~~^':'TR~ 1~C. '.oC-•L ~E:~~:p~TY YO. ~ , ~ _='t DE~CE ihyERE "~'~e'S~1 ~ National Dairy ' O~ 09 ~1~ ~EC. ~~i ''4A. 5~4TE ~ I~B. CO'..VTV 1~C. TOYYN ~14D. C:T~ pR V1~.lAGE IdE. WtiM~N TNC 'iG~ crp_ - ~ ~.~qREO :ti = I ~ 'E~ .6VD VJMpER " " " G'.':E AES:- ( I CORPORATE L!M~T~' , { ~ 1 S . =:~,ve •n.e.ts.,1.. _ ; ~ Florida ;St. Lucie ; ; Fort Pierce i Y~ ~ ~ 795 Airoso Bldv. ~ _ ~ 75A. ~~T..ER'S h~~tC 1SB- MOTMlR'S MA':DEn NA~AE ~ ' 2 ~'A5~ M:ODI[ LAST F~AST MiDOIE L~S~ r i t 4 a~ed Arden A~es Barber g ATTENTION ~ 1EA. iYiOAMA\~'S 4~ME: 168. MAfI~NG ?DDRE55'. I~NCLV7E 2~V CO~E~ ~ I ~ - : ~5 ?OTFD ~ ? ~ ~ i ~ ~.+'oBEiOME.«EO- T„~,g. ~e~are Arden ; RFD~ 3 Naples, N.Y. 14512 ~ ~ '::'S!~+AR • CCR- j ~ ' 'is C~~E ~/a! OE i ' " - ~ ~~~yyy ~oGqp~~.y~iE :MTEAY~L ` c I`PART I. DE~TF w~5 C1IUSED EHTEN ONl• ONE C~VSQ~ y: ~'~A ; DfTWEEM C'~5[T e OEATw t .__q9EC~ :ER~ti:- ~ 17 ~\AMEDIATE CAUSE ~ iF(~ ' ~ ' ~ a BfEV •:CEP>EL _ ` . ~J ~ . . ~,A•4. ~:~E ~ Coronary Thrombosis n!`(l~ dr'~---10 min. ~ ~ f~' ~ D~..E ~O OR •5 • CONSEOUENCE O~ ~ - I l !CCNO~TIONS. AY• WMICM 5 plUS ~S~ ~ ~C~JSEp'AE 5°:T qGDTwEE B~ Arteriosclerotic Heart ~ise . ~ ~ ~ ~~.:tiDE1~L~tN4 CAUSE lAST D.1E 70 OM AS A CONSEQVENCE OF c , ~ ~ ~ ~PAR~ 11 C1`1FR S~Gr~F:~/~!~T :prD~.T~.0Y5 COMDIT~ONS CONTR~S:IT~Ni TO 1~A. •UTOOS~~ ~1s9. ' .YtEp . -^'+S::ENEO'.N ' . _ _ I ! DE~Tr~ 8JT rOT AEI~~ED Tp CI.l:SE G~VEM iw P/1RT I~A1 E~, T A EAti~~y~~.~. TvE C~_SSE Of LEA~~~ I ~ 0'1~M1~ a ~ - IO ~ ~ ~C CU~'T COIi~" _ ~ , ~ - _ _ r - _ y 1`~• ?CC.DEYT. MOM~C~DE. ~198. MJhiMTo~r1YE~¦ i9~. M'JUR ~19~. NOM D~D ~V:UpY OCC~R~ ~E!1~EM ~.A~'.~RE ~ _A~ES !Y ~I7 1 OM ii.'~ ~ ` U I 5~_~C..^.E .,vDETERM~NEG ' ' ~ - ~ I ~ W~_ . i Y ' I I S~E ~ti:~~Rf ?T wOR~.• : 19F. ~LACE Oi IM1Jp`/. NOME. ' 19G. IOC~TION ~~.STRECT S MO.. i~T? JA ?'1..~.:E. 1p~1YV. Cp;y7v. Si~TE1 ~ ~ rES v0 I f~CTO~~, CfF~[E lIDG., ETC. 1 ~ . _ U ! ~ ~ ~ ~ . ~ ~ ~ v y.., C~ ; TO BE COMPLETED BY _pR_ TO BE COMPIETED BY ~ CERTIFYING PHYSICIAN ONIY CORONER OR MEDICAI EXAMINER ONLY ~ - ~ V~20. PART 1 20 PAQT n 1 ~~4 ~O TwE EfST Of M? rtN0'p~EOGE, OEA7M OCCVAA~D •T JN T'E l~S~S Oi E~~r.~~M~?'.J~ •v^'Oo ~..E ~':?~iOV, u• ~ a .il ~'M 'rE !:ME, ~AtE /WD 7lACC ~aiD DU[ TO SN[ r,.tOM1M OAV TC~w OP~M~ON OE~TH pLCUMR~D AT T:NE, ~~'E'~Nf vt~C( •x0 _ ~ ~ a~ C~~~SES ST~TEG OJF TO TME C~~SES ST~!ED ~ ~i t ~ ; : I C.P.Long M.D. Coroner 7 Si:~.EG ' S14NE0 . ~ ~E ~ ~ . . . . _ ' . ~ B~~i G' S C.4~. •ttEwOED iti[ U[CE~S[O C 1~51 SEEr+ w~lv[ I B. Pf+OwOVNCEG OE~D C. ~C.~~ . •~C 5 G[C s ~ M'i\TN G~I vE~1M M7MTw O~• ?E~A MO4TN pI1? •[~1~ ~ MONTM ~EAA ..\TrTr,1 1C~M ~ ~ l ' ~ ~ ~ ~ ~ l ~ ~ _ ~ : , w~. ~ : ,o ; : • ~ a» 8 ; 4;7c .T 5:3o P.--~- - ~ ~ ;5 70-- = _ i_ , , G. •TT[MC~ti4•oMIS:C!~N. rf OTNE1~ TM~M CEI~TIf1ER E. COPOM[P'S VnYSIC~.~Y. .f 'JTwfY C(0- (.(e i i~ ~ . i ~ ,c'~j ~ ~ f' : . . : rloTir i4 ~pwl:~Ci~ti. COFUM[P, MIOIG~I I~AMINCP, ~p110hI11~iDM~G.C~~!~. CC.~~'~ C'~'F:':A,. ~ ~~'7 ~ f C.~ P. Lon~, M.D. 167 So. Main St. Naples, N.Y. 1~+512 ~ q; ~ e : t • 22A. Ww~~~ c~trw~t~Or wuwor~~ wur.~H u~? ~[~w 228. v~wC[ o? ~VAtAI. G11[M~l~o~. o~ ~tuo.~~ J2~ ~oi~Tic~ ~h~. ow ~own+ fr~T[! ~ ~ :e ! : ~ ~ - - ~ ~ ~ - ? - - ~ 7 ' 7~ Lakemont Penn Yann ; = ~ ~ -1-1 ~ =+F ~ . 21~. wAMt •tiG ALr.w~~! pr r~~r~[~~l w0~1 ~138 w(~~fi11~r~OH NO ~ ~ I ~ ~ ~ : < Towr?send Thayer_F~uieral__Chapel-- Fenn Yann , N•Y~- - ' D 2255 ~ ~ 4~~•.. ~ N• ~f~wl...O~ rurew~~ L~11[CTOw ~~248 s~4N~TU~~ O? •ur[~~? o~1l~crpw ~~]~C wl4~s~w~tiOti MO ,a ~J ~1 V , ~ ~ A' ~ ~a ~ i~li 11 i s C . Mc~ore ~ _ ' ~2792 H U _ . _ _ . " 7!A ?.~.a~r~.w~ i e Or• >bH• bt9MTM O~? vlAw l!A ww~~i ~~w w~.ao~.~i .~w..:• . , ~ .•a~~o~~ l~• U~II - ~ ~ ~sc ~ ~ g ---.6 ; 70 Mar'y Lou Rex~ Reg. ~ 8 5 ~70 r~ ~ . E 187 z5~s ~ eoux r~ct , ~ ~ _ _ _ _ - r__ ~ .