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HomeMy WebLinkAbout2847 2C~0322 ' A~iARYIAN~ STATE OE~ARTMENT OF HEAITH + ~ OMf10N Of VITAI RECOtl~, ~Ol w. rRESTON STREET, 8A11lMORE. INARYlANO Z1?Ol ~ CFRTIFICATE OF DEATH • a~ccfr•.~+u~ r.a ~raa. ~eu r. wn a a?r~ m?~ouc f` a~~~ a R Cw~rnins D~ 6°o' tYg69 O'~q~ , ~ 1 SEx ~ RA(l S DAIE Oi ~IRIN ~ AGE ~(b +acr~ ~ nr r ns~~ M~n . ,~'i', ° 'a e ti~'hite Nov 12 1902 ~67~" m r"~~' o,, at~r~~ct ~s~a. « io..q, 1~ (?TUEN Ot MMA1 (OlMI1tY'! a ~ coam or o~?n~ : wueeuo ~ wtv~t w?eeucp `~-'~`1 i~"~C'~~~vt~O~A ~ p h~oorrtn p avoecEU O Prince Ceor ' a r~ ~o c~rr a wwwa ouTM ii wu~carasvtiruawsi~rutaN~n~a.~~aw 1?a USt1Ai O(ZUPAi1Wi IK~nd o1 wW1 AoeM i~e ~~nnaeus~tua qn~ skM1 oddrtss) dunny nost w n MI ~r~e d ~Nw~ ) 1t11 y ~h~verlv P i ce Geor 's ~e~~$ec~ 1N°~°eway Storea ` T-~ o ~3~ uSU~i RtS+JtN(~s~d ~wA. mtikpA~nn: Res~~ E~fori Ik UP! OR IOMM ~va cm irms+ lb STREEi AqD MIIIAlER . • V •br•utLM) Si111f 1~ (qMi~ ~ YES~ NO ' ~7 • 'N _ ~ ~ F~n+EeS ~uaF F~1 N~dd~ ~usf !1 Mp111(RS MA~O(N NAME Frtl I~ddl~ los~ 'w`~ ~ l:ar~r earton , ~ ~ :~o itiAS D((fAStO EV[R 1N US ARM(D fOR(ES? ~6D SO(W SE(IIRITY NO 17 INfORAAANT ~i ~.`'.~7 .y ; YK.ro o~w+irr,wn) fMr~+M,..w..r....y ~ , ' - CLUY'dZ?~t]S 83111e Y8 1 6 ~ \ ~ ~ • ~t UUSE Of OE~IH {f~~« only a+. couu pe~ I+~e 1(o). l~l~)) . . ~n~n nen ~ PAfI 1 tXA1N WAS (A:1SE0 !1' ~ , ~ ~ ~ ^ IMMIDI~IE (WSF (o) OUE 10. OR S A(OMSEOII[IKf OF ~ ~ ~ f«I~Mns~A~~.~«e c,..~ ~-L~bte? ~ t; '~~/1j~,~ l ~Q ~ ' m~ te ~ id) t _ o~ , staU~g.1~,~` ~ OUf 10. OR AS A(OMSfGIftKE Of . _ t N i . . . . „ . bit ~ . i t r: : ' l~l ___1_- Y, r SIGI~~ (ONIRIEUI{qG 10 OEATM BUl N01 EEU1E0 i01NE tERM1IW D~SEASI OR(OIq1110M G~YEN MI PARI 1{e) - . . i; . ~:~'R "~.~1. r~'..Yai; v} ^3'- ; ~ - ~ ~ ~ ' _ ' ORW1p(NOPERATIOMWASPflfORM[0 IOo Wi0P5~ 70A If YlS, WFRF IWO~NGS (LW~'f~khl: 'h (IR11F1UIG ' :D. . T''"' ' . ~'~.i'~~• 1'ES ~ NO ~ (A1lSli OF DEAilt1 Y~ f,'r •s. U~ ~ ?16 IIAIE OF lNA1R~ tli !K)W IMM1t1t 0((URtEO (Emw ~ohr~ el ~pry w Pon 1 er ?ort 1 han 1~) - 11l~''~~. Uc~IFO!Ot~t NOIIR AM MonM Dar Y~a ~ • ~ . NI+Nhe• T 11 e-- ^ - w. tt- ~t~ PIAtF Of pltUltr ~o~r ~r¦ 14tf1 /YNM~ ~ li1 tOCAI~Ow S~,~e+ a R i 0 No (~r a to.w ~ vrn ' \ ~/'j x ~t. . _ i'~~, 'r..~ (riMl ~t~ IK W - : ~ . ' - . ?4~~ , • ~}:(Itus hocpi~~d) otter?ded the decensed 4~.~n ~a- ~3 . " - - . 19 to~ - - _ , ~ `J • ;i~ ~N~? ~oc~ ; = i• o~ l~ J-`~ - ~ i9 L- nnd ti~iit in tm~) (ourj opmion d~ofh ocWrred on the du~• :~~d . bvm th? ~ ~.!2s~ti SloMd nbove, (1} (w~:) (dd) (d~d no1) yiew the baiy aNer deoth ^ _ _ _ I. ~ y . _ , si: v, i . - ~ ~ .~~~~n~~: ~ ~o s?~c~ _ y ~ ~?t'h-~~~F ,~~n L9'"ancia C1 nm C7 , ' ~L 1 :r • ti ~ 1JI? AUtNtFSS - J _ _ _ ~}_~i(`c/l~ A~~~!itL'H_ i m~-- 7.7.Z`L_1~1~,t!ls_~R~.~..~lh ',+~.r.f ili~ ._i t 't: i{~~h=--T iaA UASi I3t KAMf 01 (EM111R1' lM (RfJIAAIORr 1~d lOlAl10M ( or lo~'-- ~i ^C i ~h ) luu~~1 : _ ~~~~~1e ° r~ Lon C~r..~ Lc Il~ ~tt~vill~e t: ~ t• ~ l ..::d t• i..:'~ t ..~:~l~ I._~~a,~:.r J' ~ ~ ~ ?So il(UBl RIGKIQAC 1~! ~~ti~l~'At1 Vr\a':,wt ~ i ~ . !~l.,,,.r~':~l,~. .~'~J N~/ I~~arr 1 i ~n~~ . . . _ .rz^~.^/'. FILED A!i~ KECOROfO , ST. LUC~f ~~UNT`I FLA. ROGi.f i :ZITRAS CL~RR ~~+"'~U1T COURT RECORG v~::.F~ED~....~.-~. Oc~ 16 3 2o PM'10 zc~322 ~18~' ~2~~6 i ~ . : _ :