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HomeMy WebLinkAbout1083 , .,r-, ~~1~ l[~ f ~ - i ~ • ^ . ~ : ~':,:S:~` lirO`2~~f.0 ~ LED ~AJ =:G"R'JE~ ~ . : ~~~iu~iE ~~uN1r f~A. . 2v4J2~ . ~a~~E~ ro}T~~S : Q~.E~K C!kCUIT COUR , ~ ast Rtad ~n-~~ ~4~ i•~ ±~?DTSTRtCt OF COLVMHIA DSPAlITMEIfT OP POHLIC I~L~F..FIED~ r eniFic~te CEATIFICA?E OF DEATH ~ ~ ~t ~ ~ arcfully ~ ~ ~ 1~~~ t 8 ~ a,..r t+.. F.s x.~ ~ 1. x1Uts os a~~Afl~ Iint d1~111: L.d s.. DArs al.~rA n.r r... sb. xor. or ne.ts ~ `~''D' p""" Jane B. Thom DEATH Feb. 11 . 1971 i 2:15 AM item O~ ~II• ~ SEX tJOLOR OR RACB S. \wet !luried, alarried, DATS OF HIRTH 7. AGfi Uw ran ' ' ~ H :ion ahouldL~ w~~. ~tr e~.rA1.~) . o.ee, y+ ~r.. . L White l~farried Feb. 20, 1913 ~I :y fupplil~. s. PLACh OF DEATH 1~1 M/~]~g:On, D.(`,. f. tiSUAL RFSIUEYCIi (R~IKIt ~Kt11[~ ItNd. J~ t1U~1IY~WR, nad~~tt bt/un \~atE Ok ltQaPITAL, ~IUH~tI\a llOafd 01t OTHfiA 1NS'riTUTtON tiTATB Md b• ro~~~TY MontRome~"~/O°~ ~ (/J wut u uislifrfw~, ~itt d?ttt ~dna~) • ; ~!,ould b~~ S1ble HOS Tta1.5255 LOU hboro Rd. c~Tl ~.t~~~`!~~`>>E"~it\ui ' y P 9 wheaton ~eS W t i t t~ A J. . IIF:F:I' AUIHtl:.~ii (IJ IYral. /Irf IurO/u.M) ~:.a ~n p.:- Wash i ngton. 0. C. 20016 1 u Foxt?all vr. ~ t!p~ birC~ ~•pt A4 OCCUPATfOPI ~(iiK iiw~ v~l ~w tlb. D1 ~OT aUY1NSY OR 11. IIRTHrI.ACi 1!. CITILSY OF NHAT COIfYTItYt . ~Iw~~! MaN ~l ~iM 11~....~ tive ~ ~c~~CI~Y Ci0• ~1~~~. w lwrr+ e~w~ti) Yea 1ta. F.~THEIt'J ~7A]fE lib, aiOTNER~ ~IAIU£~I ~?A~IB t1. NAalS OF St'R\'lY1~f0 3POUSE i John h. Boney Clara E. Mlells Conwa Y. Thom arfifute Dh ~f. Ertt u~ ~T.::. 1~. 90('IALSlLCURlTY\O. Ih. l:VFORafAUT RSL.4TIUYSNlPTODBCB~SSD I7b. :~DDR~! s~ree~ C~~r sa~a n perman~at A~°'~ F~~~ -O1-0242 ~onway W. Thom Zhusband) 13=05 Foxhall Dr.,Wheatoa,Nt [LtOid ~IZIfA It. CAOSL OT DEATHs (8~tn .~.t~ ows n• r G !ur (6). ~~d (r)- ~ ln~ervd Bet~riee Oaaet ~ an,l Ik+th ' ly exeC'u!!d. YART 1. UEAT1t V?A~ CA~tiED BY: . ' J 1~f~fEUTATE CACSE ; I Cv~d~fww~. :J a~~. ~ • ~ rl.ak aaa~c ri~s fo i ~ I ~AOM CY1.K ~fa[- T llCE 7Y1 1 E ~ t0 •llbnf~ • tAe wdtrl~i ~ r~ ~ :e1e of Deai2i i O t.,r. i ~ S. . . Uepar2men! - tt+11C Health ~ ~RT 1 (YfNER C.' 'ICA\T (,JXI) V5: cwunlwt~o~ to Je+th bu 19~. ~l' ~l'~l'? 1lt~. ) n, N' r F'~ m~>C~.mw cr..! ~ .iateal t6e te~uuad ~ a~wrl~two p _ ~ 1~i XU n t ~uamt au.~e ot Ikatl.' 49 ho+~n af- V~+ t ~Sh ls a r10- M IF GPF.ItAT1O~i tN.~S PEAlY?It~fEll IOa. UA"fE O~PEItATlO~T IC~~. ?'!'IO~ IUCN ~)PF:1 ~X ~ ~f !he laws ~ ro~IP1.~:re tr~~t> >o. sot, y~ • ~ Disiric! oi W (j 21~. ~~~~ty it arewleat. suieide. Mrui- ilb_ H(~ 'It AXU I).\Tti Ok 1VJL'Rl': ~t~+nt . 1>~Y. Y.*~I tle. I)F~('RI[iE NOH I\JCRY OCrI'RRED ~ cde. or num~er w~dett.wined (Ewtcr w~trYre oJ /w~rry ~w F~~t / o~ J'ot /1) . at V 21~1. I\Ji'RY AT VPORK . lle. PI.ACE CF 1\JUHY: (At Xuwe, P~nw, PKfury, 71f. I.aC'ATIC\ CITI' CUL' ~Tl °I'ATE (SpK~J~ 1'p or Vo) Slmt or O~ce Brdd~r.~, BIC.) FIER W _ ; OUT I~; Yz. t e..tlt~ ~at m(rdrio..M.4 an.oa.a .e.e..e tros ------1 _~Q_-----• u1---•'° -----~~L 1f7_/___. 1ia1 (A {~•.1 l.o~ :'"THIS w~ t~s d~e~as~d a w--------~r-~~---•. I! ~C. aad t d~at? ~rnd tcoie th~ ~ sd o W dat~ asd \orr alaud ube~~. SP:rac.•~ zza sicrwr~c n E C\ED A'[`I'E\DI\a IfERICAi. ATAFF PHl'~. I)IItEC.'fOR PHY`.j, r tte P ~ICIA " tAl. ADDR~S.4_ ~.-'-`=:~3~ ~ ~n of :h... x.. ,a, James . Boland ~835 I St..,~t.~l;,*a~h:,, ~ s punishabl~ _ . ~ :;r imprisoA- p~ ~t_~I. T3G. UATF. 2k. ~.~alt: OF C'E\1F:TEItY OR C'ItE\tATORY Ik1- L(~~'7'lO~t ~.~a.~r ~ .r ..o3h. ! ~Y)::=,. ~$titl CIi~~IATIOX ` uea~o~•+~ ~ 2 1 1 Parklawn Cemeter 1~ihe~ ~,1~~~~C ~ I4. Fl'XERAL A4]IE ,jQc~~~1 .~+"~•f~ C'j•~• ~•I~1~^ M L'\ T. ' IL' G~i.~~ .b:~U. P. 7i" ?~t J J J I..C. . ~ A ~tsT - {UURE.~V \1~~'• f~~:. ~i L:. 1':n..'i. U. C. 21YJ16 ~ / , i``~4\IBE1C~ a a i~~ ~I ~ , ~9\•`~ a ~ ~'1'.~, r~~+~ : ~ !tE:\tAltK~. i ~O~ s.i`~s ;•G':~~ ~ P t - ~ : HY$ ~ ~,r 1~i~~ a~ ~~'r ~ ~ i ZSM . . ' T ~r~~='i E~,a~ : .A' + ; . . - _ - - ~,c ;f. ~ - ~ - - ' ~l'. 3~. ~ t - :ti; ' FEBRUARY I 2, 197 I'i • y-~" - ~ Date .1 ssued NOT VAL 1 D W I TNOd~~. ,~S -'SEAL - - - - ~ ~ : TH 1 S I S TO CERT I FY THAT THE A60`lE I S A TRl1E AND CORRECT REPRODl1CT I QN ~ OF THE ORIGINAL CERTIFICATE FILED IN ORDER WITH THE VITAI RECORDS ~ ~ DIYISIO~ OF THE DEPARTMENT OF Hl1MAN RESOURCES, IS~TRIC 0F COlUH61~. • ~ ,,,~Ct~L Q"/L ! ~ ~O~ ohn H. Crand~31 I, Ch i ef ~ . , • . . . . ~ ~ - • ' ~ - ~ ~ ~ ~ " : ' . ~u~/,.y~. ~ "S . : 3 ~ - -y, ,~'~i 9.3r, i^` `r.L ~~s:x~i$'`~l:t:`n'T'~a"~~m i5.at.~_ _ . . ~Gr+~"q~.~~~