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HomeMy WebLinkAbout0950 .,~--r..~-~--T°., ~ . ~~~7/~~~ ~ STATE OF ARIZONA a"`T" "o~ O n T,•~? R s l~J /~j ~~V ~EaAFtMENT OF NfAITM-DIVISION O~ HEA~TH RECOROS AND S?ATISTICS D109. ; v•: ' ~ CERTIFi~ATE OF DEATH ` ~ ~ •,r~~s• •.4~DC~C ~y~~si SE~ RACEO 'OLOR ~+ov.+ o~• +cu . _'~t aSFD^ ~ ' ' ~ l I ~O£A~N - ^ F:_ ~uc. : ~;1{/'i 1 z :c~ ~ ~t~.~ 4~~r.i.t~ 1 Kovember ~ ~ . ~ ~ - - _ s.. ' a ' ~ s Cpi~T~--~ ' 't~. 70Y?M O~~~t• MOS~i1K OA Y ' •[SID[MC[. IYC li~ll • ~DOw( :ti. p. , ~•il:.-• . _ ~ 1 IYSTIiYItI" _ ~:,-~a !s.cc~~~n. ~ct~:~r_ Medical Center ' n J~ Da~ ?GE v[,?AS uti0~1~1~[ ~f uv0[R ~t ?RITAI TATUi SURVIVI?~6 lii w~T[. G.vTu1~nS.ti ti~v.-: . 1~67~R'~M f~0]. 0~~1 Mw3., M~r. ~~~~1[O QNIOOnI[D SPOUSf_ _1 ~~y / • - • ~ ~J J c. .O+cr[w r~u~o~vo~tro. 9. LC7R2.' ~J? : C/tOC~G~C'R.[.. a c•, o.. ~~i~€rv oc wH s ~ ~ s¢tuv~ r a uww~ otcuv~~~o?~ -T ~s aECE~SE^ a:E'! ..S•-. ~ ' - ~I~VTRV' ' t • c•-"- . + :~L't1.' Pi~ 1 A. ~ J-:• ,J_ ' ; . .1 , ~-Policeman ~ " ~9y,2-4 j : J ~a.. , _ _ - _ a. :+a~[ a. Co~~t• ?O~ O~ C~rr ' ::o . - ~ : E~: E. - ~ ~~~-~r'i''-~ ~Vr~7 ~~//Cf~~)/T, %~1 ~ - _'E' _=E55 O~ ~ ' rtir~ un,.iTSf Ow LONC L~VEO W AR~20N~~ PpEV:OuS St~TE ~ s~ ~ ~OOwces ~r •*[~O< <aE~DfvCF~ . . 'i`i, . f . A'{ } ~ ~ L-~ ~ • 1+ +)~ti / f (1~?.~~ ~ ~ /'~~)•'J~- ~ ~~f ~~1~_----~l~Lu~L. - 3~. ~113~_ ! ~a. - r~wsr •~~oo, a c. u,: ' ' a' `rs' ui$biC t,y~i? OiNER'3 - •AIDEN ,SJ ! i-~> ~ . -4eon~e y. ~ ~::u3 ~.uE ~.;;?.i.: . _ _ ' ~ '4\A~. V~ A ?~TtOM5111T0 :`O~!SS S'+'l["~O ( a•.7'.'+'? . . - ~ . octue~ - r - - ~ . ~`.t r 1G~9~.;~~~ »~9r~ . Q:-L .~i''liltJ ! 2 ~ ?t~~: ' ~ . ;i~_ S'aT[='E~.~ • A(t TN NAS ~AUSE~yyB V: l(~~(~l• OY[ C~VSC OM [~C« lltiil ~ M)r•..~r'i ' - ' ' 'S£ C~ 7E4~., . (~'t~~ ? ~ ' { .O. ' a•.- . , i A. ~M~!ED~ATE CAUSE f~%+~~~•fA~WA.~ ~~~,.,j.+C.t4~.~!/ CfJiC'4YL~Ct~~ ' r•~'-'I ~ - " ~ r-- -.1 -f=- ~ _ . .c ,ca.s[ i OUE TOOR •S • ~ c _~a.r.:. i,+c . . . a a ~:a.~a'1+.4 : C ~ ~ / [L.LG~1L' ! rr :-a~l.. ni• . - . B_ CO*+SEQUENCE OF: " w- . ~ - _ . F F ~ ~ \ G \ ~ _ . ~ . r • ~ ~ r . , ' . . - ; OUE 70OA AS • n _ ~ tic..~~~.tiCnv. ~ ' . ~ . . : a 3 ~ COVSEQUE~VCE OFt .I~-fC~j~~ ~Q/~~ ~G~Q • l', .c.r. . - ~~S -'~•"'t""' TPART 11. oTHe~j taNIFICAVT CO'J~yy} ~ ONS -T AUTOPSY~ ~a .~c nso(..~ 44 '~•4.Cf C~•~1'F4 ~ ////~/J I - ` ' ~ . . . c~[•_.Y •'.I` / ~ir/ i::~ ~ YO• ~C,Nt : ' • . - • . ~ _ " U~T1 Q` M~` 1~~~~ U~~M A:iMi ~IYH~~_ NOA O~V ~NM~M• t• ~~`.1-. • • ' ~ .1•if•)~~\ ~ IMniA~1~~~1'..,'14.1~N~0«UA~ ~r Y ?~.~.~i ;,J.. ~_4w ` u ?S. . . _ . . ' . ~r. , y:' teY. ~~'~Af1 OF Iwf~.~~. ~Tai[,r~tr:.a._•.rn~~,f~e.~ w~iENE LOGAiEU• • ~wicT ~n~.w: ~ ~ t~ii-ta ~.~~r.- ' " ~ ' - • ~ t. ~.t~JVHY ' _ ~.C." ~ ) ' nr~~f~• ~ . a~~SiCiAN OR w?ED~UL EXA,!'!E~ C . . . , p~• .[11• ..o. O~~ r_~w r r.Y~~~~r~or ~s rNC sOw. u~e~o.u. ..rr•.s~cA~~o.. ~ti , • ..oa ~......~~..r!: ~ I 4\~is.GCCVAw~n tw t..~ Ynqw~w~vOUMt..r...~ C~wt.,u•.~~n.t~' •.t~••i•. ~ If• ~_y~ ~ / uaGl~s?n 11rAs - u0. t~a• •~ar ~ ..,.~w ~ ~ur. I . e . we^~~, UA~ AM wOYr ~ M6.~ GtP YOf ~ ~ Y~~ . . a~ _ ~~•uti~uwt io w1 a : • • ~I[+Y U00~' ~ff~ ~ • V~AV VM. ~ ! D~.~t.. ! I _ ~ ! . . /V /~~/0. JV t~[~tw. ~ 1_ aj P ~ ~ .~i-.--.'aT:-~..-Tinee i~3F~~~ovc ~wo ro t..a S~WaI~TY1~E ~+«ec.~c• . + _ f s..• .titn~loca ~AD IAOf[ S~IOMAI JyOGYfMI Dy[ •O ~ !f ~ Y~ •~~[c. . i~r~[ I - - ' ' ~ • ~.?r. J~ 4 ~ ~ ~ _ c,~..i~._~EI ~ ~c •..•sa -e.e ~ ' .1~~ ~ JL ~t f ~ ~ze. •~~?e ~~.~e ..e~t~ - ' _ _ _ _ _ _ - w~s s~cvto •n •ao.cas • • _ ~ ; r:., _ 7".~-~ c~:. , „ ~ , „ ~ - • - -.•coso~s?oa. ~ ~~~rii,• c• CSOA~ ZOI38 rur . c..-~a~ , -~.J-:r~;- . C,~~~ ~r;_, , n ~ l~~ v. l ?(1 . i~. South~~Cre tor - ttn~[ - -~rt> - _ __~y_'__:. " _ . _ STA Dw[Sf : • a•,' •~tl ~ fv~l CtO~i S~G~.I~ ~w~ ~ ~~L ia:. ~ ~ f; . : . _ /tj; ~ ~ • - ~ ~•r~l _ . ' ~ 1 f. l.o~ uG~ -~n~ ~ _ : --~,ru.~ _ 1~~~,t~.e! , ~ - C'~!X!,.,~. -s - :,-r ~ r _ ,.'___.o.- ri_~ ?G. wf 7~ il1A~Y1~[ . 1 . - . . • = "ot•.4.i970 ~ 2722 ~ Deputv~,6. I013 ; ~ - - ~ ..~Tr_"_~ •r •tT'~' n~-~i1?( ` .CP _ 0-~ .AL t\ .J ~ J...._.. r~^ ~nT~~i.••~ ~ _ ~ a a~_av... ~ ss Date Issued: FEB 2 6 ~~71 ~ - C^ ~'Y OF b:.1:tIC0?A ) 'u-'S Q t P' A ~ . - y ~ a~~,~ _ '~:~'_s co~~ i~ a*rc:e ~nc: exact r~productian of. t~c dvc~acnt pf~ic#al~~• ~ r^~j ~~r_~ c~ ac~~ o.^_ f± Ic in the DZ:',SZO". OF VITE+L;~.~'~Z4:;~, . ~~r~~o v~~ . ~-r~c»W ~ .~i~. :1.:~ti~:~: i:~:T Qt t:t~t'~s.T:t~ :~1!(~E1`Ti}{~ :L:17~~•.~1. .:i~~.. • .~t •a-'_• ~~~22,~ N!/~'~~ w . ..a . Q <i~ ~W T~S.1^~ '2^!i^" r':E. :l'~~:OT'~r'~' ~F :1Z~i 3~~~J~S~.R~ nd by ~~T ~'~Q~~..G. - o~o~> • " ~ ~-~F : ..~~ao m : t~'.•.•~' . _ _ W~ rV - : . ~ t ~ V ~ ~ ~ - ' ~ Y l ~ • t ~ ~ . ' ~ "~i `~~V l ~ ' ~e i ~ ~ - . . f ~ ~ ~ . ~ I ~f . ~ : . :.:t~s~;~, ?t. , 1•. :'.~:.::ri : ~ - . , ^ ; . . ~ - ::~~14~Y'~!lSS~i,;;• . ~ . . . .~f t~. ..f.~ T ~I~:l~ ST~~T} _ . - ~ , ~ ~ - - - - - • . ~ - • - - - - - ~ ~ _ _ _ _ _ _ _ _ _ ~ _ _ _ . _ _ _ . -n,_ ~~4 s5o ~ . . . . ~ ~ - - _