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Ni 214149 No. 71 Chas. E. Nou~buling. Publisher. Y~ Beaver S~. Aibany. N. Y. A Verifi~ed Transcript from the Register of Deaths Date of Deatl~~r 12_ 14~?_ _ _ _ _ _ _ Registered No. _ _ _ _ _ _ _ _ _ - _ _ Place of Death 171 _ B~n~d lot _ Arr~ T~rr~Lowq _N, Y t__ Name of Deceased----- Lew~~_~t~i~~r ; , Age,------54----Years~ ------------Months- ------------Days ~ x Sex--- ~al'! ------Color or Race-------------lhit~ ` ~ Single, Married, Widowed or Divorced - - - - - - - - - - - - - - - mitr=1~d - ; Full Name of Husband or Wife____ J!~~ ~ Date of Birth _ ~ ~ _ 1 19~2 _ _ _ _ _ _ girthpl A _ _ _ ?'~ow_ York_ C iLy ~ Citizen of what Country-------------------------------------- : ~ How Long Here } a Resident In U. S. if foreign-------------------------------- a9~:$~;t1~utrairRR D - - - - - - - - Social Security No. - - QO_ - - - - - - - Father's Name---------- ~dsard_~tsi~~r------------------ Mother's Maiden Name _ _ _ _ _ _ J~nni• Blits~r_ _ _ _ _ _ _ _ _ _ _ _ _ _ If Veteran, Name of ~i~ar_ _ _ _ - °O ` Cause of Immediate C use _ _ _ _ _ A~uts_ ~YoOBrdial_ _intoroti : ~oroasry thrombo~~s ' Death Due to:---------------------tiear__ diaees~------ ` ~me Dr. in Attendance l ~tober 1952 to _ till Death ~ _________April 1957 Robert Jot~soa - - - - , Medical Attendant or other Attestant _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ; . ~leepy Hollo~t Ce~tery Y. T rr;~to~rn Placeof Bu~al--------------------------------------~7F----- t~illias ~t Dwy~r Tarryto~n l~. ` Undertaker------------------------------------------------- ~ TScrcby Soltmntq Atttst, That this is a true Transcript fmm the 0lfia• o! the Public Register of Death as kept in the _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ , Toxa Clerk Town of Yt. Pl~eaaat i~astal~otsr State of New York County of------------- 7. Terrytown Dated at---------------------------------------------- ~1. Y. J ~ the----- 28th --day of-- ~-~==---------19,--- ( S~8'ned 1~~'-~ ~ -%t~- r'`~-`~=== ' , . Official Title - - - - - - - - - - - Re Q i~ - rer~ - - - -:~,~;'j'`~~'=' ~ 1? 1I't'~1~ ~ r . y 'w ~ ~ FIlEO ARD RECOROE~ ' ~~Y . ' t ~ ~ St. WCIE COUNTY FL . ~ ~ ~ R06ER POITRAS Q _ " CIERK CtRCUiT COU~It 1~ ~ ~ ltECOROVER~FiEO~ ;~ti ~ ~ ` ' _ _ ~ A~ 11 I 4~ PM' T I ~ 214149 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 194 ~605 ? ~Q.~~ ~ ~ ~ ~ ~ - ~ ~ - - - - = r. . . a ~ . . . ~ . ~ _ . 3n.z,v"'.