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Home My WebLink About1711 i i~ WARNING: it is ilkpl t~ d~plicste t6is cvpr br phaosrar or p6ofo;r~h. ~ ' NYi : ~2 3~?~~"~ ; 66 ^ l~? i e:e v.~ e.z~u ~~~f~Q COMM~NWEALTH OF PENNSYLVANIA ~rv DEPAR7MENT OF HEALTH (F~e lor Mif ~ ~ ~ C«e;t,co~.. St.ool VITAI. STATIS7IGS ~ a~tl;~ ,O~ LOCAI. REGISTftAft'S CERT[FICATION OF DEATH Registered No. --•-•437 _ ; f~ull Namc - ~ _.S$ra-- E: _ ~?it~.__ - - :Y oE Deccascd _ . _ . - - - Finl M ~ddN ?mt Llsual 16 ~ Bortonda le__ Rd*._.___________. Media ~ ~,~,,t~~ Delaware~_ e _ - - - - . . - . - - _ 3 -ti N~ab~r ShMt Cih w eo..n tew+h StoM I °f U land Delaware " [kath _ - - - p- ~ - - - _ Pennsylvanw f ;9 ~itti. 6oror~~ er To~wski0 wrdf } L L s ~ Datr uf Dea~h ._2.~ kh--.~S~i..kQ.~T._..ZQ~V_------.....Soeial Sccunty I~o. Z~ ..1.Z...ZS73~.~.-----.--Racc ~litiH----------------- =a ~ ~ * c RQ !11.~nta1 St.~tus . ±~C~.~'~Ci_ed..__-- - _ - -----s~x~~~al.e Date of Birth___l~t~._17~~_~Bm~---~-~-"~` - O..uF.at;un Birth . Houseyd.~e_ - - - ~~~~e _ ..Media,P~enna..--------- ~ If V: ter.~n. whi~h War . _ . . . ~'rlrran'~ Serial 1Vo. . . • _ - ~ i \tED1Cf'~L G~RTIFICATE Inter~•al Bctw•ccn ~ ['.irt 1 Death was ~~;,~a by~: fllEd A110 RECOitOEQ Oiutt and I3cath I :t. ~UC~E COUN11f flA. , _ ROCER P41TRA= l ' { ~:,,,:,~~~:.,.~e~u~e r.~, 2Tecrosis._of...Gall_-Bladder _...~tfR~-c~aCUt~-~oWtt-~-- -2-aa-yS-- j 'j itECORD VERIFIEO~ ~ ? ! i [?ue Tn ~ h ? Gall.. ~~one..- ~ -pr-s•-.--- ~ 21`~28 - OCT 09 ~-'T~ - , ~ ~i Due 7'0 (c l - _ _ - - _ _ - - - _ - - j I _ ~j ~'.,rt fL OTHER SI(:i`IF(CA~iT CONDITIOi~iS: contnbunny tu dsath but nut rei.it~d ;o the unrncd;are cause g:~•en ~n : i 4 P.~-c I( a i ; i1 Coronary Insufficiency _ _ _ _ _ . . _ . _ . . . . _ ~I ,\:.::rnt Suu~de or Ht~nu: ~de _ - . . - Huw• did inji~ry oeiur _ _ . a _ _ ~i ti.:r :c .,t~d T,;1P c•f Pcrk,n ~IS~1~f'/ ~ ~ C~r::f,;.~ c~~,k u.~:;h ~ti+o, ~r.Lint~msqer (12r,Lintzmeyer)_ ~ ~ , ~~.i.i;,~t< ?Sedia..s Penna.~.. . _ _ _ _ _ - . _ _ . . . _ _ _ . s~~.a c~rr ~ T!,:s :s ,o ~e~:,f~. th,:t the ir.furn~at~vn here given es correc!!;~ cop~.d frum an or:ginal cer?tficate of dtath daly filed w'ith me ' ; ~ «(..,:.,1 R~y~.t..er The onair~ul cert~f~~at~ u~11 be farwardcd to 5t.+te ~'~tai Stst:st~rs, Ha:r:sbury~. P:nrs~i~~an~a fur pcrma~ent 1~itt1,4'. : ~ ~ "`h ; : ~ : ! ~ ` ~ . 2~- ~34 i i , _ . _ _ . - . _ . 1+ t«ol lq,~tre~ sf V' S?ot•.r;n Di.kht ?N. s _ 95~ Va ain Street Chester Penna . ; ;:i f f =s< _ _ . . . . ~ . _ . . . ' ry` e~~. S>~est AOdnst Ci . br~v 1~, To~w~?iO - i i.. ~ ~ ~ _ _ _ - _ 30th October _ . . .~9 66 - CoM bt~n~d D/ loaoi lyithW . f 31st october 19 66 p~ , _ _ . ~ ~ Fn~F~'11~ ~ Do~e o/ Inw of 1A;¦ G~+~hcot.on ~a(jK _ _ ~ - ; . . . _ ~ . _ . ~r~_ _ .