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HomeMy WebLinkAbout1331 . , ~ OH10 DEPARTMENT OF HEALTH tc F11e ~o. " R`~. 1~=". ~o.- DIVISION OF VITAL STATISTICS Pr„n~~ R~a• D;sc. lvo. O Rcgistrar's \o_ ~ ~ CERTIFICATE OF DEATH ' DECEASED-NAME Firrt ~ :Middlr _ Lu~ SEX DATE OF DEATH !~torrb, D~~, ]'eJ.J ; 1~I~LiAH ; A. FUSS Male JUN" 30 19?1 RACE ~birr, .~S.o, a~wn~~X AG~ Griu unoet 1 TEAR U~OER ~ o4r o~te ot 61RTH I.~low+b, Dr~, COUNTY OF DEA7H ir[i.rx.~l~~rif3J _ fiu r s1 .Not. D+~r Horri Ali~. Yri? 8 1914 : . = i - Sb Sc. 6. ~ / ,o. CUYMHOG~ ~ CIl~, VlLL~GE,_OR.~~CA' OF+ II~j~_ 1NS~OECiT7 UMiTS MOSJiiAI O~OTHEQ INSi1TUilON-NAMf /JfwOli~Itillitr,sirts:~.rt.id:~Ra.P.~lt~ ~ ' ~_y,• . ~ .rs~.~~h,~~~; ii[Tt'.C?7 ~O:~D ~fO~iTiiL 7b. .~a.~ ~F~' ?.ia^.~ Jc ~ 7e. E STATE OF 61lIM II/=M~~iI~:S.+~.,. C f W~T COUNTiY MA4R~E0, roEVER MAR2~E0, SURVIVING S?OUSE /IJ u~ifr, jirs udiJrR u1~re1 ~ torwtryl f ''~r - WIDOWEO. D1VO~CEO (SDe[if)1 a. Penns~l„~tat~i ~'~t`-.. • t~c~ S`tates ,o married Ruth Fulm ~ SOC~At SfN~tTT NU : •~43fD EYER iN U. S. ~~.MED iORCES? j COUN r Fl~ ! ' a+pt~4~ou ~1 ll) ~ri, jirr u o? d~tss o/ fnrirrl ST. LVC E 192-09-108'a:- POI7RAS ~ ~ .;;J~L RESIDENCE IZa. .i . / ~ . ~.._.t ~OGEP r.-E:E DECEASED USUwI OCCUMTtON (Gi~4 ` .~rlii~ KtND OF WSINESS OR IND ~F~fD !E DEATH - - ORO VE~ uo.4ie !i r Srr~ ~ rtti. ~ _ :2~D IN S tA~Z' ~la~~l~~~. R Q +~b. Avia~~.~bn s :`7. G~~E t'o. i ~ ~~V~'.E lEFOtE qFSiDENCE-SUiE COUNTT G~TY, VILL~GE OZ tOGTiOri tNSiDE GIT1f UMITS STlE~ A~p M! r ss.cN. Ohio Sumhritt4~-~;~~ Copley Tovrnship ~SO•~'/»°f fW~ ,.b. ~4e. ~ ~ tae. z fATMER--NAME Fi•tt ~Ki~/t ~.Ylt MOiMER-1NwiDEN NA.uE Fird .~~iQdlt ~tl ~ - William Fuss • 16 (Not known) Anschutz I~9~s , s. INFORMANT-NAME /~W~I~NG nO0RES5 S:.rrr or R.F.D. n~., tit~ or ~ill.rjt, cutr, zipl ~ Ruth russ 1407 E3rh3rt Ave., ~ - i~a. MRT i. DEATH WAS CAUSED BY: fENiER ONIY ONE GUSE 7ER L'NE fOl (ol, lbl, AN6 !di ~P?OX~MATE I~tTE2vc,l ~ETwEEN N ET ~NO DE+?TN Z t e. . a~~,~C~„~.~.,~.c ,~-~.--F-..~l.~- L` c~~-~s,~ c~F l-~ ~ ~ IMAIE~IATE CAUSE ~ ~ ~ Coardirionr, i/ re), OUf ~O, OR AS A CONSECUENCE F_ ~ ~ t c Zc.uL---E ~ E•~~~ti..... . - rrbirb s~~e nit ro S Ib r ' ?y' i~irsedirtt cautt (a1, DUE ~p, OR A CANSEQUENCE F: - ~ ~ Z ~tstis; thr LRdrr- / • ~ :_.st!G~~ ~~-G-+-~ ~ ~t ljia( [anft l~tf + C.~•t `l%'V~-~~.~~-~.: c,~ /~Ll~~!-~ ' ~ ~ ' - 4.,.h MRT 11_ OTHER S~vNiFIUNT CON0ITIONS.Cohd.tiont conlribYtiej fo d~atb bdJ aot ?d.+ltd ln :dntt;~rtR ~w p.rrt l(o) AUTOtST IF 7E5 u-nt Jfadinsc co .iidotd „ . L_ /s~ ~ ~{~v~~ /Yn or wo irr drtr.s.inrti'camr oj dwcb F - ~~=uL~ ~ ~ ~ L Irt 19a.~us 19E. ~Y ~ - . _ - ACCIDENT, SUiGDE, HOhVCIDE, OATE OF INIURY HOUR MOw IN/URY OCCURREO IERIt/ MJIYI! O~ injr~Y i~ p~rt / si part itt~ JK) - ofl uNOETER.uiNEO lSpeti~~l /.~IoAr6, Da~, Ys~) _ ?Oo. 20D. ?Ot. M 20d. ~ J INIURY AT W04C ?tACf OF IMIURY A! basrt. /r~m, ih[rt. I+dor~. IOUTiON lStreet or K.F.D. wo., ri:~ or ri!l:rar. ftlft. siyl `='E ' lSpeciJl )n o. ao1 ~~~e btda.. rrr. (Sprci(T/ r;~ 10s. 2Cf. ~a~ r r .?lonlh D+ Yt.tr •ND lAST SA'N MIM,/MER 1 DID/D10 NOi D"eAiH OCCURREG .if fb~ plaCt, Oe : at~i~C4T~oN- ~f~.+rr, Da~ Yta. 1 4; PMrStG.?y. At~~E Ota VIEW TME ~OD! (MOUR~ !bt dalt, asd, to ~s I ATTEND;D TkE O ^ .Howfh DaJ )~e~r AFTER DEATH. fbt betf 0/ wr _ 2G~ ~ ~ ~ f ~ 7 / ~ ~ Nv~- l~t,4notrlrJ;t. drt to 21:. Ocrcp.5cn fapu ' 2te _ _?lc ~ 21~. ~ 2!~. 11 ;2t~'. !bt r.+usr/t1 ff~ttJ. r~i CE~1ifiC~TO•~ ~07pn:2 O.: :1~~ b.:~i: tha reJr.in~t: ~n Ho+.. o( da_tb Tb~ dretJrat ua~ y.n,:o:.~~rd dr.,d - l~v tbe bo:1~ .:n.! ~or:h: rr::t~!i~.r::~~~, i~: n:T epir,i~~n. dtlt:~ .1lonlb D.+y Ytar Hot~~ - nciurr[d on ibt d~tt <n.: d~t !o tl.. C.14fQ~SI tt.fltl. • - 71~- Me. ~lb. M. ' CERi~Fi~R-Np.~'F ~T)pt or jritt) S~GNATJiE - Dtj~tf O~:itlt O/~TE SIG.'ED . - l' • -+~C' ~7b y i ~!`2` ~ ~73 . / ::;i ~~o ~ - MA~UN : AD~2;55---_E~tT!FIFR STRF'T OR R.f .4. !.O. UTT OR vllt~GE ~ STATE ZII 1,~~~_.~~,~~~~ C-t_ .~'1'~ _ ~~[_.`t` u~~/~~~ ?t~. 't BUBIAI, CR`_~a.T~„^,ri Da.TE h4~!E Of CE1v.ETERY OR C~E~`+TGP~ ' tCCATiC'~ (Cil~, ri!ioSt, o~ ro~nt~J /5:.+:rJ _ ~~''Rt`rtial }~~~7~3~1971 l1c Rose Hill B~ar~al Park z,A Su:.~:~it Co., Oh. - _L__------- _ (tiAMi Cf _N:3.:M~i (~IC. NO.) ..---rFyV~2A~ ~~~Z 51~i4/1 9 N.7.~ ~ j " - ~ s - ~s E. D. Chase 5570-A J ~a - - ~y~ ~ 3408 ~~y ~ c.---~------ ~------tSikEE: h0.) 1 :Uii) ISTAT ~ (ZIP - ~._s~~.__.~ PJ.'.=74: ~v Ati~ AD~i_" . ' . ~ I THE BILL0:1 rAIRLkrid C~?APEL 85 tJ. ~ iller , Akron, .?4313 ~ _ - - _ ' DATE t:'-D a{ ~R ...J~ S S'v••~•,+ ~i/'~([ ?c:.4!.i ISS~:~D ~:+ATUg= 0= P~9 ..N lSSU~N^ y~i DIST. NO. ~ ~///w i ti~( _ l//''~~-, A y ;~,~I / r~ i lyl ' r . i~ /~i~ - ri 1911 ~ , i,, y _ - , ~ ~ _ j~~. j ' ~ E~.iM ~~~y -