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Home My WebLink About0158 . ~ j~ ~ CERTIFICATE OF DEATH - ~ ~ ' Mic?ipo~ D~poAS~M d Prbiic N~oY? ,..~1 ~~11 ~.JY~1~ • . ~la~t~~f: ?~~q r~~V r~~ ~~f~ Skx :~~li ~~I ~ a,. . . - • ~ i~:3[.f"/ ~~lLU:it'1I It 1~ll~C .I••l'_`.°.=~~J:-~ ~'iic/ 2~C[ va~..~. ~ro..«. wf.E-~.sr o.~~ ~ q~~..e1~ ~ D~• ~ UATF O~ ~IRtM ~.rw~w o~. ~<~~11Ni~ ~N ~ r ~~uwey'•t ~euf ~f1 - ..of ~ tr~s .an,~s ' ~ ..w. 1 n.~ ~.t . ~ . e . ~ ~ 1_ ~SS VY_jq +y~ i I~ /IlL/~LL7~ ~.1_~`~~'' ' Ir - c.~. :v , . .,t~Jr1 OE oEA~?i L - "wiw~ tm ur~n ?~OSMIAI OR O/H[R NSIIIUIK~ ~Niwf ~ . • .r. . . • . s~tcr~~ w r0 ~ . ; ~ > , . :..:r t i~ i~ ~ , ~L~ . . . 7c.,t/LU.Lf t1d~C9U.r7<7-[/u.C - - - - .~~it ~~,[R~ ~ . .~.r ,r. v f ~ , ~?re CITI2EN OF WlIAf COUNTRY MAftlEO. NLVIM M/1~R11U. ~iU~V1Y1fH. •.«Nli! ~ r . ~ .~n ....e~w ..~r. . .own. ~ ~ w1OOw[D. OrvOK O ~ tinc~• ~ + . • ' ~~LC~:i.''C'JL _ • il•S~ _ --iN. I~~(LVf.~.~----- In F~LQRC~ I~CGR~yZ ~ ~~~~:~~i iu.i~~ wiwwt~ - USt1Al OCNfwT~ON ~w.~ ¦..e o~ •.wa ow.e ow~.w rofr a jR~?~O W WSurESS O~ ~r+t.~;r:: ~ ~ • ~ ~ 7I ~~AO l1/t. ~YfM I, ~1~~~~0 ~ ~ : ~ ~ ~b t~~--- - - j~l~ U?~/.'~/1 ~ _ ~~~~CEsa~F -Sr~h - COUwt~ Uir, TOwr~.OR LOC~TION »is~w c~n o..~» 'ft~lE~ ?r~:: •c:..B~i y~ ~v~c~n ns o~ no+~ j ' r e 'i ~ ~ !~a_•~l~Ui1% t .i n, i.? ~a ~ ~~in:2 - ~~~~t • n~s~ rwa~ ~•se ~MOTNER-lNA~OlN NAM! ~~n. r ,.v ~ t'~'•:. `CL~E'/L ;t~ l~~~.LP_ /Ll/tL1fVl/Il Ih!~ZMANI-NAN! ~nt~kR~1G ADORESS ~snen o~ ~.o MO. U~~ M tP~.~, 14s~, !Nt nc~ 1~~.G~n~ ~n / d~/ i'ac~v.s# 1Je~u~.i~ ~~?~.c~w~ .nn ~k~:? - iqfi 1 •rr~U~.wry OEAM WAS CAUSf~ tY: ~fNI[R ON(I Oh UUSE IEf LM7E IOR (o), (b1. ~K/ (a)~ E~~r.~~~ 7..s•. w..ea.n c~~a - - - - f lol ' I ~vf~ . . c ov~ e ' - j :.~«c~no~ s. n.... I e 1~ ~ 1~ , ~~jy(~lHj~/~/ - ~c . ~ ~,tt ro 101 A ~ rrfD•~~I C~J1~ ~o~. ~ - - ' . ~ St~hNG ~wf ~..oe~- ~'o. .s ~ co..uow~+a p~ ; ~.~~c c.usi ~.s~ ~ (q t ~ u E~ S~Gtv~F wNi CO DI NS~~o.n ~un..o ro oe.~» ~vr r e~u.[o *o c s ~+e.. ~ r.n ~e~ wlJTO?SY~~f YES ~.t~~ r~..o•~ ~s co~- ~IS /q~ S~N1tD ~M Dli1~r~~.lr'v C~YtI ~ ~ ' !IA O { „ O[~IM • •CC~OE?+T, Si1K~DE. MO++~CWE. O~TE ~ ro..tM, wr, ~tu ~ MpW ~N1URY OCCURREO ~ e..m wwn or ~~iuo ~r ..n • o~ r.~r m. ~ OR U~+~ETEQW+ED ~fnt~~• ~ 7'Oe p~ 7F M MI INl'JRY AS WORK PIACE O~ INJURI/.~ ~w+~. ~~a+. svetr, ~K~O~t, I~CAiION ~ Sattt pt tLO. NO., Gt~ O~ iOMM. ST~q ~ . s•(:~~ •IS O~ ~O ~ drKt NOG., eK. ~ SMC~' / " (;a tq . CERTIf1~ASipN- w~+~~ D•• •e.~ ro~+m w~ •e•~ ~ra usr y~r Nu./wt~ uM on oq/ow r+Of v~Ewr n.~=OE~Tti OCCUrtfO r~e ...c~. a. +rt ?NtStGI?N~ iO rOMM D~~ f~~~ I~Qpt ~ITE~ •M. ~~.H~ ~ •ti~.1•^ !M~ ~'Sf ~-~tC '~f ~ 1:. /0~ 7 ~ ia - a - 7 ~ ~r~~ - 7 0 ~ ~~-i: i- ~ p~ j U i, ~ 6 0~~ uuse s~ sr.+~o. CE+*~~Kwt~~rv-NEOK~t Exw~u?+ER OR COtONER: o« rwe ~.s~s a r~rt »ov~ or a.n. DKlDe+r r~3 ?~p.~qi..~to oe~o t~~~~~.•'~c~ O~ :+r qOr ~we'O~ ny n+vfST~Gw*qM. ~w rr p?wW~+. ~ rONtM O~~ +ou• Dt•~ OC[~a~lD Ow MF D~r~ u'O OY! W tw! C~uSl~l~ 5~~~lD. M Il? - ~ M iFfiLf~EF,1,vuY ,n+[ r~~r~n / n { 51GNA1U l otG~et o~ m lT-AiE SIGr~:D '•n. a••. ~~r ..~~0 f7t-.~~'" ~C n1 f ~ ~ ~n ~7/'~t.~' ~ Llit'sclit~ : k ~ ~ - .S - T w~N:N'v A~GJ_AF$Sr:'~t' " ~ S/NE~ O~ .D. ~~i~c+~ ~-iva.il ~ ft~r~ p _1'C~% f~'~~ ~ t ~L {~i~lAl, GRENUTfONj~WOVAI ~CEMEtERr OR CaEMAtORr-N~a+f IOCAT~ON cr* •^~r-. s~~*t : . s•ea.~ ~ ~ 7is L.uz.i.cL I~~~ Titv~~ . ir~i.clur~ait ~ OwiE ~..c..•~, o.•, n.a~ iUNERAt HOME-NA~i~DDtESS ~ s~un o~ ~ r.o. ..o , cn~ o~ +o.Y'; sr•n. r~• {/2~f ~ ts. ~ ~o~ f:o U.C,t 1•>.L('1LU'rr.'t --~.`'~).''~~f ~ FIXVFRAI ~7JtKjOiT-57GNAT(1RE s ~~w i+/'u~ ~I OAf[ tfCE~vEO IGC~I GiSTtAt ~ /~1~,,, r~ ? K. : i ' 7~ ~EC ~ ~9~0 _ ~ - - - :r~-~=--~~ ~a,r.....,_.-~--_ ~ ~~OT YALID UMLESS THE RAISEO:~$pAI.~F tf~'C13Y Of HIGMLAND PARK IS AiFlXED THEREON ~ y-.. - ~ STATE OF MICHIGAN) ~ . 7° ~ • ; ~ I.hereb certif that this is a true ~ v~ ~ COUNTY OF WAYNE. -.~Y. Y.. Y _ a~ r ~ H I G H L A N D P A R K i= = C~ p y o f . a r e c o ~ d o n f i l e i n m y o f f i c e. «o~o ~ ~ ~ ~ ` , - ~ a~Amz (n ~e7°s~oov . ~ n ~ vco~ 0 ~ ~ "s: u W ~ ~,te _ DEG 3 t970 ' . - - ~ g«~ TREMON McDERMOTT, CITY CLERK~ ~ ~ ~ y ~ ' BDOK~~ fAGf ~ 4~ ~ - . ~ ~ ' ~ r ; s" ~ , ' : - s -~.t '~m- ~{~^'"~{a~.,''~= . ?