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HomeMy WebLinkAbout0896 ~ FILEO ~~C Y.~C~DEO / • ST. tUCt~ CJL'NT11 fC~ . ~ ROi,:r^. ?:ITR45 t : 248359 RFCOERKFFR~`~IOT CCURT ~~o~SQ 0 J . F~e 13 I iv PH'73 ~~,i,~ CERTIFICATE OF DEATH ~ s: ~TE NlE NO. n.ACE a oEwn~ usuw~ RFS+o6vcE p+~e.e aK.~.,~a c.~.a- N ~,t:r,,.a._ ..s~a.R. e.ro.~.b~.ti:o,) ?COlM7Pl B~~ •STAIf T~AS e.COtWIT - - b. GTY OR 10VVl/( i ouh~ c:?y l:,n:1~ 4.~ pnc ~wct eo ~ ' c lEh'GTH Oi S?AY c. G~iY OR TO11YN ~i orrsd~ c:~y L'w:h. g.~ p.~c+~c? w,) IACKLANU ~F8, TIXAS ; _2~ Da~rs`^ • Precinct ~k- S d Nwt~ pF(~Frot++?r.p~J gws~•cN~dd.e+i: f dSTREET ADCItfSSMnrd.qwlou~ ~ ~~U W i i fo~d Fia 1 I USAF E•9ed i ca I Cente~ i__ 540b I nd i an Desert ~eet ( ~a~ Ant~niQ ~ aK MCE OF GEAiH wS+DE C~iY u?.uiS? --1 ~ IS eE5~0E++CE wS~OE GTtt l+~+ai5? 1!K REyOErrCE OM w Fwlw) ~ i ' E rESp ~+o~ 1 rESp Ho~-- r~s? r~o~ K - _ W F~f W Mea. kl~..+ s. ~wiE oF oEwn~ < a.P• a~w ~ ~~_J u I y_ 1972 _ Li,RDA ~ NEfF_JR,____ ~ s~ 5Ex a coiat ot itwCE - iT~ - - ~ i wtE oF s~n+ 9. AGE a• ym~s ; K t;v~ R- i YE'Jt : rt_ l,'tt~~R !itS ~ MMna~] Ww~ MY~~~d? ' ~ :ni b.nld~~ : W~MS D~~n ~ Wu~s Mw~es a 1?~a I e ~ Caucas i an ~ w~.•do u.~do 12 Noyer:ber I 94 2 29 i ( ' 1 - - ~ - - C:;w l";;.'y ~"'p~_ j t._.; ~--s' nwn n p Wr:fSS C~t WOttSiRY ; i t. ~RiFIFIACE 1S-e-~ v Fo.wqn ewsMyl ~ 12. GTIZEN OF 1K?iAT GOUNTRT? b draq a~ 0~.o.1+g Ct~ ~w. ~f «~.ed~ I i Alrman I USAF K~st VT~gini_a____ ! US11 ~ 1~_ FATHER'S VMAE 14 IJOiFrtRS MAtOfN HAME Lunda ~~eff Sr ~i_~~Cut~ID ~~i ~S. WwS OEGEASE(J EY~k ~N U.S !.RNE7 ' li SOGULL SECUR(TY NO_ 1). wfORl.l/wi D~a.v~~+`aM ~ 1~ 9`•~ •r a dsies of sr~r.c~ ~ ~ Jun 5i- ?•ta 72 i 455721860 ~ Ofticial Ho R 'i ~ IL CAUSE Of DEATH (E.:'w R-ry OIH lIY1~ F1Y Cy 4w ~1. r~+d {c~.; o.an .n a.r~ ' ` ~~T`~h'W~`~"~~ Pulmonarv Insufficlenc 24 Da s , ~w..,~ou?rE c.~usE ~ . ~ ~ ~ro ~ aletastat 1 c Me I arton~a t0 L~J 24 ~ DUE TO R+~ ~ syr~wq Nr rd~r. E ''``9"'°"`''~ o„E ,a W Ma I 1 c~nant Me I ano~ 2 Years I 0 ?ART ~ OTFIER S~Gi~YfICMIt COND!TIOPIS CONTRi6UT1NG TO DEnTH BUT NOT REUI7ED TO TTE TERI.tlNAI Ot5EA5E COKDITrON GtYEN 9i ?ART t~.J ~9. WAS AUTOPS~ PER- F ~ fOR?~IfO) SSSi ~Q ~0~. ACC7DEM SUlOOE HOA~CQIE ~Ob. DESCWE FfOW PIJURY OCGURRFD. .~M o( ryry + P~rf 1 a P~.f !f oi Mr. I!~ ~ U ? ? ? ~ V~Oc TIAE OF Flwr MarA Dq ~~r. 5 NWill 2 R+~ ~ ~Od. eNJU~T OCCUltRFD Y'..a RACE OF 7~tA!!tY (e.g. or abw* 6or.+~.1~n.. 4ctory. 2W. CfiY. TOANN. OR iOCJ~TION COIA~RY SfA7E i~n.~. oF6c~ b~.lo~4 , ~ ..ae ~t^ woa ~.~n~ ~df Ar +Kx~ ? 't ~ ~«•:y' ~ i.?w~a.e+~.a«..s.a r.r~ 28 .,'_u ~k- w7~_,~ 31 Ju ~ ~v~.~.~, a.~..~ 3~ . Ju ~,.7 o..,,, a~,,..a.~_ ~035 Q.R m 1ir d~t~ s~~~d u~ o.~. rd fo ~ kesf cf wq Ine.Ldqe. i.an Mv cws~+ sraqd . I n.-. s~u?nn~ ~i ~ t°.q"' a+:«.t ~r~ ~Ess ckland AFB r ; nG wrE 1 ~ ; 4~ I! ford E!a~ U 5~F ;!A~ i ~ Pr 31 72 ~ 23~. hJR1At. CRE~AI1T~OtJ. RE~.qVA! " : 226 DATE 2k. N/~1+E OF CENf'ERY Oit G?.c~AT~ Removal For Burial ~ 2 Auqust 1972 i Hillcrest C~mete • ~ 73d LOC~T?Ot~ (C:~y. eo.~. v ear~y ~ ~StN~ 7! f1ArERAI D4TKTOR 5 SG!IATi . - ~ Texarkana, Texas ~ Southside Fune Home Fd 212 Emb 562 ~ ~ ' . ~ :5~. REvIS7RAR"S ftiE NO. ~ 25b. OJ1TE REC'~ ~Y tOCl~l fiEGISTRAR ~ ISc: Pc t? '~YsFj/~1a:4~ - ~ auc -2 72 ~ . . ~ -,,:t-:,. ~ ~ 40~9 ~ ~ ~ ~ ~ ~ ~ - ~ - - - - . . t ~ ~ 1972 ~ STATE ~ ~ AU G ~ CIT~~~P~~iN•• ,l~~~IOc • - - - - - ~ + `.'~'=•~I HEREEY CERTIFY THAT THIS IS A TRUE ~ ~ AI1H:~~CT ~COP~~(~~.THE RECORD i1S r ILED Z~T TIiE $TATIS?'ICi,I. ~ j SEfnl DIVI~~U~. i~' THE SAN A:ITUNIO ~fETROPOLITAN HEALTH ' t}~`'.>`F --~Ah~SD , T E Xi~ S. i ~ ' ~ _ ~ ~;I c . ' ~ . . . ~ ~ - ~~~i % i DE~i;;Y - REGi~~~ iR Gi• `,i 1`1AL S'~i~TI:~TICS ` ~~x21i FA~ 896 ~ - - - - _ r _ - - : e~:~y _ _ . ~ _R~ _ _ _ . ~ _ . _ ~