The URL can be used to link to this page

Home My WebLink About1585 3 . 2552'~4 ~ ~005~ ° . CERTIFICATE OF DEATN _ STATE OF GUFORNIA--DfPART1IENT OF PUBLIC MEALTH ~p~A~ lY11~ OF DECEASEo--iiRSt uN1E ~ b. rDOIE turt ~ k ust rurE 2~ DATE Of OEATH--aartK ~~r. na~ ~ 2~ ~~o~R ~ Re ina ~ ~ Alexander March 2 1 0 M - 3. SEX 1 COIOR OR RACE 5. BIRTi1PLACE 's'~;"°"O°" 6 DA~E Oi BNtTH 7 A6E s.~r... ~r tMOn i rou r t~ a Female white Germsny Sept. 16, 1916 56 DECEOEf~fT • NAYE AIA Ntii~LACE Of FA?F~R 9 MAlOEN NAME AND BfNTHPIACE OF MOTHER a PE~~ Richard C. Arp Germany Ma~ie Behrens Germany ° ~ DATA q~~~~T CW~RAY II. SOCIAL SECIRIRf NUY~R IZ ~1/b(p 11[Y(R WR6ED f~OO'~EO ~3 NAME OF SURVIYINCa SPOUSE ~M ~IfE aIq rMOa W: ~ pVOKEC i!/tC~t~~ E Germany 568-76-9669 Divorced ~ 1~ IAST OCClFAT101tC er 15 I:~f~~~I~~FJMLOrv~6 COY?~r oq cirtr 17 KIND OF IMOUSTRY OR BUSINESS ~ R~ecvaciliation 6 4fells Far o Bank Bankin Business ~ dl~ M~CE OF ~A7If--IYWE OF MOMffAL OR 07ME~ N-~ATEIft fKqlR ~te~ STRfET ADORE55-~sn~T ~e w,r~ o~ wc~nor. tec x~oc an co~rw~a us ~ ~ ~ SrECHr ~t3 O~ ~D~ PL~E K akameena Sanatorium i 2131 Cariton Street ; es DEATH 1A~ CITY OR TOwl1 • ~18t COllqTY ~IRr te~sw ar stn w ew~r~ a! R~ew ~lbt us~+r s~~. r wra~~ Berkele ' Alameda i 7 months , ~ ~ USUAL 19~ ~~"~T ~•~R'M°'~ ~°~'T°" 19~ q151DE CRt CORPONATE ~N1iT5 20 t1AME ANO YAIUN6 ADDRESS OF INFORYANT ~ RESIDENCE ~ ~~~~~~No« p E. McD . Ke 11 e r ,,,,,uTMa~,,.,~,,, 20 Arlmonte Drive ~ rernvno~. ortu 19c. UTY OR TOWN ~19o COIAiTr ~19c STATE z ~ ~OOQCE ~E)O~[ - Ke~sin ton ~ Contra Costa ; California 20 Arlmonte Dr Berkele 4 0~: ~~rn aRr~ r.rr ~~rn cnrs+ iwar K~rw eccwna r ' ~~t '~RONER- w a y•nu ~110 DATE SlG1fED ~ 21~ CORONER ~.:.occr~u~.+n ~2b PHTSICIAN r~ ro~r wr~ ar ra~z srana +uon 21t PNtStt: o .~a ; PNYSICIAN~S o+o.:i..o.uww.to.~e+e..w.~~..o.r~~a~es..rn~~.~nr.~.m.M...~un.ae. ~ ~ ~ ~wo a~n~ ~aw .w n~a ~ w.a ru a~ ! t0 u0 't s /J ~ : R CORONER~S •w K~rs ~s ~ac~r~ r rw~+a~ w~.. ~~.n. . nm w.: r. .~r ~ r 1 ~ 1 21[ ADdRE55 ~ 21v "'~"w s r „ :ERTtFICATION - • 1 ~ sa~.,~.a,w~,.---; ~i~ 2427 Dwi ht Wa Berkele ~ ~ l ~ FUNERAL pt~~eeiino~ ~22~ DA 23 NAYE CEMETERY OR GREMATORY 2~ EMBAIMER-SSGN~iuAE ~ar pp~ FruufD~ IKERSE ?MI~M~~ ei~ECro~ C remat i ore ' - 8- Mt V i ew Ceme te r N ne i AND ~ , .n. ca.,~:~. ,~+c... c.-~ .ca.n..a. r>w•...~o. a• _OCAL 25 NAYE OF fUNE~II~i. DiRfCT6A •o~?c.sow•cTwc.ssucw~ 26 ..na~*.vro~-~ero:or~.~i. 27 tOC REGI TR a,~.p;K~n,... fJFGISTRAR •+ncr..~s :•w. ~ ~j~~ R J O ~J~ McNar ~ Mor an Cha el 8erk. 14 VART 1 DEATN wAS CAUSfD ~7 EN~fR pNLT ONE CAUSE ~£p i7NE tON ~ B!Jh'J < ~ - :YYEpATE UUSE ~ '~t'l4~;~-' ~~v~~ ~-lt ~s ; ,~lNl~t1~' 4' w~o ~utr (~pNC4TlQYS I~ +1NY WN~~N ~E TO 011 ~5 A C01iSE0UENCE OF ' _ ' lhiERY /J_ ~J~/J • Itlf ;.Alj$E L~~E RfSE r0 FwE ~YIfEM ~tB) ~ '-r!~lfi~ ` ~_lI%./I , ~ i.,l~*,~• ~ f% / i~ 7iI ~ SE~. AItD ; - ~JF 4TC C~VSE $T11tiNG T~ ~ ~5 A COMSEOU E OF V DE~T= p~aTH j TNE ~NDEAL~~NG UUSf ~ ~ST ~~t) • •es n~~ ~r~.e+<:v~' 30 F Rt 1{ OTMfR SKaN1~IC T COM017~,~.+~5- .•r.~,:•+c.v n.~. r~ . :.a~..~-.. s s-... ...r }i ~ r,n. n~.nr.~c r:~. 32• ~Q~";~ 32~ ~ 4 ` r ~ . .,,y. ,/.xx• ~ ~~~:V ~+DtN~• t+5:•s~~1~.`a.., , ~ / /~.t~i~'j' /Fi~-r. r a k4 ~~.f.JGr k T f! ~ s ~c.~ ~ ~ ~ ~ ~,.-,L I c kt fiil ~~t' ; X SFEI ti ~ ~(c:U(Ir~~_~ .rGF ~ .~CA~ 3~ RACE M,~.~ LIt =te.. _ . ~3~ ~Y':~+. a• A - , _ 7~Ti i {Y:'~..Ar - ~ ~r r~~ ~ 36~ HWR ~ • c ! I - ~ 'i ~v 37• Vi.AfF 6i INi~JRY ,n~cn a~~ ~vrur o~ ~x~sr_+ ~~c ~ n ~ I3,-e , ' ' . • .s 39 !~i.~ ~.~c+.•a.. -~s.~ - ii'J ~ . . r-~..:..;~~vr~~. . ..w~.y..cr-•.. .~~~RMATtON - - ~ - r., _ _ . . . _ , 10 DESCR16E MOw ~IUA~ .7~"UPREC ~v~..r. v~ . ~ . . . . . . . . . . - _ .i ~ s - - - ~1 ` REGiATRkR ~ t 60~~ ~'~f . _ _ - ~F. , . . z .F ; ~ _ ~ ~ ~-'~r .y-~ u,.,:~a.£';