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DlSTitICT NO. 2950 4L ~V~'~~ REGISTERED NO......~ ~ 99~.... `
Name of Deaeased $LES$ R. ROBffitTSON
Doro of Deat~+ ~cember 1Z,._.L9fi4 Sex-F~s~ o Color or Race ~ite ~
Plaae of ueotti Meadawbr~k gosgita?, ~ ga~t Mea~, Ner Ynrk - '
Usual Re:idenoe 24 SyraCUSe Street, Williston Park, Ne~ York
5'u~gk. Matrisd Nams of Husband
wiaowed or orvcrcea Marr ied tor) wHe .7nlL~± r~ -
If UIdDER i YR. If UNDER 24 HRS.
AAeiqln Oari flo~ws AAin.
~aro of Birt~+ December 5, 1905- eg~,, 59 Yean
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Birthplace Ne~.t YcSrk What C ntry4 U- s- :
UsUal OttupatiOn 80II8@W~f@ ~~~ry HOI00 '
ar Busins~~ :
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' Fathers Name Elias Mnrrp~a µ~,~'~mR Mae Valentine HoDkins ;
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( Erx in U. S. Sociol '
! Armsd Foross4 No Sswrihr No ASA-2A_7A75
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CAUSE OF DEATH: T1me of pe~• 6: 4 5 P_ M_ -
~q~. IABAR__ PNEUMONIA..
(B)~
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East Meadaw, N. Y. 11554 •
Certified by Jorqe Cerruti M,D. Addressl~adO~Tb*'~k 8~8=ita?
°f 1964
Of C~lIlk7tlfl~ 111 7.3f~if1 ~A~nrial Park ~t@ of Buria~ ~C•~er
Undertaker J~es A. Martin Fun' 1_Home,~_atddressWilliston Park _ Ne~.~ Yorlc
I do hereby certify that the above is a tronscript of o deQth record of
' ..........................................................................~+~+.5~..~,,...RQ~~S~AT....................................................................
~ as contained in the official records of the Ragistrar of Vital Statistia of the Town of Hempstead, Nassau
County, New York i~s5s5`7
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57 l.U~:'c ~ vil'1~fV fU.
,T~ as 'PD IN TESTIMONY WHEREOF, I have hereunto set m hand :
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RECORD VERiF1E0....••-+i and affixed the official seal of the Town of Het~i~tead, °
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I!r?Y 3t I 29 PM'73 fhis..... 5~ .......day of. ~~4b{~
71-.
at Hempstead, New York.... z>~ _ bc
N° 6'7440 . . . ~ _ ~
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