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HomeMy WebLinkAbout2760 f CER7IFICATE OF DcATH 25'7992 ~ ,v CONN. STATE DEPT. OF MEALTN ~ ~F.:F~SiO-hA4E t~wst r:axc usr ~ SEX T' ; ~ , _ Edward Howarn Keeler _ :~:ale _ ~=f ~_L=_a _ DAiE Oi B;FTN ~r0+t«. W~. ~UW i P.ACE- w.~7E. wE4~O.~r[wJ~. ~ AGE- Jsi N=[N f~[i~._ u.-[w'_ OA:E G" ~iA:r~ r.~r.. rU~, ~ i 1 i~?~~. ETC tYEGnI ~~.11TwW~ (~F~RTI YDS ~ Or~S MCA.~S Jr:ti ~ ~O~.~o~er 18,1906` ~ _iti'hitP ~ ~ hs ~ ~x ~ July _I~ 1972 + - • - - ' . i GJvA:Y OF DiAiN ' TOKN OP DEATH ' HOS~TAL OR OTMER INSTITUTIQK- y~t dt wGi ~+c~r..a~. b..[ i:ai:r ~rp ~ v5[a. ~ ~ ' E~irzield- st~ford____-~~ -St__Jflseah' s_Y,osnital- - J ! G:TY i rATE Of BiRTM fCO.Nry. d~wl US.1 I GTIZEN OF (CM.iMry1 : MA~itE3. hE'JER NARRIiJ. K1D(?W[D. ~ UST S~vi~SE ~~l ~,fe. y~i~ na..-rn r.~~~~ ~ ; i D~vORCCD. IEGAIIY SEV~aAiEO , ~ ~ , ; ~ ~M' lY--~al~to i.._D~rier~. COnnec- _ i_ C4t----- USA--- rr c'c3 } • Sin:jAL SECURITY hUMBFR ~ uSUwL CGCUVAT~pv a..o a wowa oa.c a,~+a rosr os ~ K~wD OF 8u5~tiE55 Ow :~~uS:~v . ~ ..1 ~ AON1~1~7 ~uE. [VEM Ii 1~[T~ilE.~l . 1 . ~ 1 ~ ~•-0_~',~=9_7--8240A (Ret") Printer ~ ____Cond~~yas~Pu~licGtio~ - RE9.7FtiCe-5!ATE ~ GOUNTY ~ TOWN : STREE7 ANG hWJo~R . i ' " . ~ . . ~ ~ . i I='--Co;~necti.cu~: ~M __Fai~fi~ld ~~xs. hor~a].?~~~-.197 Connsct~~ti~_Auenu~ i ~ ~ W~S CECfA$FD ~ VETEHAN7 li YES. G~VE WM , uN:T OA S+~:o ~ , ~ f-:\i~~1 ~ES Oi ~ii0/. . . ~O ,y ~ ; ' E iNi 40TliEfl-4A.Oih AAYE ~•K.t r.=o.a ' ~ ' F/?inE4 = hA=!F r..,r Y~ca~ ' ~ • „ C:~arles Keeler ' Susan Bo~rlirc ~ - . - J 1hiQAYMi-NAYE : MAIIINC- AD'J~iESS ~Si~E~ O~ wr D w0. Gn Gw rGww. Si~i[. I.a: ~"'R"-r 'y.~~, ~ ~ E . ; : , , r., . PiWT L JEwTH WAS G/~uSED 6V: ~`chTEH ONLY ONE CJWSE PeR LtNE FOA i~). WI. ~ k) w~?~o~.r~r ~::o..i ~c:wt[• ~ ~ ~ : c~ r. "irEO""` ' ST. lttC1E COU TY flA. - ~ - L•'~'~~'~`4 ROCE~t PBiTRAS ~ . t nAI~~T .A - ~ F Otif i0. OA AS 11 CQniEp.[~CE f/: . ~~.:.ws , ! • ftECORO ittF:It~EO__..=- ' ' ^a~[ I~~Si r0 i YEP~ti , 7~\~•Z~~~ J ~l~~,.L~•L'J . UuSE lu. ST~T~wO Twf ~ / ~ - ' ~ ~v.^,i14n~ CwSF lAST - ~ , - \ ; ~ 01~E ,0.~ - WMSEG.fMGf a ~ y ~ ~ • - - - ~ - E / i ~j~i~ ` _ ~ ~ P~AT OTN~R $IGH~FfC~`1T GGhDii~ONS' CO~D~i~Mi Cd.i~aWi~wO TO Ce~M W7 WT ~fu~TEO *O C~.iS[ G~ri~. r~~r AUiO?SV ~ cF rE5 wc.e s,..,+..: .;,+s.~~ncn ~ `1 ~ . / " % / ' . trr. Ge w0. ~Etcar v.w C~.:[ ts c. ~ 7 v . ~ - ~ ~ . -_-t`/2-~'''~ '~v"~ .i~ . _ _ _ MO'W INIUNY OCCUfiRiO .E~Tie w~t„~E O~ :w..,a~ l\.~..nY :.T :.i,~4 ~ - ~ ACC+DEAT. ~i~G~E. MO~:iC+6E. DAT~ OF lw,NJRY ;rowsw. rv. rtu: ~?40UR ~ ~ ~j a ; GR UhJ=TEFM:hED tYEUrn-; . ?~~i ~~ai ~.-~-Er-1. =.~:.s~ •-c_ = 1R. n. xa `ec ~ - ~ ' ~_ACE GF ~ti:~nY •T wCYE ~~FY SiwFEt IOCAi~ON ~ST11fET 00IIiD ti0. Giv p1 iOwu. Siwi[~ ,~SU.7GERV RELEVAI+T i0 GG!.~•~~60 REDG~ c ' c" :i ~ 1~5 ' f~_T"vAr Cli~CF 0.DG. FT~: IY'fC!f~~ r.1Y~^'I M~~ •~•.Mf x"~.~~0. fi:'~3 - ' he ' xo .`r:'. .r ~ J : ~ _ f 1(1 GEai.c.c~:~o~-aMrs~uwn: ~.oNr~ a.• r[•~ ~ Y.:ATw ow~ I~E~~ u~0 ~w:i Yw n.v:~E~ ~i~~E Oti piATH OGG..r+F~D cw ~ ~ ~ Y,wiM W? ~E~~1 inJa,~. aiS: ~i Y c:A:F sJ ~Ifti~"' / ' .-1 ~ j1 i r'v s-i ~,c,a i ~•FJ `i ' ~ id. ~ ~TTi\:.iJ irE ~~Lwt ~ L' ~ , • V k5~_ :E~E~.;F~ ~~GY ~ ~ ~7tw J ' ~lc - / _ ' : = i , '~-t.-,`. ~ ~ - - - - - - - . C".RT.:iCATtO~-MED:C1~l EXAA!~ihEA~ i~ r~ C~~~:O~+. Gw Tr~f D~T[ wwD HWR Ot Of~Ty TwE OECFAE~T ~~S ~~O~.OU~=ED i.E~D 's:F TO TwF (J~uH~i, ST~TFJ JE~Tn wE5K1ED Oh M UOi:t YGwTw J.~? rE~~ ~'A• ' ~ I i7• w. Tl~ . . _ w r` ~ . / . . ~ CERT~F:ER - NANE ;t.?t v~ ~r. ~ 57G!~IITUAE ~ OEG~FE M T.i~E ~..3 - - ' t L ~ ~ - l . . . • ~ i /j ~ . 1,; . 1~ . , ; :>.-----s~d~.?._oz~~mer~,...p. . ~ - - ,x~, . ~ reA~UhG ~DJaESS-GE.IT~F~ER s*at[t M ~so no ur. v+rowr 5'.rt z~a JATE SGtiED ....n. _ •f•+ 7 . 19? ~ 555 Ne~..fie~~ Ave. c'-a*^~~r~ ~.,T^ Jul~ i % ~ _ ~ 6~R~AL GacM~T:On.. REMOVAI CEMETERY OR CREMATOi~Y-YANE - IOCAT~pN a*. ew rcwv s'+'i . - ~~i . - ~~r.,Buri.al. - - - . - :y -Fairf.ielcl_1'Kem_Park--" Sta~r.fo.~a, Cor. :ecLi~u~ ~ .7A~i ~rf~~'~ :~r •f~~~ ~ F1~NcRAI M011E-NAYE AND A~70AE53 f5sw(Ei p~ ~sp wo. Ut• W*Uwr S:~rE. 7~s~ l~ ~ ^ ~ ~ July _ 19 ,1972L: __~allaghez--6~- Son_20_ _Suburban- -Auer-Sta :.`_o~ c , Co -i. : FUhc~tl..~O~.~ECTQR OR E!lt7~AlYER- GNATU/R"'~ MA~E OF E4BA:YEA ~s sJJr w~5 Ev9w;rEJ l:C~\:,: . ~ ~ ` ~ /`J`Gi'..t~r-v Robinson J. Dorion 17~9 ~ ;h~s : ~~G~r~ a v- cop~ a+ er , ' .~~5~~ . y 4 , 7 / ar. ~ ~ ~ ~ ~~J ; r~ / ~ /L L s .C'-- ~7~ ~ _ _ ' ~ l/ / L / c~? 7 ~ . : r ~ ~ r ~ ` ' - ~ ; : ~ _ ' ~