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HomeMy WebLinkAbout1259 '~s3~z ~~r+wl~Z'.~Yr. . . . . . ~i" r ~Yi.~ ~ T ,a` ~.f. CERT~~IC~E ~ ~EATH / ~ r 8:/~ ~ } ~ OfCI/1SE0-NM~[ r~e ~~s~ ~1 OAIf OF OfATN ~ rOMrw, 0~~, ~~w~ ~ 3 v ~ t''u?Y SHAW : Female , December 18, 1972 Re W fIICE wre. reow. uuuc~w ~«ouN, wGE-~.~~ uwu u.at~ ~ o.. OAtE Oi ~IlM ~.w..n~, w~. COUNTr OF OEwTM ~ ~ ~ tit. 1~?tCwl ~~niro~ti ~ib~s~ rpf. Wrf w~O~~s rw. H zi o~ . White 77 - w s, ~ Nov. 26, 1895 Washtenaw ~ ~ , VILLI1Gf, OR T04NNSHIP OF DEAI H b.siot c~~ ~ru» NpSM1Al OR O~MER NSTtiUTiON-IJ.tMf tu wpt e+~wee, c~e sm~~ ue ww~~ i ~ ~ srtcur ns o~ ..o a ~ ~ ~ y nAnn Arbor Yes St. Jase h Mercy Hospital , ; ~ ~ M ST~TE OF WTN 11~ M01 IN Y.f N.w CITIZEM pf WHA~ C041N1l11 MARRlEO, i/EYER MARtlEO, SlltYlvNG SI'OUSE ~u vrNe, pne r~,p~M Myy ~ e cow+ns ? ' f-. ~ H- wioow[o. avoRCCO ~s..cM.~ s Michi~an • USA Married Arthur G, Shaw ; ~ r~ Sp~W SECUR(T1f MMNER . USUwt OCCU?At10N ~oM a.ro or wo~e ooNe ouu..e uos~ or KWp pF NJ~I~u pR ~p~pUSTII~ ~ `+O~arRi uq, ~vU/ N lt~~~lD 1' ~ ~ ~ u 365-2b-2292 Housewife At Home ' },Q,q e E,~j, ? RESIOENCE-S1ATE COUNir tITY, VILIAGE OR TOWNS111P cm iW~n SiREEi ANO NW~t~ER ~ - ~s?ecur .~s o~ No~ : ~ ~ ~ ~ :e~ Michi ~an ~o. Washtenaw ,k Northfield~ : - - No - ,~.87-7$ Main St.- ? p iATMER-NUUE r~n~ .roae us~ M?OIMER-wurOfn ?~M+E ~rs~ r~oat us~ i a°^'-~- ~ 3~'~~ Wilmont Haines Ida St . Clair ~ . I N F O t M A l ~ T- N M~ E wtAlwG ADDRESS uneer oe e r.o. w.. ur~ oa rowr., u.n, er~ ~ 1 . ~~,,,Arthur G. Shaw 8778 Main St., Whitmore Lake, Michigan 48189 (j a A ?ART L p[pm WAS UUSEO bT jEHIfR ONiY Ul~ CAUSf IfR tWE fOR ~o~. (b~ AND (~H ~?nou.u n. a~ ~ 1~. r..uoun c.u~ nnraM oMSti w.a a.m p. NQ~G ~ f~ A P' S{ (°I t~. . Z~i'-wh " ~ , .s , owuou~ e u.- 1 ~ COM~~IIOMS. U ~N?, I ~ ~ rw~eM o~ve ~nt w (pl ~~•~f~~~C. ~ ~ IrrtOUl! CAYff t0~. ~ ~o, o~ .s . co~uwe..c~ a: . ft•uwa rwe uNOU- p~ ~ u~NO e•use i•s~ ~ ~ 4 kl t ~ MRT M. OTNER SK,NKKAN? COFIOITION$: twano•n cwn~uur~.w ~o u~w ~ur ..pr ~tune ro u~ ~ IRf p MOI YOt~l~ ~N OtttlMlMf p Ol~tM d ~ I10 11~ ~ A[pDEM. StIKIDE. HOJ~IICIOE. DATE OF W1URll ~..o.+~w. ow~, •i~~~ MOIM HOW INIURY OCCYR~EO ~ e~~ wtu~! W ~w~un ~w r~tt ~ O~ ~~d w, ~wr !-~.f~ ' ~sncm~ . ,h 2 w.. r. M ~a ~ , INRMr AT WaR1C IIACE Of NlUlT wOr[, ~~tr, s~an, unorr, ~p~AtiON ~ snee~ o~ a.r.o. rq., an o~ ro.n+, sua ~ ~ w ~ 1 f~ldff f!f W NOI pIK[ ~tOG.. tK. ~ frKar i . . . ~ ~ ~ N ~RTIFI~ATIQ1d- rOwiM 0~7 ~t~t A~~: ~ i~ 'N~D u~Si Lw ww/Nt~ ~lM OM ~ 04/oW ?~Ot ntW dt OEA~M OCCYRtEO wt b! ?IwCl, p» pl! M i?NTSK mwoeo twe TO i, r~o.~w owr nw~ ~oo~ uu~ otwa~. ~wu~~ wa, u+o, w+Mt ~esr H O~s ~ m ota.s~o no.. 6 1 '~2 1~~ ~~Z ;~T ".~2 1$ 'j~ :u. ~ did not t?S :l~j pu? ,o ~ w~O`"i `iu ~`°~i ,°~'o, . eCERTIFIG?TION-MEOKwI E7t/WiNER OR COROtrER- a1 iy . • ~we eee~w..~ .r~s na+our.c~o oeao } Y~ Vf ~ eau~r~.na+d e~e wm u+o/o. rNe w.ts~w..~a+. ~wiw• or r\ , .a+rn o~~ n.a wpv~ Gs~ N ~o~~m oeewto o.~ ~e wa .,.o oue ro n.e e~vu~s~ s+, ~tlo;. ' H r"+ . ~9 ~ i~ :2;. . J1l tt?. Et-NAME nm oa rer~r~ ~ ~ ~ E"~ Z ~1tFi ' . 1~ f4 , ow~ee a rme DAiE SIGNEO ~.w~.M. owr,rw~ + z~ John C. Nixon~ M ~ n?, t~" L' . rr~'~. 12 9 2 U~"~ MAQMG AOD~ESS-CERtIf ~/.o- un w y, ~ -rx ~Z6 N. I -,~ichi an ~+8104 ~•R M ['~1 WtlAI. C~EMATqN, REr.?OVwI C N - IOCwTtOt~ CITY, VILl/1GE, TVYP. OR COUNTY s~.n L.a H ~ a?etr~ ~ -,.t~• ~ _ _ ` ~ w _ - - r~.. Ann Arbor Michi an o~ Dec. 21~1972 ~ - Mu~ 8i~. _ pel,Inc.~40~ S 4th ~Ave;~~Ann Arbor,Mich. 48104 (O d-C ~T JP~ . teu~vco iocw? ece~sit~t ! ~ ~ tw FIlEO t,NO RECOROED ST. ~UCIE COUNTY FIA. RQGFR FA!TaAS C•LC~t ;l,=.;~iT COURT n'I P.ECCk, vL'.;~=~E~~,~ S~ T 3 4$ PM'~3 . - _ _ - _ - -----~63~22 a~~K 218 PAGE 125$ , s ~