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Home My WebLink About2607 iZ~3~iL CERTIFf~ATE OF ~EATH ~•~Ti ~ tF ti~..yBFR •.l!4i ~•1~.~ GEPaFFMtHT GF i.~~~ It~ H: 1i ! • ~ ' • - . . _ . _ . ' . - . ~ . - L N1111. ~~i OFCEASCG ~~~'+~•+.a~t'!~ r•.r,~t rlr ~a,t ~wk ~ ~ T,~ UAS! ~i Dt~1~1 r . .c . ~ I 1 ~ T~:~tGING ~ L:E Octo~er 14, i~69 ; 6:? )Q_~ ) ~tX / CQIGN <~k N?:E S O;k~Nf•~ ACE ; - ~J..• ' 6 U11TE Of 81R(H~-- 7 A'vk . . . ~ ~u• I r~.., r~„~,rS - i_ _S M.ale cauc yorw.3y 74 ~ _ . ~ l1FNT , H hANE ANO BiAtMPLACE ~F iATNER 9 NaDEN NAME AHD BIRTHP~ACE Oi MOIHER ^ alAp` I John Lee. .Ior~.ray Ssra i:or~?ay --`L- hl ('iT12fN Of AHAT CO~~NTRt It SOCIAI SECURIIY NtiMBtR 12 r.ow+[u ~c~uu~~~[o •~o~~~o !3 NAYE OF SURYt\1NG Si'pUSE r..~e ~v :..-,~v?~~• 086 12 8380 ~.^•:~~arridd Anns i+ga .S.A. t~ tAST OCCUP+~TION 15 "~'x"';;"' • ~6 na~c os Usr Esr:or~v~ ~urc4Nr op }:FV 17 ~iND OF ~tiLU51RY O4 d!,S~kESS .v. nr. hi s Ca tain 28 U:JK Transporta*ion ~ t8. VIACE O~ DEAM-N~IIE O~ MOSFITA~ OR OIhER W P~TIENI ?a: ~.rtr ~18~ SIREET ADDRE55-~srrca~ aw vc.rne ~au,w ~~~s, ~-.~y :w,,s . _ . A'-t Antelo Va:le Hos ital ~ ~6:?0 W~st Ave J oF _ _ -`,r 8; . - Ji ATN 18o CIT~ AR ~OWN ~t6i CpUNT~ ~1Qr . I.ancaster ; i.os Angeles ~ 17 , ~ ' 17. i~~~p~ 19? USUAL RESIOENCE-S1REEt ~ppe~ss :a•~n ti~n su~K~ o~ -v• ~~9r ~h~DF U~+ CoAPOMiE UYitS 20 NAME AND kAIUNG ADG~ 55 OF !h~ORMAVT 1. Sif. ,s~ ~j1 ,:1 Rl~ ~E.:,iDENCE ~ r ~ .x~„„~,., 404 l~orth 12st 5treet ~1est ' , Yes anna Lee ~ • z~ [~iu 19c CITV OR TOtYN it9a COUHTY ~t9~ S1ATE ~ j'~~j~ l~ ~zth S~ j~~ ~ e N~o~c Palmdale ~ Los An %eles ;California i'aLnd~le~ Calif ,.,y. 21~ CORGNER ~:U PHYSiC1AN .,a - ~ •.•~p 2k o 5°~r~h Jtr c~+x s .w_ _.~ii..~ ~~21: D~TE S~~NEO ~ ~'~'IAN' r , i . . ~ ~ . ...,o _ « . . . . . i.. RJ~QCT~J %~jt~ ~ ~ ~S/69. 5 ~;.~.-~rya~ v ..i-e ie:.~v ~~.c Y'SO~I 3~~y 17D1lR6S i - :.ORpNER'S . . . , ~ i ''i~ ~CAT10N . . _ . . _ . ~ A:.(:R[S., ' - , . M, , ?o/~y/69 ~~/~Y/69 / e/~y/69 1 14 n'sst ~ve J. Lancaster Ca ~~'1~ ' YERAL HZ~'{~+„~;.~ "i~' `~~"'s..rz ~22~ DATE .'3 hAMF GF CEMETERY.CR CREMATORV 4 EMBALNER ~ 51GhA~~R£ ar r.o~ r~~r~c t~CiNSE NJYAEf1 ^atip R 3urial _~i0 1 6 _ esert Lawn I`.emsr3al Par ,_J~aL 25 VaNE M iJKEP~I D~RF" ~:.i :.~?[+s~+ v.T;x. ~s wcn. 26 _ ~ . 2? ~L REQISjRARyi~ 2B • • ~ • - ' ~.rRaR ~ha 1 of the Valle~ ,:ortuar ~ ~ ~ ~ • ~ ~ =%-'C ~ ~~;T 1 ~ 29 ~ART 1 DF~T~ WAS CAt'SED At ~ t4iER GVL'! ~)\f '~~AUSE KR UNE FCR A R atiD C vrEJ~i~t~/ L /s ~A~ ~'+C~7 • I ~ ~ A ~ A ~'rL.~ ~ / • 4 4 ~1~~ _ J . l__ a?PR07~~ /~7) t?C r,R ~i ~!::~SEGUE'EF Of w :NT'ERYl1L ~ ~ :.AU,E '.,Y.`~~~-!~S :i AK~ e~~~-" 9EraEEh ~ ::arE R'SE tn fME ~Y4FJ. ~'J8/~~~. O\SF1 M9 - . ~}F tiE .'4JSF ~a. :fA:~Y; _ ' _ . GEATH ~'hCiRL°~hi, CiL~~ y~E TU GR ~S • CO'•SEJ':EV_i O' DF~TM - 30 PJ1R~ 11 ~XMER S~u9;cK~qNT ~rOADl~~tG~.S/~- ..c • . . . . . ..i. -..u. . 31 o.tu.~ ~ ~~.sa.-a... w~c:» ~l~ T32i ~ .w u•i w:v~r.y/~~ ~ .nc+~c. - ~~?17~/OC.rY'~• C/1!'Qy~'~/J~7'7 ~ ~ ~,owa~.• t~.t~oei_• v~: . ~ ' w' ~'~'l U ~ps ~ g ' 33 Si•E:.IFY ~o_,c•~* ~~.u~t az »^r _ 34 -~a_•_ qf ;,i• . 35 Ifif T MO ~ ? O~iE vi :A1upv- + ..a~ ~ 3oa ia~.1R ~ • ~ ~ r '.~i.1K ~ - . P~lif~ OF il~lluRY is(RFtG 4\^. M;JOiY'R V? :~X~K/~ 11fJ i:r..-.~ rn~v.. - y7~ : . 38 , . . ~u'~.., . ..e :t9 . .v..~v. ~ . . ~ i • . _ . . " - ,-;,a.uari~rv ~ , .~,FS a0 r[v. rnee NaH ~!~~car oax ;e~to , ~ ra... . w . „ . , „ . . ~ K ~,.~..e 'i ~.rarE " e c o E ~ ~ ;iSTRAR C~; ~ ' M+ • ~ s~ .e.. vc i i f ! FilEO t,4_~ ~ECuitDED St. LU~i= =~~3NjY FLA. ROL:.^ ~JITR~S ~v~ ' Ct.EnK E. ~UIj COURZ ; ' aFr,~a~. !~~EO~~ . ~ ~RCao~~ ?~io NoV I~I i i 37 AH'73 ' i Legibility of writing, typing ; ` or printing unsatigfactor~' in ~ a thiq document for microfilming.` 268362 ~ ~ 1AU1~,#J~ 6~ ~K : ~ ~ .