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HomeMy WebLinkAbout1630 _ 2'78~.f 3 ~ COMMONWEALTH OF VIWG~~~DS ~o ~ iN~~ATEcO~~c~~ H - ov~t~+r o~ ~un+-wau?u of _ - ~ ` ~2 cenrc•n .~u• . ` r~ ,etAn.no.. ,~,nY. ~ - ' - _ - v ta(A ~ l 1 ' aw~ ~/urM~ ~ - - - - - . . . - - ~ - - ~ a~.tM~V~/1~1 . ~ _ . ~ 4. _ _ ' - (Iy~11 ~~~1 ~ _ " 1~ iM~ w~a1f ~ n ac~wo ~ rsw~~ , ,,,ar~ - , - ~ ~i i+oaf ~ +t~i 4~ ~ _ - s~.: ` . = ' . ~ ~DINI ~ i o:n a _ ' a~ca.°~iw - - - - - ~ . ~ . ~ a•r¦ ~ ~ ' ~ ~pA ' j ti,w. . . ~ rn r • MIAI! U M06M4 O~ I~i+ r V~+e i ...~~1 ~ospdtal j - ` ~ > s SjM~i.bLZTiT'a~' ~t7r~m2 oc~ ot i , 2+ ;J ..rwl M NMr ~ 7 n u ~ Of ~ ~r C? ~ o~ a..« - _ - - ~ - ~lll~loy Le~te " . . . . ^ ~~s =3-- n, c a cn+ , ~y . ..vu° > ~ ~ p,:.~~~t~ ~r=---- T-- ' - f .es~•.~ p Y `~70D ' v~tl IO~ ?OM~OM C01?'1~' A~ , otct~aeos ~tsee~c~ i ~ ~ ~M A * . . ~ . " _ ~ ~ ...v . ~ . " ~7 • MI• ~'N:~1~. ~ _ ~L • MWfws 1 . r 1 , ~a. a~ ~awa ~ ~Q ~..K~ . - w, OceHn Yie.r ~v~-.,;,Q ...a , a ..y«K~ L , z ~ ~.«o~.. ~ liorfolk _ - - - - - . - ` _ - _ _ • ~ . • Y . - ~sl~y Tpl ton ~ d acu~eo _ ~Z~ . ' . , N r~~NO ~ ..~~r . otce~seo ieuM a~ • y~~.,j ~ ~tC~1 .n..r cow*n ~ o ? °,~-r ~ L l~lallLiR . ...M~• ' ~ Y00+~'~ - . . : . > L~ . ry~'i~ . . . . . . .7/ _ . ~ w vf~f~.v .e,w ~ ' 1 1~v- 1M fOn..! stcue~n ~ (/Ct• 1~ f ~ ICort?: CYm21nx _ .~,~Mr 'L25-22-16~ . . , _ - ~ 7• • wf` ,Y l V~ . . . " « ~ ~ ~ .-.a.,••- Kra. Mirs.ft, L. E.i:ncn . . ~ H~rber - - - - - . . . ` „w ~ 7~ '~JY !1r Jl~M ~.f.r ~ y....., 0~~ i ! •~n . ot.r. r~s c~.~seo s• C6[lf 1G~~ S~i![le~ RI I''nC3T.y ; ~ostatit zCKG+~ tG cio~s~i and , ....«..n : .~y • ~rotmined. F sit~ un _ ~ :v~ ~ v ISICIAM _ . ' •y . . ` . ~ ( ~+~.•~r~+ r ~ F ~ • T ..r~'~ ~ `QQ ~ ~ , y ~ iJrtiw ~ ..1 - ~ ~aJ~ .F ' .,l~., • N _ • - r. x ~ , F ' C`~V~ L.w.~~l~'~• ~ • . _ • WS~a1! Crr.O'~... 'r~t~. w ..t.~. •,M •..t.~ . ~ _ ~ ~ _ ~F•J~ ••J • IY • {~t~~w~. . •:V ' ' ~ . : J . • ~S' 7 rG "'y~ • ~ ~ FyG~~ s tatt~ ~_f..yu x. r r~( t•. f: v ~ •a s..^ J.. ~ ta._ .w . '~~'t' ~ . . " . ~ . . t~ .w y • . . ~ ' ~ • • M ~ ~ • J ~ ^w ~ _ . . _ ~ ~ . . . se . _ ~ _ - . • ^ ~~-L~ _ ` " . ~ . - ~ !1~~~ ..4MFD L~{~~ ~-:1f{~ .K~ . 7• ~ I~ • n•N~~4~' . l ~ t * ' S , ~<ru~u ~ / ~ ,__la.L_ ? . M.D ~L /i~-{~~CS~1 i V~~t.'/~ ~ -1rt~Ik,Ya~~~J - ' yCf.~tNl ~ ~ _ - . . ~ . .-e . +~..--TH nar! . - w~ .t awr~•, c n..... ~ : s Wt.~: ~ ~ p G :•t"°". Por~at Lnrr~ G~wter~r t+orfol'~ rirt .n1~ ~ Ilollort,o?~-Drvwn ~berf:l Hooe~, Ina. . . - - - - _ ~ .~..~a•...~,.•.. f ..:eeis _ ~ . t<,o. ~ ~ ~ `t_= - - - - - _ . ~osf4l~s., Yir~=~ j! i _ ~t l~ ; - .t.~M ~y _ . _ ` ~ a~wv.~ ~ R~~~'. . ~ Cf C r ' . ' ~ .G•sf~A~ - ' ^ , = _ - _ ' / ~ _ ~ F F . f . ~ : ~ B , , , ~ . ' , ~ ~tIS I S TO CI;RT:FY '1'H1?T THIS IS A TkUE AND ~vRR~~~, : ' y~ - PFtuD'~CTION ~F THE ::RIGINAL RECGKD FILE.D k i i'H i~:: ~ ,yQ •i / •'n F.~'(:Li( CITY DEPAhTNF.IdT OF HEAI.TH, NOFiFOLh, VIftG:h n~ l n; . , ~ ` ' , ~ ~ ~ ~ ~ ~ ~966 peputy Registrar ~ . `r.:.:• • Rte Issued , ' ''~,i~~~~.~~' - ~~ICAOFII3i 1i•L'~i0 ` '`t•,~ - ~ • it of writing. tYPing ~E~~~ _ Legibil y - ~r Printin~ uns~tigfRCt~r~' in '"'F-` ' . - . . : ~r ~icrofilming• } ; , , : , . , ..~-r ` .n: _ . _ - . ~ ~ ~ , • r~~~, t ~ . ~ ~y ~ 5 _e . . ~ ~ 4 S+. ~~2 ° a,~. 4