Loading...
HomeMy WebLinkAbout0796 , ~ ~ . - _ n,. ' ~ ' , _ . ~ ~ ' ~ ~ ' :EASEY STA'fE UEVAMTMfNI 01 MfAL~N ~ • ~ i ~ ~ot~~r~~eNUwc~ CERTIFICATE Of DEATH sr.rEnuHUwu~ i;'•,,~ ...,..~_.:.,.Y.~.~~....~.. ~ tr~c[s 1• NAME~F fFn~n iNidulrl ~lorrl G~ DATE.OFDhATH R:O~ ~G~ f~ECEASED ~T~rr u~e ~ryN o, v~~~u i r ~ ~ ~l~G! l. Cob~ a R~re 1. Ap lin yri. If und~r l Yr. If undn :1 Hn. 6, Dr~ d NueA 1. Vu dten~ed enr in II,$, A1~d Fprte~~ fY~~, ~o, a ~n~~l (l~ rn. ~iw ro e~ /a~e~ o~ ~nvJ I~ar bnrllryl Muei~~ ~y~ o~r~ Mie, k~ White ~ ~ . 1~ l~I~ce fSt~h a 1urr~p ~anuyJ 9. C~uxr~ d•hu covnny> io. ~,~a ~ N.«~~e L~i. Socul S~turiiy No. , ~~~1:' R S8 8 r ~dc~rdC.l ul.mo.a(;,~ • ~ ~[sio~~et 1:. PLACE OF DF.ATH • USUAL RFSmF.NCE (U ionitwir~: rndext befan ~f~1iM) CwMY S~we ~.._~at 1. Counrv II.~.. K~ 8~...._.__.__. • oa~ . ~a p. Q~y ~~ICAetk bm ~nd ~in n~me1 c, City IGMcY hoe uid ~i'vt ir~el ~ e«°~~ Teaneck T~°`~ P li de P rk M*~ ~ ~ c. ~nw o no~ m wpuZo~r m~ututaa ~ia ut-~i~ d Sueee ~Wdteu (If nra, P,O. Addrc~d ~ p~~, ' ~j Ho+pal a ' ~O ~ Munui~on ~ _ S 1, a Wwl cup~i~nn Lirr L o~ wnr ,N~ n~j nwr o rorl~n~ Ir~~, r~r~ i) nnrr I 11, D, Ki BWIMI! d MOY/IfY 1 ~i ~I ' y'[!~ Hn~e~rife ~O °`''p°~° n IS, ulur'i N~na 1C. Maher'~ N~idtn N~mr N V.n~~ n - ~ ' w~ n ~ ~*n- C t~' ~N~ . '.p~ ~ l~. Ida~~'~ N~e ~nd Addr~i~ ~ ~ .~j ~ P k J ~u IA. PART I DIATH ~AS C.11:~E0 NY E~u~~ u~lr aw rnu hr In~ ~a hl 11i ~ lr) A~prai~e ~Ma~J ber.n{~ ~ ~ , . an~ nd ItuY , ~ r+~ Im~edim Cww (~1 +~,.~r. t:o./~~~o~i. ~ey, Wbu6 ~'UZ] Yi,r. y ~~y/ 1111 IO IbOV1 f1Yff Aue w ~61 ~.~fis~ " r. "r~r'. ,ur~~R ~e. ~r.~• c.~~~~.M, <o~. r>~nt c.~,e fuu Uue eo IU ~ •~lin~ N Ali~h ~ 1~~ ~.i ,.i~r~e PAP1 II OTHEA SIl~51F1~ ANi f ONpITI~)ti~ I^~. iu ~wup+y I~h. II yu, rt~e find n~~ eon~idend perfonard~ in detennininR c~uae d denM aw~. _ r~~ tio, r~. ~7 :ao ~.~.ct or :p~. ,~ctiden~ ~wade Hom~aJe .Ob. U~« ~nd Har of In~ury luc. Har In~wy lk~uercd f~ nrn naimr o~ rn;ury i~ P~r~ t v N o~ h~~ INl ,rriolr+ ~ r_~ a i~ rbr b~~r u~ ~IY ~nrnYrf~ I A~ ~ :Qi. In~u~y (kcwrcd :Oe, pi~re ol In~wy h~~n a~bo~r 6u~nr, 2QI, Ciiy, Torn a Lnu~ion ( ounty Sutt , Mile u(~~ Fa'~M1~ile 'arw. (a<tory, fh~rf, o~Jirr AIJ~ . N~ ~ lork n ~ork , , uot+ c.~~s. 2L I(~ttrnded, t~un~ntdl t~t dece~~ed ~Irom, an) ~ ro '~nd lui uv Ihie, her) din on ~ _yf~~ ' y ~ , O~ar/ or, ~ni/ ~t m ue t6r d~u ~ iatr! a6nvr; n~d ro r6~ b?u o~ ~ny ~~~jt;'~(uA~ Muf ~mrrl i~~Cr 21~. 4~~endinF V~y~. Med. F' C~um Ph ~ 22b. AJdr ~••ti. ;2r. ' ~ I r r(~ , t~' 4~, ,,,,~r Due S~Rn~d ''R ~ ' i~ ' ~ ~ / 1 E I r ~iRnnurt 'd' 1 " ~l' :1~ hwid, ~ fem ~on, emor~l 24E. Cem~iery a ~rem~~ary N~m~, • 2~p~, K~on City ~tu~ ~~p~~~~,, ~ ~ ~ . ' P~amus New Jers~e~ ~ f I1J Nund D~i~ AM, U~r 1'r. 21~. Funen Nome N~me ' 1 ~ •,11b Y~M: ~ 1- - tCe n-Musibmit~ ~r at'~ ckensack New Jersey :i~. Funerd Uii~c~a ti~~;n~ue N, J, Licrn~e No, 4RI~~Cif Rt~I1G - Sisn~aure tSb, D+rc Rn'd, !y Loed ~ , s; ~ ~ ~ ~`~j"~ 19 2690 0 71 i,w.„ y SI . . » ' ~Y'~' 1*~ , ~ . ~