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HomeMy WebLinkAbout1369 , - , , . ~ ~ • y ' t~`~~ t COPY Of TH~ ' ;y OEPARtMENt. ~:t,,~~F~t,'A f~ ~ ~`y,~;~7 . t~ ' ` ' ~ R~1StRAR DAtED • ; ~J~ ~ ~ ~ ~;~lEPARTMENT OF HEALTH ~ Q"'• ~ ~,~y VIiION OF VITAL :TATISTICi f~ ~ ~w~y ~w Diw. Iiw . ` 1t~p~+w'~ _ ~ CERTIFICATE OF DEATH „~r,,, i.,, ftX DATt OR O[ATM ~ wr+. a.s. r«.~ F. MILBURN ~.Female Au t 1 74 Gt«! r~. ~ ~~l i rw w~oe¦ ~ ow~ oYu~~or a~rN ~.Wr~. Dn. COtJNtY O~ O<ATN , wa 1. S~. Sc. 7~. nN. wl1A~~. a WCATIOM q pl~TN ~~1pE C11t ~ 1~ MOiMTAI O! OT11lt 1lISTITYiWM-~NAYt ff/ ~N i~ ~il1~r. fi~e insH ~I waiM1 G',~Q ri h. e Alll oce [t Hos ital u~~ Nm~ ~Il.~r i. u.S.A.. d~i:a+ a ww?t oow+in rwu?~e~eo. p~ e~ ruen~'~ wav~v~?a srouse rU ~:I.. a~ S.A. ~o.~ai'r[e~ Frank Milburn a p~~~ ~Ee w~s oettwsEO tve~ IN V• S. AlMEO IOKlff IYa. N. w~larsl NO (X )a. Pw ~~w ~J e~wer~ ~ 29 -1 -9401 IP. I! NA1N ~t «GMwT1pM /GiM ~is~/ ~I r~?! J~iw /rri~~ ~qf . KINO p N1S1NE3= W IMO{ISt~t .vr~i.t /j1~. M+s d.wi.rll , m°?a;~ , e her s~.. E ~-+iu~e cower ~ aa. .~~?.o~ M~ow~M. ww an Nn ~rMtt w+~ Mu~~ , . ,w~o ? r Ro d ~ATMM--~NAM! Pi?u ~Ii~/rff Lsit rOTNE~--MAIOEN NuIE f isi? . 4 i I I l~ I. W ~ _ ~ Alice Ro er - tNFORMANT-NAME ~u?~t~NO noCtESS rSn~.~ R.F.Q. r~.. r:r~ «rill•~e. urN, ai?I ' • 7 At a er ~ ; autt i. OEATN wAS CAUfEp ~Y: irwrra aur au uusr rE~ UNE fOf t~). o?. ~NO w~ s~ru? ~ ~ , t • ~ 3 ~~n c~ • ~ ! ~~~litf~N. 1J M7. OYE TO. OR AS A CONSEOYENCE Oi: i rHs1 s~s~ ~lr~ - - ` OY! TO, Ot I?~ A C01/SEQUENCE O~: ibli~j t~I ~~br- . 11i~ [Il/f /~it ~ ~l?~T 11. OMEt f~GMIfICAM1 CONCrt10Ni C~~K~~~i r~uri~r~i~t q J~N6 ?r~ ~~t rdod ciant pr~~ n?~?~ I(~) AYiOK'f If TES rere'aJirp r~~ulnnl I)'~~ ~r M~r ftlrr~~~u( trr~~ ~J Iw~i ih. ~h. A~CIDEMT. fY d0E DwT ~NIY~• NO OCWf~EO /F~ur? ~~jrr) i~ ?+.t •r ?wrt !l. i:~~ !!1/ O! YMOETE~MINEO ~r~. Dr~. Yti?I 70~. tOc. INJUlT AT WO~ t Of IMIYIY i. IM~. ~nnt. f+«~ri T~ON ~Sneer R.I'.D. 1~. ~i!l+~~. i, :i~I ftN~i17 )~r M ~~St i!/~•. Nr. ISIr~i ~ CEfI~~lGtlpi- Abri Dq Y~n .N~~+~ D+) f'~+r ~WD IAST SwW N~r/NC~ ~D/OID MOi GEwiN OCCYffED .1t ~b• ? ~•t~~ MltiltlAN: Al~v! OM v~[w TxE WOY ~NOY~1 ~k lra. .r. N 1 ATTlMtlO 111! ~ ~ ~ / .M~i Wl Iwr. 'AIt~! OEwtM_ t1e ~s ~NY/Ilsf, ~M N ..cWtO MD~ - 2i~ - 3. - ~ 2i.. :~~~;.,~,s. urd. ' CHi1NfAT10M-~O~M~il~ Os lie i~iu ~l rb~ ~~siMri~~ N~rr ~1 l~+~b T~~ /~~tl~r r~i M~w~~~cr/ /r+/ ~ II fM II~~ i~/M /M f~MM1~/N~. is ~1 ~Ii~.~~, twrr~ .W~ri D~~ Y~.. H~rr ~ H[MIII N fM IN r~ JN f~ I~I fNlIIII JfI/fI. ! M. IT~. ~ 6 C!lTIf1ER--H~ IT~?~ N~?i~fJ ~ 11GNAtY~E Dtp • r Iol~ OATE 31GNE0 _ i ~ ~ 7 ~ ~T i~sr - YA1 IMC AOOlES~-Cl~il/1[t - STlEEi Ot .~.0. NO~ UT O! YIIIAGE STAiE I~~ 9304 St. Peters Church Rd. N. E. Louisville Ohio 44641 ~11t1A1. UEMAT~OM YAT! NAME Of CEM[TEtr O~ Q~T~ lOC/~i~ON I(i~~. ~ill~st. ~r r~r~I)1 fSfdfl ~s""~'~ . 3 19?4 :.~-iillside Cemeter O iM • MAME a EMM~yER lUG NO.1 fYNEU1t 0 CTD • S~ U / IUC. q0.~ ~ : - . - . ~E~ ~~y~ A~p App~u IS~fEfT NO.~ (C1it? IStI?TEI (Mi n Wood Funeral Homes, I .?03 E. Main Ravenna Ohio 4 66 ~An ~ECp ~r ~EO '3 f~G~1ATYlE • DAtE ?ElMIT ISfUEO S~GMAt OtY. Iq. u .2 is~ 1 s7o0 r. ? ~ x ~ ~ , ~ ~ F LED AND llE4~R~ED ~uc~E couM r ~ _ ~ CCf.• ~..'•tRAS CtERft C~~3~Ult CJURT ~ RcC~°D Y=p~~lEO ~ OcT I 2 ~6 pN'1~ ~ ~ ~ ~ 2~259'7 ~ OR ± ~oo~z~z ~E13ss ~ . - _ _ _ = f , ~,,~~~~,Q Y' = x ~S"~,v ~':a l„ ~ { Y~"~ ~ i ~ _ . _ ~ ~~_m..~~'~~-~~.~~.`~; ~ _ .