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HomeMy WebLinkAbout0305 I . ~ ; ~ i ~ . ~ ~ - ~9 ~ i~ ~u°cii couN~ ~~i~. - ~ ~ . ~~EPK i~:cui ~a~RT NOX COLlNTY HEALTH ~~EPARTMENT RfCtfR~ Y~R'r'EQ T[NN[![t Ot~AwTM[NT oI M!l110 NtALtM I:D~RRATINO ocfi t~ ~ t~ ~~a KNOXWLLE, TENNESSEE 37917 ~9~~~ CERTIFICATE ~F DEATH 1556-1974 ~ ; . TENNESSEE DEtARTMEMT OI~ N1~L~C NEALTM ~t No. ~ ~ VITAL RECOROS EN rtore~utf D6cf/?sEO - MAME nK~ ¦M.u . , w. ~ a?Tt oF otwm u~w.r. w.,..n D FIIED. leonidas 0'Entrecasteaux I~lord, Sr.. ~ June 27, 1971+ ~ ~1 IN ?EtMM ~~^u~IL wsq. wr~rt~ ~wMar. SEi wGE - ua K ~~aw~ wr ON! Of W1N ~romM. w n~n ~R lIACK INK. „c. ~fnc~ni ~1;t! ~ C ~q,~ Sb. ros. swK row~ r~b ~~Jfle _ 1916 ~ tOUNTR Of OEnn~ C~iY 10wM. OR t0[wtWN OF OEwiN ~.sa~ ati urm HOS?ITAI Ot OiHE~ INSiiTIJiION - NAMf ancur ru M w~ as wot n ar~. s~n f~~ wiw wwta Knox Knoxvi 11 e k. No ~a. Uni ve~s ~ t Hosp i ta i - . - S1ATE Of ~1l1N 11~ ~~M Y.f.A.. ClT12EN Oi ~MNA1 C011NitY W1lt1E0. MEVER MARtlEO, fYt1/11~ING SfOYSE ~r t~M, sa~ r~we~ ww~D l•4JA~ ~~s~wwct toMran Mn00~ME0. WY~OlCEO unusn -~~.t ~~W~. Tennessee USA a.Married Kathryn Greene LitiD. 1? ~AIM occe.a~ ir fOdAt fECUt~IY M1rw~Et tEMCE ~w wu~e~ waat tK1lAlC~CY~wTqN ~an a~ao~.wa ~ow~ wu~s tlNp OF WSI i,s.nv+~or. snt IfMtM ~A W Mttf M LtiKQ rOU w~wnN YH. ~~fr quan <<S~L~M« .~e«. 415-44-0889 W41 11 Jud e ~w. Knox Count CIIY, TOWN, OR LOCAiION ~wiNt t~n ur~ri SiIEET NtD NYY~E! •~~~:i~o~. ~IDEl1CE-S1AIE. COUMt? ' tsMC~~~ t~f w MOI Tennes see ,.b. Knox- ~k. Knoxvi 11 e~ , No 6012 A ache' Tra i fATHER - NAMf MOTHER - IKAIDEN NAME iNfORM/1NT - NAME • ~wuMG MOtEu , . . . • ,S. Roscoc 1~1ord, Sr. .kanette Reeder Mrs. Kath~ n G. I~lord - see 14e lt. rwei • OEwtN wws GuSEO ttf: (ENffR ONLY ONE CAUSf lER UHE fOR (e1. (61. a~d (e)~ ~ we "U~ ~rw~s.~ ; - ~r~~M~l! C~M! . ~ - . I` ~ ~ I((( ~0~ ~ p . . . . . ~tM t0. w{ /1 COrtWwKl p. _ . . . _ . , . . _ _ . . . . _ F ~ CoNDit10NS. 1f A/tY, (b ~ 1KHICM 6AYE tISE i0 • . IMYEOU?iE UUSf (o), ~ q, o~ At w to.Ypw.ct of: ~ STATUIG iNf YNOEt _ tTIM6 CAYSE lAfi `e? /ARt 11. QTME~ SiGN~iKJ1NT tOND1T10NS: co.n~rwws cw~uw~us ro ~urM w~ wr uw~ w cww unr ~r ~Att 1 Io) AYTO?SY /f TEf w[~i ~us~w~f tOF . - nb Oa rp1 pwM tM MU~rer~rs ew~ W ~fAfM ACCIDEIIi. SVICIDE. NOYKIDE. OATE OF IIUYtY ~rwtM, MT. trW~ IiOlit NOM/ lWYIY OCCYttEO ~erfEa Mwtv~[ p ~~rt? u iwtf ~ o~ ?wat n. mr ~a Ot UNDEtEtrtwEO w~utT N •'vR ufDlUt _LUt i N6 CER- 1~uutT wT woK ~tACE Of ~MJUtt w~ ~wrt, rur, mir, r~on. toUtWM ~siun w a1.~. ~o., cm w tan, nwro COAA?tEfE anu~ rao~ ra ossK~ ~us~ tx. es?wm • . - :'Ul CEli1Fl- 30~. 11: 72 HOURS. tHYSKWI - CEtT1i1G?TION S16N~ATUsRF wcMi DATE SK.NEO ~rom{, Mr, ruar -.*~hTUIE UM~ 1-w7i~rN! twi MCWY A1M NAfM OCCYYN ~ l > n i E 6. w~ rMe ructi ow Tw we, un. to na wu w ~ 3 ~ . ri [ro~ae~st. wt ~O tMl twuRM~ tt~ts. tie. ~ ~EDKAI EXI?K~NEt - CElTIfiCAiION ~~fu GATE 1~6NE0 ~rartr, M~, ~uu t,r E'~OED ~Y Ow tKE uWt O~ tM! Ct~r~rwitOM p tW q~f ~MI • u T r; O R 1 Z E 0 0~ rwc ~..ims.noM. n rr on¦w~, aw+M oc- . Sww w nu ~..n we ~o ~w ewrsero nuu. v HERE 1ib• f E7 oRl OR TO ~ERTIFiER - NAMF ~nn o~ n~rn twuN6 wDOtEii s*.~u o~ u~..a u** w ~an ++Ne ar af ~~Y n,. F.L.Rawson M.D. as. 1928 Alcoa Hi h~ v - URRIER Ot u. SiAiE. ~ut1At, ctEW?iWM. iEYOYJLL oATE ~.o¦*¦. ~wr. rw~ CEMETERT OR tREMATORY-NAMf tOGT~ON cm o~ ~aw s*uE . s"a Burial Ks. 6/29/1974 Hi hland Mem. ~+a. Kn xvi 11 Tenn. WNE .s~~en o~ u~: ~eo„ e~n a rw~, nw*~ an R - 516NA ~ ueenc~ ~oua RS , o , Inc.-Knoxvi 11 e Tenn.37920 ~ ~ ~ . . o,, ~ • ~S/'~ . • r r ~ • .:"~I ~ ~ ' ~ -I'11 • i}' • . ~ ~ i-:~ ~~,1~` ~ r i ~ ~'i;r~ ~ i~• ~ + ~ ..~t-'~-"~~d ~~l~~;~ i .jj = "'+s,t~-~~ ~ . n+ r_- ~ . r • ~ :~F~a~ to~ '~:;tf`a~ the above i s a true and correct copy of the record f i 1 ed wi th the ~,~~4ss f ~ Public Nealth, Yital Records, by the Local Health Departrnent. : ~ c~~~~'~-~ =Th'~,s~is''v~~~,t~,i+~;~fi'en the seai-of the issuing Local.Health Department is af xed. i~~r,', j,Q' I' c x+` Lc,''. , . /jlf111f1i~~~ ~ . f p Di r or nd Reg r r bOQIt ~~3t~ • _ _ _ _ . ~y ' I~ ~ ~ ~x> " . "`2 ~ r ~~W"~`~ r~ . ~ N~'~. ,w, . 3 'sS- ~ _ `~~E..t- ~~:-'~.~,.z_`'a-~'~_`,. _ ' ~ ' . _ ~ ~