The URL can be used to link to this page

Home My WebLink About1762 ,rm~r.~Ktr~v~rx~~+masnau~w..'w~rrR~ts'cr.~iw.~++mfi~:wvum ,~w~ wur~«;u r. ..,~~.,~,~.~~~~~A~m..~....o....,. ~f .ry{p; ,`.tt _ i ,i . ..,i i....,.~l.ii~l ~"t ~ 1 Ltr'r,rl".'~fi`;f C~ 1I:f~L~H ANU ~Gl:l.Al )t~Q'JICES $(ATE DFATH If0'~ ~0~~ ~ ~ pNI,ION OF NEAIiM u~~ ~~!0 ;:.~~01 ~ ~o~ IOCAI FIIE NUMBER ORIGINAL CERTIFICATE OF DEATH o~ ins~wc~ro~ti Adn OE(USLD-NAMF F~n~ Mi001t Lau SEX D~TE Of 9E~Th hknrh Dor Ywr r~~ v~~,,~,a~~,, ~~r;t,~?t?~ r•Lt,Stti~nRTf~ 11ART 1. "•~ale ~ctaher ~1 1974 ~ ~rtrol D~RC~Of'f, d Mta~cci E~am~nfr'l/ AA(E-w~d~, Negro, Amtt~~on Indian,Elt ~?qe lCU B,rlhOay Urdcr O~e Ytot Under O~t Day DATE Nanlh Doy Y~or COURTY OF OEATN .aroner'f MandDaak Ycan Mont ~ Doy? Movrs Mm~tes °f EI~TH ~ whitc isoec~rri se, se, sc. ~e, ~~u°~st 1~, 18~1 ,ro. Racin~ NAMI OF UTY, YIIIA~E (If NelfAer, homt IOwnthipl Infie: Cily ar NGSPITAI CA O1NER ~HSTITUTION-NMnE ~u ~lacai~an ol O~othL,~~1nC _ Yiilopc :im,ri p( Not in Eit~er Giv~ S~rr~l ond NumGr Or lOtafiOnf K ~~,~,~~es QNO ~d, St~ L1lkC's IIOSriLal IW ~e. W S1ATE JF BI0.1X (IT12ER o( Ylhol (oumrY ' ~(Mern~O i~ Nev~r Marr~M S~avIVIRG S10USE (It W~lf, 6ivt Moidtn NOm1) - ~ III Not ~n U~S.A,,Namf COUntry) • ~ e, i~'iac~nsnn v, 115A ,o. 0 W~~~W~~ ~~~vorced I1'C11C C. Bartel , SOCIAI SECURITY N0. USUAI OCfUPA!ION Gwe Kmd ol Work Ourinp MoN ot Workmp lA~ KIND OF BUSINESS GA INDUSTRY ~ n n E~~~ia~r,«a ~t~to rocch,~nic ,~b,~titomohile rP»air f, s~rvice u~ua~Rruden<ewnen ~p, ; 1• 1~3 I~o. ~ecemN l~veE i~ Oeoth qESiDtNCE; STATE (OUN(Y NAME O~ C~TY, VlllaLE inti,dr C~tv or MAllIN6 ADCRESS I~am~ Addntt at T~mt Of Drmh) ~ OttorreC ~n Intiniubo~, ;II Nr~iner, nome Townsmp) V~liap~ l~mit~ 4.eRrs~Emaee~or~ IQl~CA11SlTl ' ~~7t1AC Ye . Adm~awe f~o. l~b, ue.C1l~fIfltll~ L~~'115}!T ud,L7 s!Q~o ,~~34~ tilorris St rranksville FA~MEA-N4ME F~n1~ M~dE4 lott MOTNER-MAIDEN NAME FirSl MidEl1 101t tVill~am S~ Nart ,a, Aaqusta !i~lson N z ~s, ° iNFORMANT-YAME MAIIINv ADDRESS Ureer pi RF,O, No, City or Villoqt Srot~ i~D WAS DE(EASED E~E0. IN U S, ARMED FORCEit ~Q ~ III Y~~, G~r~ Wor or po~e olkf~rict) ae+ervcdFor ° ~~o~~~TS. 1r~ne F,~rt ,~,3349 ~+orris $t,~Franksville,'+~isS31~~i t7c,7(~jre pNO ?u~w~own COdmq ADD~OMimatf InIfN01 H~p ~a~ ta, oAAT i DiaTN WAS f~11SED 8Y Emer Onty One Couse Per l~nr For ~A), (B)„ ond IQ Berwun O~qf ond OraM (o~ddlon~, If Any, A. Im{~lQlole (GUS~lZ ~i K 1' r,~~~ W~~ch Oarr A~u to Due ~o, oi as o ~ ~ ~ 0~^""~" Wi ~mmed~ot~ ~au;e (A) 0~a„~e4utnce o1; /~Q ~~i~ I'fit f ~~l f P7 A~i~~nc~ ~I Srmmq Ihe Unoer ` 1r~~9 Cou~e la~t, Dut to, or os o C Canseeuenct oL OccuOOtion PAAf II OTMER 1~6~IFIUNT (ORD~I~ONS; Cond~~~ons Comnbut~nq ia Deo~h bul nat A~lated lo Cou~e AUTOPt1' (SpecilY) WE6E fINDINGS (ONSIOEAED IN 6~ven ~n Patt I(A~ ~ Yff ~11p DETFRMINING Y~ SE OF 0 oATNt mp . /~G~(ifir!!'Y?'r~ 0'~ 0/ C~~.~ 19a, ^ 19b ? 0 ~ - rj~ AC(IDENT ~ATt OF~MOnM Doy Ytar MOUt NOW IN1UiY OC(URAED 1(~~ICr Nolurc al Iniury m Parl I Or larl II, Ufm T fousa z Ll SUICiDE INlU0.Y M, ~ jV Iol ~po, O MOMI(IDE ppp, 2Uc, 20d, w v~ INIUAY AT W00.K PIAfE OF INJURY (Mame, Form, 31ro~1, factorY~ Ek.) l0(ATION S~~crt or A.f,O. N0, Gh Or Yilloqf Lott t~0 ~ Q Ytt 0 No ~ fSoe~i}Yl 70 . ~4 (ER1iFtUTiON-MOmh DaY Yeor Month Doy Yeor AYD !AST SaW NIM,MR~ALWF 0y DiD YAU ViEw THE DEaTN OCCUAAFD Ai TAe t- u~T t, onTi ~ PNYSifUN ~ Mo~lh Dar Yeoi BOOY aF1ER DEATM tllourl ~a~e, onl, fo Th~ !nf p el ydy Knawledq~, Ow i Allended The C To J 7~~ 9 7~/ ~J Ycti a G~4 To Th~ (ause(t) S~~b~ ~ Decra~od from 1~-1 /-73 ~ ~ 71D 71t. 71d. ~ 21~, i PM, r~ p fFAi itfAT10N-k,EO~(Al E%A1d~NtA OR fOROtiEA: Ur Th! 8of~1 0~ Tht HOUA OF DEaTN iME DE:EDtNi'NAf lRONOUN(ED DFAD `~~r~ I~ E~mm ~otlon a~ Th~ Bodv o~d~or T~r ~~~tt~~a~~ o~, In MY Oo~~ron, O~oth MonM Ooy Yeor Nour ~ O~rorrc0 an ihe Doi¢ ond Du~ To Thc (ouu{~) iioted, W .11a . M. 47b, M. ,'r~ ftAnH(A-NUdE (TrOeor PNn11 SIGN TpA~~~ (E~Ri i~lF' ~ Titl1 DATE S16MED Mnnlh Doy Ylof :~-,~la~au~ Karl H. Kolmeicr, i~~7.D. aa~~~/l/~~~~,t,i,cl~,'°"6 /~1_a~~. iv ~o ly . ','"I~ - IUNO AOJAESS •fERT~FIER 9treef or A.iA, No, Gty or VJlopt Stote =~p ~ ~ : ' s~ T~ ~ Racine ~'lisconsin 53~06 ~ ~ ' ,;A '3,~01 ~~I~nai ch privc ~ ~ _ , , BUplal (EMiTERY OR (AE.MATORY-NAME lDUT10N ~~~dy S~oit ~~~o~_co~~o+ ~ .QtAEMA71,pk' ~t Racin~ l~'i~constn o~a~~ , ~ . ~,est Lawn ~~emorinl Par, ~ • .~~a~o n ouqouA~- ~~b 2~c. '~'~R•~U~l-DA I~Nun11+ Doy Ycar FU4EAAl N04F- 9A4E aN~ ADGQFSS Srrrrt ar R~.D. Nc. Gtv or V~Ilope Stote ~P la~' ^ct~'~~r 1?,1~7~ a,,rrn~~a5r~ rt?~,i,~.At, fin'~r ~nR C.leventh Avc.,~?ni~n ~r~v~, '~isc. 53182 ~~i 41d. ~,j~ DA;F ptfF~VED !r lxoi iwis~ro~ . ~i„ ~ ~lUNER~ ' ^EfTO ~ S~6!UTURE AEGISTARA-~l;~~r~~ ~ ~n~ rr,~ /IO~is~~"i•~/ 111J • ~j ; i i ~°~'5974~°~ ~25b. .~.~L:tl:~vl ~l'~'4~/~ ~~5~ ~?6c. . ._..~U`~ ...~--..269~.__~_.._ ~ o~a3s- ~~~i~ . ~:4~~. .