Loading...
HomeMy WebLinkAbout1558 I, •ccosccc o~st~.c• ~ NEW YORK STA]t~ ~ ~a-.-c •,~c r~..~c~ ! ~ DEPJIRTMENT OF M(~ ~ t O Z9OB BUREAU OF VITAL R : y0 CERTIFICATE OF 0~~•il aPR 2~ i975 364 T1rPE AlL ENTRIES OR PRINT IN PERMANEl~lT BLACK INK , ~ 1. N4ME~ F~Af? M~DO~E lA3r 2. ~la c~~t O~ O~~tw rOU~ ~ [ ~WA?[ YJ~ITN O~~ •t~~ o~ ~ ` Vincent L. Sul tan ~ O 9:25~,, ~ ~ - ------T- iu.N~ _ • w.ci ;w.~-c. •aa.o. e .ca • ..rt. ~ . ;.~a• ~ o. e~ +a.c.u. o. u s. awuco .o,ccs• ~~s. ~•,cs- s.ic.n w~. o~ l~ ~Y(AICM ~AO:M. tt~ ~ YOA~V~ C~~~ ~~U\= YIM. ~ t- ~ t ~ o~*p oI ~t11v~t! ~ ~ ~•I Wh i te 7 ; T~• MO VYaMOMM ~ ~ ; N •ws. ? ~ ~ ~ t V ' ' ' , 7A. courr• wvi~ ~7S_ Towr ~)t.c~•• ow r~?~~i[~~O.~t~G~wO?s~~~ ~r ~7E. wos~~T~t J~ o'wcw ~rat~ry~~Ow ; . 1 ~ ~ TOMM. C1T~ OA YlltAi~ 11~ M(I~r[A, i~~[ ~7A[[T • MO.1 ~ /_;u;U Na=sau ; N. Hemp. ~ Mineola ; 10 Days ~ Nassau Hospital ~ . ~ , .i ~ ~ •.STAT[ 0/ ~IA~w 4. OlC(O[MT •Q~M tO C~T~S~Y O? wM~T 11. MA~IT~I lTA~Y• 12. iltA~lti~i f~0Y3[ l~/ MI/C. MYOGI MAY~,1 v~ u , s.. Q iCOYST1~f.~?~OTY!• uprtM D~~ •(~A COY~~~T! i_ New York 2 22;01 U.S.;. Married Florence whitley ` ~~s~. asu~~ occu~~*ww !~•[r ~an~ce~ ' fa9. a~ro or wsiwcss o~ ~roust~~ ' ~aC. soeu~ sctu~~h re. 4 ' Sanitation Man ~ Sanitation ;107-32-8306A ~ ~ h I~A. !T1?T[ 119. COtiM~• I~C- TQwr ~ IeD. C~t11 O~ VlllAi[ I~E. MiTN1M TM[ t~i. sT\[[T Aw0 YYM~[• ~I ! ' ( F ~ .^ii'3 ~ ~ co~?oe~rc ~~..~r~r ; New York; Nassau ; Hempstead Park ~~~g p 14 Covert Avenue ~ : ~ ~ tSA. ?~r..cw•a wu.t: 156. worwcw•a u~iot~ rwt. j' Flwst Ysoolc ~ t~lr r~1lsT u~oC~[ L~ft ~ ~ l ~ " . ~ Leonard Sultan Catherine O~Flau heri y,; ~ ~ ~0~. iwrowyu,T•s..u+t~ 't{e. ~~.~~rt ~oosus: ~~wc~uoc i~~ COOC~ , F 1 orence Su 1 tan ; - 214 Cover~t Ave., F1ooa1 Park, NY 11001 i s~, w . i s, o ~o - o f U d O ~vwAr i oc?•~ w~s c._sco c+-C~ Cv~r Ow[ c~usc ~c~ i~wc io~ ~w~ ~e+. ~,.o ~c•. i ~•?¦oa~~.~tc uTCavw~ U O L. ~~crwcu~ owscT ~ oc~n~ ~ Z" -ri C ~ ~s ~YYC~c c~usc ~ ~ ~ `L//C ~ ~ +~1 f. ( c~ br ~ s~ ~w~ E C m ou[ io ~s ~ c [ov[wc or f a. • 'rl tOwO~~~Owa. n~w~. wM~tw ~ a~ CI . 90 i cwrc w~at ~0 1YY[OIAT[ ~p~ ~ ,S.i xj d . tAy3[ IA' 3TATIYC Tw[ T A•! ~ Caf[QYU[[ O ?.i ~d y.+ ~ ' Yti0[AItIMi C~11~[ 1~3T / ~ cC ~ q , p : c~ P~. . a ~ P~RT ~t. oTM[~ s~cw~r~c~wt Cowo,T~W.s to~o.t.o+s corrwiwr+ri to t~A. wuto~f?t 1~~. ~/~[i,wcws r~wwrss s~0[11[O ~ ~ . ~ O[ATM •yT MOT A[lATCO 70 Ch.3[ G1YG~ IM ~AlIT 1 lAI •[3 w0 ' O[Ttr~M~Mi TN[ C~Y OI O[ATM? k ~ • ' ~ 1 •[i ~O a 3 , a ~ 19A. ~CQOC~7, wOr~~tr0[. tYS. ~o~~M O~? r[aw lfG_ wOY¦ 1lD. MOw D~O ~w~uwr occ~w• tuTCw w~*u~c or ~r~uw~[~ ~w OA 11_? ~ ~ x lu~t~o[. uract[wr~rco ~ .C t) ~ C~ i ~ i 1 a~ q Y+ O i~ SY. ~ 1lE. ~w~u~~ wowa± ~ss. ~~~cc or wa~c, ~oa. ~ocwr~or ~srRUr ~ wo.. a~ w n«~sc. ~owM. cowrr. sT~rt~ ~ ~1 E+ 1 r[a wo 1 ?wc~oR?, o~srcc s~ea, cTt. 1 r W ti • ~ ~ i ~ y a.a i TO @F C^!iPl~~ B~ m ar- rn4w: =TCn av ~~.V.,~ ~ ~ i 20. O~RT ~ CERTIFYMlG PMYSICIAN OhLY 20- PART 11 ~~ER OR MEOICAL El(AMiNER ONLY ~1 w a C A.TO TM[ ![iT OI ~I RMOwL[OG[~ O[~TM OCCVwACD A. OM TMC •~31f 0/ (i/W~M.?~:OM MO/6A IyV[STIiAT~0~1, IM Y~ H`,,,4 ~p a ~ TNC t.yt, O~T< /~~C[ ~w0 OYC TO TM[ ~O~Tw O~• •E~• O?~NIOM O[ATM OCCYRII[4 TM[ t1Y[, DAT[ YIO ~11~C[ M~ ' C~uS[3 C 1w OV[ TO TM[ C~YlCt 3TAr~O_ a a a o~. ~ i l1iM[ . . " ~ , / f~iM[0 ?I~L[.~.....»........ . ~ W W N 0. TM[ ~F ~Cl~lw A~T[MO[O Tw[ O[~C~3[O C. Laf? St[l~ ~?~Y( 0. ~~p~OY~C(D D[~1D C. MOYA O. O~T( llpl[~ ~ C, U~~ ' MO DA~ [~A Y0~11~M O~~ [C~A VOATw D~T T(V ~Ip1TN O~• 7~AA WI~TM 0~1 ?~N ~ ~ ~ W O ?wo~: J ~ TO: ~ a' f ~ Z pA ~ ~ /~T Y. ~ ~ '`.+5~ D. ?ii~~D~tii M~~ltL?Aly ,i OTMIII 711AI~ C~A~,?~Cw: E. Co~OrCw'3 ~rif~C~M. tI Orwt11 TwM C~Af~/~[A: ~ ccwai.. ~ w q a s~ - ~ x7 r~ O 4~ H~'1 s~. w [~w~ o? t u •M~~~t~~w. CO~Ow[~. ~[O~C~I ~aYruC1~. co~orc~•s ~wrs~u~. cmtti oi~ ro~~: ~ ~ o> a R~ ~'f~~t~r~ ~ '~,~q,~ o,~ v~ x z ,v oo ~ ~ d+ - ~ ~ :r_ . ~ ~ t2A.. r~. w~i? ~ M O~~ ~~~u jjs. K~C[ OI W11ut. C11[M~T~OM O~ ~[40rK 22C- lOC~7~p4 lClTt OA ~OAII. ~tAT~1 ~ ~ ~ 2 Hol y Rood Cerfieter estbur N Y ~ a,v ~ ~°Vne • ~ 097 Hempstead urnpi ke ~~"~*~~ra~ r~. ~ ~ . . - ~ , ~ . : Inc. F~an 1 ~ ~ t i4I~~~~ [ ~~I~ 1~ ~~W I~1 A[c• 1~C. t{~st11N~OM IN. ~ ~ ~~,.~s . ~ ~ ; \ ~ / ~ 05728 - ~ . . - ~ . AZC ~1 ~ S YO~tM • ?t~~ jf . 1~ ~A A[Y0~4 ~[AYI~ I{t1/~O YOrTM ~A~ . , i a~ 5 3; 72 E. Trucks , ~ : ~ l ~ r ~r,iJ!- . . . - f ' i - ~y . . Y- ~ - _ ~ ~S.~~e=?r~^`:'-~L~~'m.-~~='.`.r,~=, ~ .3 ~a6"s~-.~3.s'?~~'_=