Loading...
HomeMy WebLinkAbout0546 ~ . i, ~ - - . y'. ~ 31~8 : - C 1TY OF N EWARK, N. ~J. No ~ 9495 I OFFICE OF ' - MKHAEL FRATANTUNO. M,D. = Registror, ~ Bureau of Vitol Srotistics Thet is la Ctrti/y lhat the follov~ing ii corrtctly.copitd /rom a record oj death-ia my office. DO NOT ACCEr'T THIS CERTIFICATE UNLESS THE RAt86D 8EAL OR TMIS sUREAU ts Al~1XED HCREON. ~ NAM[ OR NCfJ1*[~ ' !!LAC! OF O[ATN I DATR OF OfJ1TM ' - I ~i]. T~.7 Aw...~ i~7 ' 1 a~i~ A~iQ~iO ~ ~tr~~ 1 - NlWARK. N. J~•-.~ ~ ~ ~31 `7~j - r lOGtAL fECYRITr NYY~tIt S!~ COLOR ( MARITAL CONOITIOM DAT< OF ~IRTM AOt Y11f. MO~.' DAI~ l~itle lilllt~ I. 1lds'ri,~d lf~roh ~ 1, 191'~ ~ f ~u?cs oF sIRTM CAU~t Or D[ATM _ . NspatiA Ca~s; 8epttlo Se~'m~. =~nilv~o~th Sspatit~is. ~so~sl~e. - ~ " stlNL[N[NTAL tN~ORMATION II Dt/?TI! WA~ OUt TO EXT[IINIU. 6AUi[~ • '-=3--.., ACCIpWT. ~YICIpt QR iqMIC10[ OATt OF OGCYRt/iGE _ s1ec~Ir - WNtJI[ OIp i~iAlllY OCCYRt., . uT~ ow Toww " wuN*r srwn ~ DiD_lJaJIIRY OCCYIt tN 011 A~OYT MOMt. O!1 ?A11M..IN IN~tJlT111AL rLAC[. IN r{I~LIC P~.ACtf - - . . _ . . ~ ~ . ~ M<GI/lI T7~t 0/ /tAC[ - . . . WMILi AT MIORKt MEANi OF' INJUIIY - . NAML OI KR~ON WMO C[RTIIt[~ WIUi! OF D[ATM ADDiIt~ _ ~[nilo L. Ee~ar3qnsa, M.D. Bsth Iarasl Nos~tal ~warlc. ~.J. ~ _ !~r Wi~ut Wl~~soJ, I have hereunb~ set my haad and affixed the seal of Bareau oi . ics. wn*It. I•, ~W Stahsi' Ne N. t}us......~~.......day of........~!'.....A.D. 19..~. llEO AI~C AEC R0~ p ~ ~ir. ww a Po~~ S~ 3j~~~.y CtEPK CtnCtf?t COURT `~I~.........RK~crac oE~Vial Sawtia....~.»»»•. AFCQP.^ VE~':FIE~ _ !!uc t1 3 ii PN'15 - . - R 3 ~ 546 ?.p,. - ~oaK 24 ; . ~ ~ _ ~ ,~y ~ ; - - f~ ~ ~ . -