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HomeMy WebLinkAbout0833 . ~3 ~TATE OF N~Vf?bA-=DEPARY'MENT AF HUMAN RE30URCL`S Roll 37 Image 628 OIVISICN OF HEALTM-SECTION OF VITAL STATISTIGS r TrvE. OR ~RtNT IN ~x.~ ~„r~i• 1165 ` VERTIFICATE OF DEATH i~~? 9- ~9 i ~ , ~FRMAH[NT INK DECEASfO-NAMf ~~~f~ <~s~ SEX OATE Of OEATM ~ ~Owfw, 0~~, R~~ ~ . SfE MA~DlDO[ FOt ~NS~w«~s , LEO BASIL STACKHOUSE : Male ~ Se t. 10 1974 RI1CE wwnt~ N~G~O. ~r1~KAM IM04M~ AClE-l~lt uwt~ ~ o~~ ORTE OF ~IR1H ~~+M, D~7, ~~p~p~Ty pf pEATM /_C nt ~ ~~nMO~~ ~~~u1. r03. Wtf uOU~S rM. ~t~~ I 1 . ~ ~58 ~ k ~ ~Se t. 16 1915 'r. Wask~oe - CITY, TOWN. OR tOCA~lO:~ Of pEATH n~sq~ tm ur~q 11pS?IiAI OR OTNER NSTIiUf1ON-?JAME iu Npt n~ UM~, G~ anttt ~rO ~auWt~ ~ t~tC~~~ 1!S O~ MO Reno Yes St. Ma~' S HOSpi tal ~ATE OF ~IRiH Ilf NOi 1q u.f.~., w~rt CITI2EN Of WMAT C011NiRV AMlMED, t~VER MARAtED, tSIIRVtVWC SPpUSE ~r owf~ OR( MAO~N wrt ~ C01?~Rt ~ 4+~.'~^+YED OIVOiCEO ~ S?[uII 1 ~5,.~ .t~.~. ~fi ssouri USA Married Doroth Shul tzt Stackman MnE~! DKUStO - ~ - ..eo . a•m SOGwt =cCU~uT~ r+~ia6Ft-~USU~I OCCU1~Ti0?~ ~cm cwo o~ .+w¦ oo.a own.c .wsr o~RMD OF WSwE55 OR tn~t/SiRr occ~~eeo n~ i•~o~awo urt, [n~ u~en~to i ,~ST,~~T,~,,~,~ ~60-18-1844 Beveraqe Mana er Harrah's Club ~ero[~ce ~eqa wsat t~n ~u.ns ~STREE! ANO NUM~Et .c..~st o++ RES~OENCE-Sf~IE COIiNTY C(T1f, iOMM. OR lOCwiWrr T ~ "°'i g75 Meadow Spri ngs Dri ve «evada .~..Washoe Reno ~ Yes iafHfR-Ne.af r~qr ~pp! uS~ MOTf1ER-MAIDfN N41AE ~NSr r~ooae ~:ait Ervi n .Stackhouse Gol di e C. Bl ue ~ INfO1GMNT-r~.M~F ~ MAqpJG ADDRESS +srcee~ o~ e ~.o .+o, u^r d zo~», s~.n, tr~ ; . ~~,Dorothy Stackhouse ~ ~875 Meadowl Springs~Drive, Reno, Nevada ?IIRL 1. •?r~O~u..rt ~w en~t j pE~Tl1 w~5 UUSED (ErriE[ On1lY Oxf C~USf KN luvE FOR (o), (b). wrrD (cj~ ~!M!!M OMSl7 ~Mp p~~M 1~ r.WD.~r[ Uuf! f ~ ie! Acute Cardiac Arrest .s ~ c ..xan•.:~ w: i f ' ~ toromo..s, u i.n ~r~1tg COrG12Y'V Artery Occl.usion ~N~cw G.+! aite ro 1O) J ~ (YM{7S~I~ :I1YSI 10~, I TC. Of ~S ~ COtillO{.~MC~ ~ S:~~IM(~ 1M! VMCI~- ~~1: <<, Severe generalized arteriosclerotic Cardiovascular diseas ~ ?~RT a. OTHER S~n+Fk~r~T ~~w~tKx~S. co~a~•o~s ca.neaun..e ro oe,r¦ ..or ~EUno ro uuse eM.. n rur ~~o~ • A~~~ ~ YES .e•e ~~MDIMGS CCH- 7 ¢ Old myocardial infarction left Ventricle ~~"~@S M" ~Yes~~~ F IA ~IA ~ ACCIOENT. SUiCIpf. MpMICIDE. ATE Of M11URY ~ rp.t«, wr, ~e•~ i MOLlR Hpty INJURT OCCURRED ~ Ewilt wlW! pr ~wlu~? ~M ~~~t ~ p~ ~~at n, ue~ ~ ~ O~ UNUETERIMNiED ~ veu~. ~ ~ ~ ~ 206 7k. M. MI. t tN1URY AT wp1tK ?t~CE O~ ir+~~~lr ~o..e. sr~[r, r.eron, ~p~AT{ON ~ snee* w~_r.o. ro., em o~ rown, sr•n ~ ~ /31tGr1 tES O/ w01 +OSSKt KDG..IK. ~YFG:n~ F ~ ~ ~ S i CERiK1GT~ON- •.w*« o.• ew ..a+M o•. re.~ .ra usr s~r M~.irEe u~ a+ ~ i nw/oa wt v~e.. nN DE~tu OteuaEO mE ruce, e~. ?NtSKuea: T~ ra.w w~ rw soo. •m~ o[•a~. i o.n. ..p. ro n.t ses* - , ~nln0lO ME "~':40P n. o«~.uo..o.. !m ~m O/ Mi INO~/l(JCil. Q'lE 71~ fl~ M*o mt e.uua~ s~.:ee. ~ CERTRiCwTq~-rNEDiCwt Ex~~uNER Oit COROt+ER: ow r~e ~•s~s w n.e o. a.~„ »t oecEa..i .ws r~owo~,..ao oe•o t..rwwrw.. o~ r~e wo• .wic~ r..e ~.,.esrr,...o•., ww.o... ~ .i o,r ~ o~~~ «~~.no o.. ~.E ~.ry .»o o~ s..~.o 7~40 P.µ;?_ ptember 10, 1~~'4 7:"~'0 P.M. N . ~ CfRTIf1ER-N4Nf mn o~ .n«•~ SK.NAS E p[pne nnt DAT SlGhED ~ I,~ Edward S. Gallagher, r1.D. t ~ , ~ , . ,x~; /y~~~ ?1k ~ept.3~, 19~~+ ~ ""p"~ iODRE~-``~"t``° 10 Kirman Avenue` ~ ° ' °¦do" ' Neif~da 89502 ~ RIAI, C4E T{~ -O~vOY`l ~`0ti'~E~EAr OR C~i~v.?OC.r-r~aME ~tOCAfICN C n Jt t0~... _ , ~ ~ ~temova"~ ~"~ur~a1 ;Floral Hills h1em. Park ! Lynwood, ~ ~N~'shington ~a , y D TE ..or. c• •tu~ iVNE4~t MOwtE-N~u~f ~rvp ~DJRF51 • sntet o~ ~ r +.o ,~n w ro r:t, [u _ ,~ept: 14, ~+~~4 , Wal ton Funeral Hom ~econd ~f . , keno, Nevada ~ f- ~~~e -k~ f~ • EG+St SK~~rutE u nE ~r .a a ~sT+~R rs~~ L=... 1. c ~ ~w ~~p~. ~974 r ! 1 ~ F go~~ 244 P~~E ~33 ~ 3 ~ ~ - - ~ ~ ~~:'.:r.,~J'~, a._~.. ~..:,_~.A . - , ~a . _