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HomeMy WebLinkAbout0620 ~ - Dh'T~20IZ DF~AAT14a1T OF }tEALTH • VITAL' STATISIZCS DIY7SZON - , lt r _ . s r'~ . . --1 ~ r- CERTIFICATE OF DEATH O ~ ~ ~.l~?~, , ~t , \ ~oc~~ r .w~~~ ~ ~Mw el hbNc H~eM? u~a r+u ~w.w• OlCEwSEO-nM~f nn~ .wae u~~ SElI OATE Oi OEwT?t ~ ~OMIM~ nu ~ TTpRMAN REIGHARD ~ male ~ A ril 18 1975 RACE wwn, «~aw. u.i~K•w wou.., wGE-u~~ w.w~ ~ r~.~ u«a~ ~ w~ CAiE Of fLLM ~w.nw, CO~-MTY Of OE!?TN . , ~~..~»~ithite u.~~ ..o.. *~'~gril 9, 191 Wayne • ~ s. ~ s~ • ~ ITY, VIIIAG~OR TGWNSNiP OF UEATH Mswe cmr u..m MOSHTAt Ot OiNEt NSTR1JilON- ~u wo~ w t~rq~, om sne~~ •no ~nwa ~ s.eu?. .n w ..o „ Detroit Yes Harper Hospital StATf d 4RM ~ ..oi ~.f..., UT12EN Of K'HJ?T COUNTR~ /MttlfD, trEvER W?RllEO, SuRVtvNG SlOIISE tr ~+Me, aM wotw wr~ ~ ~ Ohio ~ U.S.A. N"°`3•iagc~$o"""" Jean ~lis r.sEO SOClAI SECUW11f NUtit6ER UStlAI OCCU?At10N ~u~re cwo W v+oea oO.u wn.~G ~wst M KIND Of WSNESS OR tNOUSTtY ,..io ~ ct.rr `_:`~~~0 rw MO~~wG Ury. M~+1~~ ~1h~~01 „ 302-O1-3198 Autp ~ngineer General t~otors Hyd. :n ce~_r ~VM~ .c- i+ RfSiOEr+CE-Sf~IE COUN~Y ~~Ty~ y~~lJ?C,E pR jpyyNSM~p Wsw~ cm wm ST~EET M~O Ntlw~iE! ~snc •~s u Mo 7:~l~ ~ ,M I;ichigan Wayne Plymouth es 39667 Greenview Place /wiME[-?~t~uu1 .~ut rqwa us~ /.WTnER-MAIDEN NMeE rw~ .~oa~ w~ Not Available Wot Available INFORMANi-NAME MAIWG ADDaE55 ~frqe~ o~ ~_r.o. wo., em p aw+, f~•n. tr~ Mrs. Jean Rei~hard ~n 3g667 Greenview Place Plyctouth. 2~Sich. ~~i OEATM WwS UUSED {Y: ~EtJifR ON11 ONf UUSf IER tNE fOR (o~ (b~ AN~ (cJ~ ~n.ritw o u~ ~.a a•+w II. wreDull C~.VS~ - " ce~ Chronic Granuloc ic Leukemia 2 ears , ~ w S! ~w[ ~ ~~..o~.~~.... u _ . . ; rw~(w p~tt ~Nf :O ~6j ~ IrrtO~~i! C~Yff ~'f'. py~ IC. W~1 ~ CO+~StWNrC1 O~: ' " } {t~1iMG ~M! YMPI\~ ' mno c.vu ..sr ' [ ~ ?Ati 11. OiHE! SiGr1~~~C~i CO?~D!TIONS. ~~no•.s co.nusutu.c w oum ~vr wot nur~o q u~u eMM u. r.n ~ w~ IW~«Sr IF rE5 ~.~~e nMS~.+es co..- Il~f M MOI f~0[~l0 ~M Olit~r~MWp 4V!! ~ ' Yes M Yes ~ ~J`~~ ~ ACUDENT, SUKk~f. ?tG•uCitlE. DwIE b W1urY irp.rw, p~~, re.u MOUR NOW INfUR1 OCCURRE~ 1lMIl /YNLL M/N/Yff M?~~1 ~ W/~tl O. rrt.~ ~~i ~ 1f~1W~1 - ~ 74 tq 70~ M ?01 ~ . ~ INIURY AT WORK ?uCE ~f 4^~IURY ~o+i. r•ar, srne~, ~.ero~r, IOCAT1pN ~ tn~t~ o~ ~.r.o. wo., un o~ fowr, tua UIl. IY ~I1 O~ MO~ fOMK! WG.,~K. ~f?lC~nl T?~ ! tC/ ~1 ~ CEl11F1CAT~pN- ra+» w~ ~u~ +~a++M ou •1•~ ~~o uu s~r wr./w~a unre o« ~ oN/o~o wot r.t~? *w OEwrM bCCY[!ED mt ?ute. c.. mt ~MISKuN: ra+iw D.~ tW ~00~ ~tt~ O[~m. ~nOU~~ O.t~, u.0. p M~t1t ~ 1 ARfM'~1IO iM! 2 TO~? f~ lg tl~ : p M~ u+o.niou. aA n• o~c..?ro ~w.. ^ µ Zg 7rj tt1 C~(~ t~~.7 ~t. ro n.e uuu~s> >r..~o. C~'YIU?TlCk~!-a~D:!at EtnMU`ER Q~ CC%Cr.iER: pa r»e a.s~s a ~~e „a,~ p~ a.m rwt oeeeu~r wws reoe•q.~.ceo ouo l~..r~w~tbw W M hO~ ~..~10~ ~+4 ,wvtlt4~r4M. ~w rr O~~a~d+. ' rOMTN O~t ft~~ py~ Oi~M OCCW~fO OM M! 4~q ~w0 Dui t0 r.y (~yy~:Sr ft~ryD. t~. _ µ m « CERT~f1ER-t+.u~F o?t o~ SK3NATURE ~ I ~ne a unt DAtE S~Gt+E~ ~+o~*». o~r, swi , y: ~H F~eem~~~ t~Tilner+ 11•D. G,.- ~`-L~ M.D. ,k Atiril 21 1975 ~twriwG ~~C~cF55-CEt .~ar SI~U( O~ ~~.D. NO. Utt Ol 1OMN s~•rt 1. 2 0 G:~~e::f~ e1a Suite 0? Southfield riichi n k~(YT5 ~v~~l, CREMnT~;.n, ltiwiOvwl CLMffERY OR CRfNU?fOAr-N~f lOCwi~On ~ITY, VILLAGE, TWP. OR CQUhTY u.r~ ~sntur. ,w Burial Glen ~den I.ivonia, ?~ichigan - ~ - DA1E i..O~.i~ w•, ~ fUNEDAL MOME-NANF ANO AD~RESS t sc~lp O~ ~~.0. w0., U~• ~ tO~N, t~t1, !v 1 €r; April 22, 1y75 ,k Fred "vlood Fuzeral Noae Inc. 3b~.00 ~'ive :i•~ile Livonia 48254 F . ~ ftlNEtUt1I OIRE~'tOR'-S+Gy,+~la~~t - kEG15iRwa-SrGNwIUiE . OwiE RECirvfa ~r toCwa ttGattw! ~ ~x ~ TA j Y~~ ~~~~1' IM : ~ ~ j i i.. %?:r_~ ~ ~ j ~ '~I~ _t: - ~ y~' YO~~~i~e:•' . ; ~ , ti : ~j ' I bere~~ certif~ thxit tLe foregoing ~is a true co,~„~~'~~~# ~;u~~~~` t~e ~ ; o~: oit. Detroit Departmeat of Health; atte6ted by the ,~a~e4. ~ 7~,~:~ . w • s. . ' ~ : • ~ ~~.'I . ~ , l~V • Y x , r ~ . i-~T.S~ '~.~K t ~ i. r,~ ' 1J . . : 321~40 ~:}E y'..< < ; . ~~~r . A ~ . ~ . ~ . . . fl:. .~ti~µ;Y fL '~i~a . ~ ~ • SY• _=lS,Rt ' ; ;~t' ~+~~C ~`~~,.~r-'~ ` r!' • - ~QL ~ ~ ' 4~ I~~~~ ~ l . a ~ - \ ' ~ , t :~l1istics Z~. y 26 hN' 15 _ ~ . - :__~4:~:~ - - Nor . ~ : , - `~t.' _ st + r _ . . Yote~ ~ . ~ .3 ~ . . ..so%~ i~ . J- , l 'j' ' ~ / ecn~r~~J e~cE ~ . . r. ~J. ' - - ~ ~ s~ ~ ~ _ . _ - r„~~,~.'"