The URL can be used to link to this page

Home My WebLink About0788 u , 33~~'712 ~ I her~eby cert~fy '_his to be a true a;~d correct ph~to;r~a~ic cop;~ ' o€=~~~1~~:~~rt~'-~ate on file ::ith +.he Cin~inna!i 3oard of l:ealth. . i~ • . ' . '~~?.J ~~,~.i~i.. ~ ~y ~ ~ ~ i.~ ~~r v~ . - i a ' ~ ~ ' ~ ~ ' 1 ' Local . e~istrar ` ' ' 2 , ' ..e } + {Si1L~; ~ e~? {J'~.-iJ . ~;!-,~"~i ::t~~~~. - j J ° _ ' • •,'?€'r~ • ' ~9__ " . . . 4H10 D~I~ARTM~NT OF l~I~ALTN ` ~ ~ n"`~~~'~~ r. ~ DIVt~ION C!~ VITAL STATiS71Ci h""''"'' °ai~~ CERTIFICJ?TE OF DEATN w'. ~~CEAl~O--NAMt tiar •M+dlb Lat !iX ~AT< O/ O[ATN ~-~1v.?r. pv?• 1'+e+d . . n'A fs1"^:~ . ,ro• ~T _ .~~h ~s.._.~~.~,... . -•)i 1. ~ ' - • ~ ~ ~ - - RACt R'~. N1~a. ~+krxw O 1..~ tn+oee ~ r1•~ V++o1• t ent O~~t W M~rw . y.ww. p.~. CQ1,1NTl/ O~ LitATN N~. f fitf/~ ~ ~~~lMll • ~t NH . M. ~St!! 'ti t .~r. ~i ~ ~ ~ ~ ~ ,11~~ r f~ ~ • - • f~ _ . Gl~. vNUO[. Ot tOG?ItpN q O~AIN fNS1~C~1~ UM~I~ wOM~fu q O~Nl~ iM~hIWIOK~-~v~Ml ~l~ ~ N~!~•. i~~~ ~fr~~1 ~~~I ~~1 h~+;~ ~ fS~ft ~MN~ r+.~n~i .~..~r•r~ ~~7N . , 7?. - 1t ~ ~ ' SGiE d N~1N ~U w s~l:.S..~.. wt C1htlN a MIIWI COYMt~1 W!l~IO. nttii• r~N~10. 1Y~r~~i~ f~O~S! •1/ r~r~_ sNi +.+~rw ww~i ~M~11 ~ vl Oc~ !0 1NtH1! ~ ~ ~ T ~ ~ ~ ~'1 O ~ S ~ . S . r'~ . ~ 1 s`'~ ~ C ~ : . SOt~~I SECUUR MYW[f W~?i OKlAftO t~tt ~M Y: AfA?i0 i0ltH~ ~ ~ ;Y~tiNi ~~~w~i la~n. in ~Mr+pl r..xa.l ~ uSw( Ot~w~nd+ (G~~Y ~tNI N MM~ ~t~W 1~M~ Nd ~ ~ l~?q O? WS~Nttf p~~+ONS11r~ r•~1p !~~/f ?te~. dl L , . ~~1 I` . 1 ~ , . c~ 1? ,j,r~f?:'n~~S'~Y!12`n~t~twprr. ~~~+~r.~~;nn .~t4~ ~n . . • - tfS~~lM(~-j1l~l (~NM17 (11T, Wl{?a~ a?«~tt~1 - fN11~ ~ilf ~Ir11f s;~E~~ iN0 MJMI/f ' T-i 1 /s~~ AMNI , . ) - • s ~ F 1N ; " ;t? ..1 ~ 1' ~l~'T ~~a ^ f.'~l` 1 Y.~r'~1- ~~it r~ tN ~ ' • f iA1MEl.~-N~Yf ~ I nst .~~1 rO~N~f-Y~~OIN N!~[~ - f M~t .Hs1.fl~ . /.e•! ~ *.5-.,~~.,:. '.-~e+v..r rs~, ' ~ t ~ t-- _ . tS ' . " ' a• ` ~ - MFORMA[VT--PtAME ' rwi~?wG wt~oetsi ~fi..•i.~ ItJ.U. +....de ••:l.~~. a~rr. a.1~ f n.~ ~.,,1->>+ • ! s~a - '~~.C ~ t•`•:~~1 ~ -yd ~ ;•a.ta.1 ~ l ~ , '^f-1 7~. ~ t7~~ . ' • . r ~ ~I ' ~ 1~'. ~ . . . aEwrn w~?s ciwr~o sri -twtE! ONI~ OMi GtISt ~Et iMH ~W ~~r. rtwD ~u: ~MWi~r~t! ~Httt~~t twt ~t w_rF~&1!~~ „ ;T~c 4 - a n. t ~ urwcw~n uust ~1- ~ o. ~t-. ~ ~ . ~.1j:.' a,: ~ `t L~- a , - ---1 ' OtlE i0. A CONyt0litMCt Oi. j t 1 ~ ' c ~~/~tun. il ~sf. ~ C' + ~ ~i r1~si t~~~ rii~ I• N/ ~ ~~t,..;.. ~ .t ~t~ ~1'~. . \ . ( \ ~ i ~ \ ~ . rs~~fwt< <ss 1~/. i0. O~ A3 A GW+SEQYINCI aI . ; .r~r~~~ rji r~/~•-j ~ - - ~ t..~R i.w~ I~a! ~ i~_~ - . - - ~ - - ~ - - i IAft ~t OINff S~W'~~l~U?M/ CCNO~NQMSt ~~IN~~s~ ~~rfr~~~~t dt~ wM AM ~f~lA/N tMl/~ ~MI /~~I ~i1f01Sf If tEi rn~ A+~~t~ •r~u.1e..~1 : 1~ N M w J~~ertn~r~j ~os~ o? I..t~ 1 < <<ti , - ~ ~ c ~ ~_s ~z, t~ ~ i~ a 1~ _ ? = a[UOEwi. SY~U6F. C~OE Ow~E Oi ~MAilr ~W/t ` ~KWit OCtYttEO ~lr~n ~+er.r ~l ~w~t Mi ! sr ~rt U. ..r~ .'tr t O~ u?+Ot~tw~?,~t0 ~1N.d~+ ~.Mrr~uA. I~+r. 1~t/~l i ~ 1J~ _ _ 70? Ma JO/ - - 7M/yf~ A~ WOfR IIACf O~ IfUVt1 ~f 1~rl~I. fr~. ~Ulef. ~n/~lOCA11QN f~HIHN k./.I). N.. ~M~ M ~d:~t~. ~IX~. t~?I r SNufy /n ss~ ~Ilu~ L(1~.. ~1~. UMri1)~ • - _ ? ~ ~ ; :erln~UhG+a- N....rw /~n 1•.n .Ne~ib 1?.~ •1.r. ??+6 ~~~t kw w~r~wt~ ~ aa:o~+~s~ Ct~~M Ottu+~l0 ~r rb• N..~. ~ PM/1~CI~N S~I~f! ON iYl/N IMi i00f~~wOV~i !N ./N~. I~ ~ 1 A/f(MO~D 1N12 j~f 1~ ~ i !j) . 1~oNb ~~Jl ~Iw ~~f~~~ ~A~N 11f ~~.f nl N? i ~ A 1rvr.~/ti. J~• ~ ?t• GlC[ASEO 1t6r ~?It- 7ie 2 . 7'~i i~~. \L ~ ?t• ~^l~ iN ~b..ri~~~r~,~.~~/, e ~ C[~hNfAf~ps--<O~O~+ff U~ d~ iru. ef ltir i~•~++.+/.d• Her. ~t J~~~~ 1 M Iiu~IrM r~~ p~wwr~J +I . - 1 »r i~r ~wl~ r+d ..r il.r ~w~••ris.rw~. .r otr~.•~. J~.r6 . .Ue~+b IA~~ 1~.. If~?w f ~ ...r.•id a~ Il~s Jr(r AI Jrr I.. Iii ...r~~~+l .I~/rJ. . ~ 7l~ ' ' r - ~ Ct~til~i~--M~~f ~ t fIr a. ?.yvl , ~ S~GN~f~fF t>~t~e~ w~Mfr~ L, 1 a WNt S~~tD ~ ~ . .t'"t s tl<<`:fh:~ ~ ~ ~ - . ..?t<< ~s._,,_..~~,ti ~ 7). ' , . ~ ~ ~ rw~ueK. n00~tf~-Cf~tinN` ft~tit ps.~ t p Np Utt O• v+~ ~4t ~ St~t1 l~• ` ~ ~ . l t~l i ~ (~t ~1 ~ t ~~t~ t L ~t ~ ( ~ ~ ~ ~'7~ s ~ ~ E Wfu~. C~Eru1~ON G?tt rrwr! O~ Ctrttl~r Of C~Er~fOR? ~OC~hpt ~~.r~. ~.if.~~. ~..~...rs~ ~il~~t ~ ~1Nuf1? r ~ - n 1.. t~i--, 4 s T«''? j ~'-c~ J~~ TI~-~~ . ' N~ _ , ~ . ' li~rl O~ IW~IY~• ~l~C NQ 1 1YN(~Al D1~IC1O~ S S~G. Af / 11~f MJ ~ s T n'- n ni' ~ ~ i; ~ j 1• , 3~`-- - /L . _ ( yN~fA1 11tM ANO I1DOflS1 :71t~11 MO 1• = iC~ 1 - 1St~fE7~ , . t~! .i~7: ~7 . ..r-11 " ~1'1~.~,i.. + ? .~1Z~b,~ t,. ~ ~ ~ t . . ~ . ' ' ~ ` • ~ ~ f ~ _ . _ ~ e~~:~w~ ~ s~eN.~u o•~i ~ee~~r ,sw~~ S (iN~iW1 W /f~fON +swt~ :!w~i _ ~~u ( ~ - - ~ ~ i;i ~ ~ ~,~~~,i2 ~ ` s~ ~ -~R x~~ , ~ . ~ ~ ~ ~ ~ . , / ( T ~J SKELTON. W~LUS & IONE~ ~ ~ ~ ~fiOFNEV$ aT L~Yi 4 ; i' ~t ~ 1 :~ticrof i lu~~n~ Memo Mpt IL ly . ~1:2 F~^r~1a Fe'F~?I 9i,~+,~ ` ' j ~ ~ he quality ~f~this - . ~ St. Pcter;~;?:g. Fi,?rr~a 331J1 ~ ~En~ is un~atisfactor~- {y~ ~ , i ~ r ~'S i ( ~ r i 1 ~ . c_ , + .