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_ STATE OF NEW JERSEY '?i
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~ ~ OFFICE OF REGISTRAR OF VITAL STATiSTICS s
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Tlris u to CerrilY foUowing is correcdy copiod from a record of Death in my o~'xx.
MA11[ O~ O[CEAt~O - KACE M OtA?N , OA1t Oi OEAtN
Leonard M. Mitchell 44-10th Averaie January 28, 1970
111NIiAl COM0ITION AiE OCCY?ATIOM C11YSE Oi OEAiN
married 62 carpenter acute myocardial
infraction
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Registrar of Vital Shti~tic~
6th & Central Aves..,.Seaside Park.~N~J.
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~ Date of Issue
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~ Return to: Chelsea Title S Guaranty Co.
~ P. O. Box 1152
~ Stuart, Florida 334949
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