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HomeMy WebLinkAbout0905 OH10 DEPARTMENT OF HEAL7H ~ ^ R`R. u~w. H". DIVISION OF VITAL STATISTICS Suce t~~e No. ~ Pr~mar> ReR. U' ' ReRiunr's No. 't r;W ~ rs CERTIFICATE OF DEAT}i ---~°~~7T~,~, - DECEASED-NAME tnu .~l;ddtr Irst SEX DATE OF DEATH r.~lo~tb; Dar, Ye.r?1 Thelma R. Bey~er F Jn~y 1 1976 RACE ~''b~t~, w~aro, rwt?i~rw AGE- [.~u UNDE! 1 YEAR u?+OEt ~ Gwr DAIE OF ~iRir~ r~lo.,d,, U.,~, COUNTY OF DEATH iwJ~~~. 47 ~uJ)) bneb I)trnl Atoi. U~?~ Ho~.i .?tiw. !'t~. ~fii~e bw~ , .~une 30 1907 Hami2ton CITt, VIIIAGE, OR lOCA110M Of OEAfN INSIDE CITY ?IMITS N05~1fAL OR OiNER INSTIiUT10N-NAME /I~ NOI7M Nlbfl, =Iff )ll~f! d~ MYAbL/I I~prt ~n o. wo1 ,e. Cincinnati Qhio es ~a Je~rish Hos ital SiAIE Oi ~IRTH /I~ sn! iw G'5..1., w~¦tt C1TIjEN Of WMAi COUNTRY MARR~fO, NEVER ~AtR1fD, SUtVlVING S?OUSE !1~ u~/t, si~t w~idt~ wMtt1 ~owrr w~DOwEO, OrvORCED lSyeri~~1 ~hio o USA ,o Married Albert Ae er SOCIAI SECURIT~ NUM6ER ww; DEfE~SFD EVER 1N U. S. AeME~ fORCES~ 2L -0 0 S f)"ei. ao. or rn~s~uw1 /lf !es. ~~t ~lat~: o)stnaeti 12e. 09 7- 3~.t ~~e M~ USt1Al OCCU?At~ON ~Gi~t }uJ oj ~ 0.4 dowr Jrnej wroit o! KIt~D OF SUS~NESS OR IHDUSIR~ ~3e k•~` `,,t `~td~f~ce' Work „b Queen Cit Su 1 eES~OENCE-3TwiE COU~it Cltr, vitt~GE O~ ~OUi~Or+ INS~DE CITY IIMIiS STREEi AND f:UMOE~ ~SO«~1r )rr o. sol ~ao. Oh3o Hamilton Gincinnati 0. yes ,~,6Z Summit Rd. t~ 2 fATMER-~IAMf (inf .Hi.lJ/t /rit MOTMER--MA~DEN NwME linl 11idJ/t L.at ~,s GJi1~3am Johnson Oma Baker INFORMANT-NAME MAIt~NG ADDYESS ~~r.~er u. K.?.l)...o., o. ~.tt..tr. ,~+rr.:+r1 Albert Be er ~~e 161 Sianmit P.d. Cinti 2 ?A!T i. QEATH WAS CAUSED BYI "trrffR OrrtY ONE UUSE IEII IiNF fOR tol, ~b~ AND fc~~ A??ROR~MA/E ~~+TERV~I ~ EtwEEr+ ti Ei wHD OEwTM 'IMMEDIATE ~AUSE ~ Lt ~Z~L S~ ~;+'L~7u1 r~ ~l ! Y CC OUE i0, OR AS A CQzvSEOUENCE OF Cowditio~r. i! ~ ` / ~ ~'1 J , ' trbi~b jrrt ~itt ro ~p) G%` ~ ~ ismrdi~lt c~rrt !r/, ~ DUE 10' 9R AS A CO!~SF9UENCE Of. ' it~ti~s tbt Ledtr- I !)iws uru /ait Iq~ %~'T`(r' ~ IART li. OTME! S~GN:i~UNT CONOlTIONS.~ oMJ~Rr.pt a~iAf/IGYh4a /O fIJII) bYt Il~if Il/JI(OIO aJY)f S/1f11IKp.1~f I!~/ AUTOISr IF tES unt hwC.up ~aniiJ~rtJ ! ~ 1'ti or wol~ ur Jettrwuw~wa ur~t o.• Jr..lh j ~ ~ ~ 790. 1~D ~ ACC~DEt+T. SU~CtDE, HOM~C~DE. DAIE OF trvluQ+ MOUR HOw iNiURr OCCURRED ~f~~er rr~~r.e «!.~„v.~.~ y.,.r r r.,.r 1MI ~ OR Ut~OETERtiur+f0 ~Spt:i!>r ~~lo~t6, f)r~, )'r.+rl . s 700. :Oe. ~ 7r_: M a'6d. g ~N)URY Ai WOtK ?IACE Of iNlUt~ ~1 FVAf. ~J~M, )!~f(I, IJ.fO/~. ~OCA~ION /Sh~N or K.I.P. uo., ~ih o~ ull.rse, at~ts, z.pl ~ ~Sp~ri}) ?n or so~ otfin b(JS., rtc. t~pni!)I f - ~ ~~e. ~ ~c: 1 :oq . : ~CERTtfiUT~ON- ~I~.wth prr }~~.r. .11.nri. f)..: 1 r..r ~ ~r+D UST S~W •MMIMfR 1 D~D;D~D NOT DE~iH OCCURRED .1t tbt pl.rrt, on PM~S~C~At+ ! '~U~E ON 'v~Ew 1HE 60DI~ (NOUR) tLt Eitt, ~wd, !o ~ 1 ATiE~+OED TME TO ' .~I~.rrrlr D..J )'a~. ~AFTfR DEATM. !b? b~st ol ~7 ~ / j / / i / / ~ kworirJa~. dae ~o Ilo. OfCEASED ioCM /i - 1Z~ Y f ~~e `p_ 3D- ~ ~ i ?Ic (j~ " ~ `,f1 ~ ~1d. ~ ~te ~ T~/9a ibrc~~~tli1 itrtrd. ~ .fRifRUTCpN-<ORONEE Os tbr b~.~t ~l rbr r..:miw~t+on fl•....~,r ,Ir~rF 7~hr JnrJtM! nrs prun~aectJ dred oe ~br bodr ..ed; rbr i~ie,rrs~r,on. o. ro~ op~nran. dt.:il. ` .~tontb p.~) 1'ro Harr o.ar.r~Q uA !bt J~tt .ind dut tu !b~ :Jnit•iI s/1teQ. ~ ~ 420. 27b- M. r ~ CERi1HEt-N4i?tf ~l~p r pr~n~/ S~G~++?i i Drj.re vr ~i~lt DAiE S~GN ~ 7/ 7 z~a T r_ ~~b ~ ~ MAIUNG w RES~CFRi1FIfR ' ~ STREET OR R F O. NO CI R VNIAGE • STAi ~ 11? ~ 73d. ~~f• ~~,~J' ~/y! i? ST ~.f~Crw/?~T/ ~O / y/ ~ 6UUAl. CfEMATtONi OAiE NtwE Of CEMFfER~ O? CREM~?TOR? tOUi~ON I( rr~, uilatr, or ~arnttJ IS~rt~/ ; ~ Crematio~.s ?-2-76 i,.~ Hillside Chapel ~•a 2 ~~D~~~~~~ 2 Di~n h Av Cinti 0 ~ ~ NAME Of EM6AlMER IuC NO i FUNERAI RFC~OY~S S!G^~ATUlE ~IIC NO ~ ~ < ~s. Clifford B. hodapg Jr 6l~09A ' ~%~r,..~ ~-~-z(~~1-•r~ 2q7~ fUNERAI fIRM AND wDDRESI • ~Sraf~i NO 1 ICiT~~ ji~iE~ (21?) ~ 27 - S ' li D~TE REC'D 6T .5.8}gt~M7tlRE - ID~Tf ~ERM~T iSSVEO S!G~v,~TU E O? tERSOr+ ~S U~NCi ?ERM!T DIST. NO. - l0~`` REG. S~ s .q 19V~~ 3~ ~ e ~ , y . ~ S4' ~ ~ `.:h~ ~ ~ ~ • 34(~4 2 !t~ ~ ,K,~• i ~ r~ A?~'~,~ ` ~ " " -=7: ^ -~ar't to be a true an3 correct photo~raphi " ~ : , t ~ - s ~b c c copy ~ - ~ Y ~d~t:file xith the Cincinnati Hoar9 of Health. ~ :°r~ z • ~ _ •~.5; r t . ` ' . ~ , . . ~ - - ' E~r :~~is.:; n ^ ~ ~j ~ " • _ > ; '~l~,~ - - ` .-C tv ~ f " ~ ~ x ~ -',kt _ 4 • A . ! . ~a ~ ~ _ . . yc: `~G~A/~'r~], Loc11 ReCi~trar ~ ~ . T~ ~ i ivW ~{rL ~ ^ r~ ra ~ ~ ' ° ~ ~ ~ _ ; ~ ~ ~ ~ - ~ - ~ - , _ x ~~<.~~~_w~._~,~_~_~. _