Loading...
HomeMy WebLinkAbout0234 _ ` . ..s. w n o~ - , i `.•~.aoao o~s.¦~c. IVtn vURK STATE a*~*c ••.a ~....~a+ / ~ DEPARTIMENT OF MEALTN ~ ~ t~+sus sue• ` ! BUREAU OF VITAL RECORDS -H.~. D~V~S~ON ~~~~STt~1 ryu~L• CERTIFICATE OF DEATH ~ S1~I TYPE ALL ENTRIES OR PRINT !N PERMANENT BLACK INK. 1• NAME- FIRlT MIDOLE LAST 2. !(a ~A CA+I o• o~~rw ~N w sr~r.a.~c~a o~sr~~cr ~.•~c •t..•~c ..o.r. o•. .t•~ -1 t r / ; - ~ ~ l~ U~ I~( • rC'6 S ~ a 9' 17 75 ~ P. ~HEC. 1. ¦~CC: Iwu~t[. w~i~0. 7. ~fc .r uwo[¦ 1•~. .r u~ocw 1 0~. •A. vnt~/w Or U S. u.~[o ro~t[s• ~~s. .r ras-s•rc.r. wa~. u• ~ u~tw~clw ~rO~ur; Ctc.~ uorTws o~~• wou~~ ~ YIy. O~i(f O~ s.~•.c[ 'AES. ~ ivliite . ~1 ~ ~ •t3 ro u...pw• ; rws. : : ? ~ C'~, O ~ ~ M 7A. Courrr lHYil ~70. 7or+r ~ 7t. c~~~ o~ ntt~i[ ~)D_ ~~riiw 0? f7~~ ~r ~7E. wos~~r~~ o~ e~+a• ~..s*~~u~~o• ~ ~TOMM. C1T1OA111Ll~Gl, It~ Y[~1w[~~ l~Y[ St~l[7 • YD.1 ~ Erie ; : Buffalo ; 61 yrs. ; Sislers Ilospital u ~ . 0 S. •.iTATC 0/ ~IATM O[C[OCM1 •OAM ~0. C~TIZC~ O? wM~f 11_ YAi~T~I 17~1V• 1=. Su1~~V.~li S?O:/S[ I~I 11I~f(. yV0[~1 ~Yr i. ICOJMT11~.l/wO~Yf• YO\lw OAt •C~w CpyMl~T1 j ~E N. Y. 1~ r3 ;13 U. S. A. married Cecelia Bl:a~:en ~ law. usv~~ OCCt1~AT10M UY[M ir ~eTUCm ' ~ae. a~ro or ws~~ess o. uovs~w• ~at_ see~~a seee~~~. i i'•~ N~elder - ; County of Erie ~ v , . . s,,.: ~cs~ocrt[ wwc~C 1 ~ 1 G[CL~~IJ l1Y(O. 1/ si~T~ ~te. ~OYMT• I~C. 10~1 ~ t~o. c~rr o~ rlll~G~ 1~E. w~iM~• ~MC 1~~_ sf~~[T Y'J AyM~[• ~-~Tw OCCL~1i1C0 1¦ y ~ .~l~~TUT~Or_ t1Y[ ` ' 1 . ~ ~ CORIOA~T[ 11Y/T!! ~ .~.e.~ .o~_,._,o~ ~ A?, Y. ~ Erie ~ ~ ~ .o ~ ~ ~ ~ ~ ~ p ~ 63 Ediso~t St. ~ . ~ If~. I~TMCA~~ MWC: 1~J0. YO~MC~'! YAIO[M YAY[. " ~ /lAlT Y/OOiC 1~3T . /tA~T Y1001[ ' l~fi : George Hoos Elizabeth L:rther ATTENTION ~ f~~. ~w?o~w~wi'~ MAMC tl~s. Y~~IIMG ~DDAC~S: UUCIYO[ i~~ couc~ ~ ~w~0~ MOTCO Iw A ~ ~~~~T:.,~.=~•~•o~~•«<•. Mrs. Cece~ia Hoos , 63 Edison St. , Buffalo, N. Y. 14~15 . ~~Yc[ •rwtit~ill411 /~lOA. f ~[CT[DCtwr1I1C~T[YAr~( . l..~lT1T17T[O. ~ P~RT 1. OC~tw KA~ G~YS[O ~7 (MTCA O~l~ OMC C47iC I(~ L~M~ !OA lA~_ \01. AIYO IC! ~~A`~~~Y~![ ~T[~Y/~~ •[T'n[C~ O~SIr • ~i• s. ~ ~M IMCOAA(CT ~rCATI/1. 1). IYYLO~~T[ C~YS( J~ n ~ arC M4! •[CM ~ClC?TCD ~ tV~G ~t ' ~ r~c ~cc~srM~~. r~•c ~wi ~ ~~~Vd~_ 2 ~_T ~ .o... v.s. as. J - ~ ou~ To ow ~a ~ tors[Ou[rct or , ! i towo~twrs. ~rr, w«~tN ~t 1 V" ~j~..~:r ~ cwvi'wis[ ro ~u.~co~~T[ ~s~ /JZ- 1't Cl~t"~s~{~~l a!' ~ ~ c~uac ~~i srwT~wc ~~c ~ ~woc~~r~¦c c~usc ~~s• o.+c •o or. corscoucwu or / ' ' tU ~ ? i PART 11. OTM(¦ •iGM~f~(V17 ~OMOiT:O\S CONDIT~OMS CO%*AI~yT~MG ~O ~~A. ~yT0~3~~ i/B. ~~f[S.M[~[ f.AC~~~S {O~S~~~.i['J O~ATM ~LT MOT •(l~1[O TO CY73[ GtY[~1 ~ti I~RT 1 l~i ' •[f MO ~ ~[T[su.w~tiG Tw[ G~JS( 01 = •T~• ~ ~i ~ .~s .o ~ . ' D 17. 4 '~)a"Cf.~~' ~ _ ~c'fGulV-~ ~ v~..>kt~ i ` i Lj ~ 1~A •ct~OCMT. wor~~c.o[. ~IYB. wGV1~~G~• •Uw Ii~C. wou• 1f0 wow D~o ~r.Vw• ottuw+ ~[wrt¦ ~.•TU~~ or iw.~•.[s a:- . ~ ~ fL~UOC. utD~I[~~~MtD ~ ~ ~ . : }1A. ~ 1 t ~ Y I~E. IMIYA~ ~T MOAI~ . IPF. ~~LC[ Of 1MlJA~. ROMC. • IGG. IOCAT~OU ~STAI[• ~ MO.. C~T• ~ v'~l~G~. T4Aw. CGrA1~ y1~iC~ ~ .cs wo ~ •~cto~s. orr~u ~~oc-. c*c_ ~ ~y~. ~ o o ~ ~ ; TO BE COtV~LETED 6Y -0R_ TO BE C~°lETEO BY ~ 20. PAAT I CERTIFYtNG PNYSlCIAN ONLY 1o P~RT ~RONER OR MEOICAL 'cX:~MtNER vt:~Y t A.10 Th[ \[ti O~ ti• Rr0«~[OG[. O[~?w O[[V~~[D ~ J~_ L~ ?w[ •~S~s O~ [~~u~tia*.~~. qnt0• ~~~c•'.G~'.Ow_ +v v ~ TM[ 7.uC. D~T~ ~r~ • L MO O~C 6~MC y. ~ ~ • 7~T..' Ir~• ?t~~ ~ Oo~w~OM O(Aiw OL[~~~f~ T~l1C. =~'r af`D ~~~C~ i G~JSCi ~T~T(O 1 Wi TO TM[ C~yS(S S'AT(D _ . , . . M „~M~o. . 91~ ' ~o.. . _ _ 6. 'w[ •w~s:U~~ •~TiwO[D •~t G[[[~![t ~~l~ s[i+ •t,rE 6. a~~r~i:wffC O[~a C. wGVw D[~~:[ t G~' ~ uOMT D4e hri~• ~ wOMTw ^w•-'i `~iOr~-,~ r~e ~ ~ a t.a r--~_~-T_,~ ~ c• u~..~.. o~• ra~w i - c - A~ ~ A /RQ~ ~j ~ TO 1( / ~ ~ '17' ~S 1 ~ r . ~T _ _ i ~ t,_ ' • y . . ^ W~ ~ S D. •?rcrO~wi ?w~t~[~~.ti. orM[~ r..~w t[wt~~.[• E. COROUEIIV ~w~HU~r, O~w[• ~w~. C[~r r t• ~ piL Q d~ . . . ' o~~`~ j ~ ~ _ ' va~-r~ • W,'~ .~~y ~ 21_ w~u[.ar yDOwt3s or~C[~t~n[w ~~w~3~t~~+. COwOti(~. ~[O~C~I [~u.~~wt ~M. .~tc.CK 6~~[G'c~: f ~ - ; •y ~ / ~ ~ r r " ~ i _ ~ _ rt r l~ " ~ ~ 1 ~ ~ ~ ' , • ~ ~ ~ ~ a~i . _I'v-.~-~ey,? s~.~K y~,~ J„~, W~ 22A. Ww~~~ L~[~wi~Ow ~[wOr~ MOh~M C~. r[~~ 21b ?~~C[ O• Wkj4L,".t~ r~~w Oi"~, , ~ ljt. LOfl~~~OU ~C.tn W ic+r. si~r~l i~ ~ ^ I ~ ~ ~ ~ . ~ •f.. N ~ ~ , ~ ? - ? 9 ~ 20 ~5 Sl. Jol~~1!3 C " ~ - "te~' - ~ : Gheekto:ca ra, A~ ~ € ~ 2]A. wwu[ ~w0 wOO~ti3 O? Iystw~l MOYC _ - ~ ' ~ ~ ~ . . • . ' 'y. 2~0 •Li~irw~r:Ow wQ_ ; Carlton A. Utlrich Fi~neral Hom e, Inc: ~ r ~ ~ ; ; _ . j 2~A. Hw+[ 0I ruw[awt O~~CCro• O~ - ~ 2~t. •cc~s~ww~~ow w0. i. ° Carlton A. UZZYLC~1 ~ r=_. - . OJ~7~6 ~ ~ bA. ~Gwyyllt Or H ¦ 25B. u ~rw o~~ rtl.~ 2~A. . . _ . tt ~sar[o 2{6. .~owtw o~• •u• _ ~ VY~~ • O~tt L = . - ~ ~ _ ~r : ~ ~~[O ~I~i1T Z ~ sr. . . / ' '{i~ = t~~! vU/~; i ! 1 1 . - .~y~~ ~YYA