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HomeMy WebLinkAbout0992 ~ ~ i ~ / f ,~.c"~.ii . ~ ~ st~~ f+~n+o or?n . Rs - 3/ ~ ~ STATE Of WISGONSIN . • ~±~y OEIARTMENi O~ HEAITN AND SOCIAL 3ERVKlS SM1E 05A?H NO. ! 1 ~~iJ l OlVISION OF NEAITH 1Q ~ ~oc~~ F~~e~NWWdER ORIGINAL CERTIFICATE OF DEATH i ~fCEASEO-lIAAAE TROAS L E LUNN ~x ~tE or o arn «~a~M a,r rw ~ RALE-MlAife. N~9ro. AeeMKMlediOw. tt Y~letf ~ih1?Een U~det Ont Yea Uadtr On~ Oot ~TSIRTM ~Aonih Oe~? Yeef COYMTY OF 0 Aill ~ ~ ~ White ~,,y~ ~ ?0 ~ ' x " ""'a a December 18, 1899 ,..1?iilwaukee ,e' ri~v~E OF C~ir. WtIAGE (lf ~ItitAtr. Momt TO~sUy) Insid~ Cify W MOS?ITAI OR OTMEt INSTITYTION-NAME ; W ~(tccot~ ef Oeof~) . Vdlepe l'ruin U( Not Ei ~her Giv~ S~net on0 NvmOe~ a LKelien) Nlsi~~sukee c~arh o~ro ~aint Jose h's Hos ita~. i 70. , W~ S1RiE 0~ ~tRiM C~T12EN ot WAoI Ceunlry n N~r 1URVIW!15 S?OUSE . pf w:fe, G'we Y-oidM Na*K) o~-,+ N, s~.we.,e c~~ry, USA w}e..~e o o~~e Gertrude nee TPrinz ; . a. Y3.`~inois 9. ~o. o + i SO(ul SECURIi~f N0. USl'~?L OCCUtAt10.V GGv~ KinA ef Mlak puiwy Jdost W Wakin4 l~fe KINO OF DUSIRESS OR INOUiiR~ ; ~,z. 39?- E.M;~.~~„~ . 07-3498 A Salesman ~,s. Retail Store ' RESiDENiE: S1ATE COUNTY NAME Oi C~TM. VIIIAGE ~M~dt C:tY ~ ~ MAll1N4 ADOxESS (Npnt AQErest ot T:mt o! ~tetA) f If At:fA + i p) Vii!Og! limiri `:\,~sa 1Visconsin ,~Milw.aukee ~~1ir•au~cee ,.,~rKo~a ~.~.3035 North 44th Street E!~ ~41KfR-N~l10E i.nt M+OOIe loit µOINER-MAIDEN NAME F~nt MiOEIe lrs~ ' i , Unknoan „ ~ ~S_ Unknown l~~ r,rCRw1NT-NAME ~NA~t1kG AC9~Ei5 Street a R.F.O. Ne. C~~r or Villeqe Ste~e Z:p wAS DfCEASFD EYE~ tN U.S_ ARIIED iORCES? -i Gertrude Lunn ,~035 N. 44th St.,Milw.Wis.53210 x:K o~w o u~°ro *°j~~~~ ~ ~ t 9. i~UtT ~ OEATM WAS CAUSEO - EMN ONy One Covse ?N Line iN (Iq, ltL a+d bProirnete lntenrl ' ~ w ~ !~t' O~net J.otU ~ ' i I C~a~~~ens. 11 M~. A. tnrncAa~e Cwu: ~ w'~~ C 7 ,:~~~cA ;oye tKe ts py~ te. Of Os e . ' W~-T~ew~e ear.~ UN s. twKearenc. of: - ~ ~ Yo~.r.q ~Ae IMAe~. :r~~9 Carsc lest. p~ ~e. a a• C. (a~seaueete ot: ?~kT 11 O2HER StGN~ftCRNT COMO~itONSs Cab~tions Contr~puta~g to OeotA bu2 nof ReleteA fo Couse AUTOPS'? 150~t~!r) ~~'ERE fllt~l~tGi CO`~S~CEAED fY ~ OETEtM~~l~~ CAUSE Oi ~'_AiN7 : ~ 100.~ Yes t9b. ~ rh 0~ : _l: ACCIDEN: OATE OF M~uuM Oey reet Nou~ NO1M iN1QRY OCCURREO (Enter Moturt of Injury N+ ~at 1 0~ Iert 11, tten 1~ T~ SUIUDE INIURY ~ ' c 2Ca. ~ N'JMICIOE . __v ~vs~Rl/ AT WORK ~tA(E OF ~N1tMY (?~on~e, fa+~, S~reer, Foc~ar. E~c.) • LOCAnOa Ssred er R.f.D. uo_ C~tr e?v~l:oqe Sso!e Zb v ~zo. ~ ra p n~ lsmttr) / f:iti1CAT~QN-Man~A Ow Yea 1MO~~h Ow Yter AND UST SAW Ntµ/Hf~ AItYE ON O~D ~Otl VtEW TNf OEA?M OCCURtEO A1 TAe ~let~, On A~ , crrs~p/W MantA Doy Yeot lODY AfTER DEATM (l1ov~ De~e, anA, T~ Tp~ ~est i _ ~ ~ ~,n~~ed TAe is. ~ T~ ~~.QJ ~d ~ ~ - ~Q ~7 ~~Ns ot Mr Rnow~e:9!. lus . ~y T~ TAt CauseSs) Sfe:M. racsed fro~n `l}~C~ ~ 21e. 21Q. YM 21e_ M. Z n I21A. ; - t~, t~fAT~OY-NtEDICAL [xuA~NER OR CQROKER: On TAe dcs:s ~f The HOUR OF Df~TH tME OffEDfN* 1NA5 PRQf:OUN(EO OEAO ~ m ne~.on o~ T~e bodt o~0/e~ 1Ae tnves~.qo~+on. In 1Y1~ panion. Oeotb AAOnth Oey reer Moor ~ .~:•~ea ow tne oae ond D~e to tne Couuisl S+aee. ~ . M. 21A. M- ~ _.S~.i~t~ER-kRME (Tpp~airmt) StGNA TIF R T~ttt DAiE S~NOV~ 2~I 19TO Y~ ~ , , Robert F. Madden I~ „s. ~ ~ Y~' x~ ' ~ ~ ~3 AWRESS-CERT~FlER S1reN w Ri.O. Ye. CFtY or v~~togr S~ote 1~0 ~ ~ .:;,`5430 1•t. Capitol Drive Mi2waukee Filisconsin S3?~~ ~ ~ " Y. lGRtAI Cfk.ETER~/ OR CRENJITOl11-NMEE IOCAIiON City Stotf i ~ ` p a[:ti?t~oN , • • • ; ~ R~l~OVAL ttisconsin Memorlal Fark 2~ Brookfield, Wisconsin i j ~ s.~. . ; ''{_-D~?TE ka~th Doy Yter ~UV[RAL HQYE-YA'AE AND ACO~ESS S?~eet sr R_F.O. No. C~h W V~Iloge tott Z~0 f ~ ~ _„~o~~. 28~1470 ,S(Cra~se Fur.eral Here,~020 t~1.Ca itol ~ ~ ' w ~~is 532~ ~ ~ "'~l DtA~CTOR-SIGNATJRE~ RCG:SiRAft-Sl4NATURE ~ t ~ f ' , _/~f;~E(EIYED Sr l~co1 Reo~strcr : ~ ~'.:i..: ~;~"yi 197~~~ ~ - ~ :.:r: ~ _ - , - . . . : ~ . r y~~ - This fs to certify that this is a tr~sP aad correct: '~io.tia~t-bf ~ t~f+acord ' _ filed ia the Vital Statistics of tho Nilxaukee al ~n~ /3~ • . 'j~~Y. : ~ d~?.'?~:,~ • ~-'Y Dated at Hil~raukee this -y~~` 1977 - . ~ . 5 _ ~ : cv.ro°r:~,', ` , ~ . Coavmissiaae~'~'He~11~ -x ~ - ~ ~ ~ ~ ~ i ~ f ~ED AKO RECOROED i i~. LUCIE COUMTII FLA. CLERK C RCUIT CpuRT RECORD YEkIF~Ep„~ ` F`:' 1~ 2 3~ PN'~7' s lttl ~ F~ ~ -