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DETROIT DEPARTr,ENt OF HE~?lTN
VITAI. STATISTICS ~IVISION
~ ~L~'~ STATE OF _ MICNIGAN
~
l DEPARTMENT OF Pt18lIC HEA!
TH r'1 g ~ t~ v
Cf ~ _
STATE fllE NUMBER
O O O O 3 9~ " CERTIFICATE OF DEATH
oECEO~+r w?~ ~.~s. ~.o~ wr _ s« w~ oF o~?rn ~Mo,. ar. r..~
• Freda N. Sperling =.Fenale , March 21, 1978
n~-,.•. wr. wa~ ~aE-~...+w uN ~ nn R 1 DAY a?~ oF swn~ ~s+a. a.?: n.i couKnr oF o~?n~
. s. "~ilh`~te
~ s.. ~ - a. 6-24-1911 Wa e
WCATION OF OEATH r~s~oE dn ~rirTS or. M06PITK OR OTHED INSTITUTION-w.. rr.w.. ~ur. ~ ae.w..i..r.y
~ ?.~,a.,,~?~.,a. D~troit ; St. John Hospital ~
. . 7~- tw?. a:
sTwrt a wn~ er..e. us.~ qtuEN o~ w~ut tow+tmr Muwco. Ncvc~ +u~co. SuRV~vwG SPOUSE Ir wdk yne ina~Oin nr.w~ wws aaaMr nu w
• a~rN
~pN alllinols~~' s_U.S.A. „ri~ido
ed~M None ,~~~s~ No
r4T~Mq~I
~c.~? socu~ sEwrolv Nu~a usuw~ oaur~t~oH ~c~..w„d o~ ww~ son. dWa„y mau a iu?+o oF auswESS oa wousiier
37b-54-4028
`°~"E'~~ ,3. Homemaker ~ At Home
~s~Nt[ etr~s.
~ CtJM1E/fT IIESDfNtE-STAiE COINtTY IOCJLLITY r+SOE Mv urrs O~ _ STHEET IWU NWABfH
~~l ? ~ vu~w[ urris a i
Michigan Wayne ~,w, a Detroit ,~10 Warwick !
fATHER-NAME cr~5t ~rop~e usT 1IIpTHER-MA~DEN NAME ro~s* ~ usr
,a. Narry E. Lewis Sylvia Battershell '
w • bwlMiG ADORESS micn w Rr o. w cm o~ row~+ sT~~[ a? ~
, „ - ,~520 Red Maple Lane, St. Clair Shores, Mich. 48080 ~
Tp~ 19. WYMEOtATE UUSE ~ lfN~ER CA(/Sf PfR L/NE fqR /iJ. /bl. AND !el l wu..i ea.«. e... w r..+. !
+aM[ou~tE PANT 1 ~
s.; , p~ C-~1-C.. y ~Y' Q I e~ I
""'Df~YD1G OUE TO, OA AS A CANSEOUENCE Of:
uust ust r a / I r+«.r ~w++~+ «~r~ w~u
L~ ro~ ~ - 1
OUE TO. OR AS A CONSEOUENCE OF: ~ . ~ r«w sr.... e~aw a~w ewa~
~ (c) ~
PAAT 11 OTHER SIGHIf~CANT CONpR10NS- car,sM.y a wu sw ~s nw~ pw, . r~ui ~ AUTOPSY lSpecily Yes WAS CASf REFERRED TO MEOKJ1l
' w llbl EXAIUIHER~ (Speulyr Yes o~ Nb/
" 20. 21.
RACE OF DEATH t~w.n. ws.y ~ia.~. • F HOSP. OR INST.. rac~a ooA 2aa. nr c..e r.....w .w en«~...e .a w..~wr.+ ~w.~?• c«.
~e+w.l 1 ! '~Yi c*rt+.~ 1~ ~ /Spl~phl rCner~ ~
22~. . ~ ~ 72A. ~ o~e
23~. • w sM W~r . srie d a w dw~. a.~..~e eo.~ D a. n» sus a..~ ~+e•o. w..eqr~.. w.~. aa.e. w.m «onw n+r
w e.w~w rr.a pw ..~e e.. io ow. wr w aw .w a. ro e,. c.+swn aue.a
~ o Z /Sqnatuie aiM Trtlel ~ ~t~~ s ~/Sr9natuie and Titlel ~ •
z Z t DATE SfGHED /Ala, D~ , i J HOUp OF pEA1H <Z DwTE S~GNED (Mo.. Dsy. Yi./ HOUR OF DEATH
P ~?q V-
t 23p.- r~~~~ 23c. M 21b. 2tc. M
~ V 4 NAwfE OF ATTENDI/uG PHYStpAN li OTNER THAM CERT~f1ER /lrpe w Ainf/ ~ w PRONOUNCED DEAD (Mo.. Day, Yr./ PRONOUNCED DEAO /FioviJ
! Z~- 21d- ON 2t~. AT M
~ NAME AND ADDRESS OF CEtiTIFlER tr+nrs~cuw on r~tauu EnwuiwcW /Typ~oiPYint/
~ 75. ( . ~'t ? ~ . t C~ ~ Q ~t= ~ G/,/~i*7J.C J~' ~~l47 _ ~~L~~
~c~
~O[. suioo[. wruq.~t Qq~ pF INJURY (ILfo., DaY. Yr./ HOIIR OF INJURY DESGRtBE HOW tN}URY p~('~f~D
on ~E~+o~Mfr riVESr. rStKC•~r7
~ 26s- 26b. 28c. 28~
~ NJURV AT WOHK PIAGE OF INJURY-~~ ~..n~. rw~w. mek ~wor. once IOCATION SiMET OR ~ f 0+r~ orr. vwucc. on tow~cs+~ro srwrt
/Sp~cih Yes oi Abl s.~a.~. .~c fSFe'~~P/
i6e. ~ 26t. 2~q
L- BUPoAI, fftEMAT10N, REMpVAL. OTHER (Spct~/yJ tEMETE(iV OR CRCMATORY-NAME IOCAT~ON OT?. YtILAGE. OIl TpNn'SMV STAi[
~ . 2~,. Burtal ~,b. Acacia Park 2,~_ Beverly Hills, Mich.
DATE f~-. Osy, YiJ NAME OF FACILITY ADORESS Of FACItITY Michigan
M~~ch 24, 1478_ 2~• H. Peters Funeral Home ~~p~~ck Gr~ss~Paint~Woods
~ 4 36a FUNERAL SE ICENSEE REGIS7RAR
R; fSrgns~urcJ ~Sgn~tweJ OATE RECEIVED BY REG15iRAR lMa, ~
,,;~8~ 29. ~ 29MAR 2 21978 y,.,
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I F~REBY CERTIFY TNAT TNE FOREGOIhG IS A TRUE COPY OF TNE REtORD ON FILE IN THE
~ DETROIT DEP~RtnENT OP HEAITH; a7TESTCD BY T~~E RaISED SEA~ OF TNE CITY OF DETROIt
.
~ ~t.~LUCi! COUNR~S~~- • i C~~~~
~ R04E~ pp11 E
~L~aK c,~` u~t cou TdEODORA nORaLES
~ ~E~ 1~1~3 ~ DIVISION NEAD _
~ . 9 5~ AH~~Q, VITqL STATISTICS
~ ~r 2~ -
~ aL ~22
~ DATE G ~ • ,
~ . B~Qx293 ~,~~E 4~6
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