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' CERTIFICATE OF DEATH
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RACE rnwte, t.esao, •trarc•rr wrwr, AGE-I.st a I te•a Iweea I t OATS CIi R'!iM Ir101t111, Ntl. COUe(flf 0+ pEATN -
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ansin ~ h. Yes Edward W. S arr
STATE Of RMtM rr rp wr r.a.•., w•ra Of 1N1{AT COUNTRY MARREO, NErER NARRIEO, StItYNeJG Ir rtre, OM r•teew rwre 1
cowls ? WDO'MIlp, DTIroRCED I srecrr i
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SOGAT NUMRER USt1Al OCC11?AT10N Jerre aw p roes wlw ewro rOR p KMq Of MISOESt OR R+DUSTRr -
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RESIDENCE-SLATE CouNrr CI1Y, VlltllCE OR T04MWSHIP ej"a a° I""'
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le.. Michi an le.. In am IN a a i la.. le..
rATI!{e-NAME mast ~ rnaore E•a lsQi1RR-A{ADEN NAME rru rlreala tut
Mike Wi ckenhi ser Minnie C1 ayton
1eMORMANT-NAME MAtINti AOORESS . Inner oa u.0. ra., do p toa«, uw, trr
Mr. Mike Wickenhiser 2301 East Grand River Lansin Mic i- an 48 12 -
?ART 1. DEI?M WAS CAUSES Rr, ~ENlfe oNtr OnE CAUSE ?ER LINE Toe (eL (?)L ANO kll Ntretw octet •rre aa•Iw
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1AJlT OTNEt SIGNMKANT CONDITIONS: GowaeOrra cOr~ua111nre p aar a1r rat al•M t0 cese OMw w rut I Tor AtR T er t'ES wee Iwslros cow-
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CER1iKJ?T10fi-MEDICAL E>ZAAaIr/ER Ot C R: ow rrr ears p ww wwa p ae•w the eucoewl me raowowrcee ow -
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RURIAt. CREMATgN, REMOVAL (/(J tER11 OR C1IEMtAtpY-NAME • l(iOCA (CIlY, VILL/IGE, iWP. +QRir00lN'IiY sow
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Te.. Burial +NDee da M oria Par ~
rrprwl, Mr, nu r FUNERAL HOME-NAME AND AOOeE55 r sraeet M a.r.e. w0., tw* Oe tOrw, u•n, err I
~ October 27 1 73 TLGor 1 i ne- '
FUIeERAI - ~ REGISTRA~R-~ A tECEI1lE0 R~ IOCAI aKrlttw
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I•hereby certify that-the above is a true and cort~ect Dopy of the c~tidcate of Death on Sle in the
City Clerk's Oboe.
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R , . 1N WITNESS WHEREOF, I have hereunto set may
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hand and affixed the corporate seat of said city, this
• 26th ~ ~ A. D. 19 73
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FLED C.tJD RcCOROED:
- ~ . ST. _LUrtE COUNTY„<;LA' •
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'~9 FED Z3 AM i~: 09
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