HomeMy WebLinkAbout2340 .
'}0543 /
3 t
. ~
.
. ~ ~ _
. " _ •
- DSPABTl~ENT~~OF _SBALT-B t
- : _ N° 1027'7
ItzARION,; I~iDLINA , ; .
~Cer:~~f t~~t~e~ ~ea~
. ~
rxIS cEItTIFTE~, that according to tha r~ra oi!this Dopaitmeat -
dies ip Marion, Grsnt County, Indisua, o~,:..,._...~.,....~M~l~!1~:...~..,.
~ . ? _ Age.._..6~- ~
Cain of 'death - ~ Y ~iifi~ _ ,
- _
A8 PhY~--~ JD~is. ~ 8ip~ o~ bnrialM~ ~w`!Tl~a...~.. - ~
tiegistered No ~ ~d1N~~#,I~CIM?p!1 • Mi~i'~4~s
- - to-c~--- l~ne~al ~inctof,......._.~..._..._... _.r.~...»_._.._......~._
L1~ I f -
y ig
- - ~ ~ ~ Registrar o! Vital Statistics .
f ~a
ti ~ ~
I . -
t
f
h
E
I
t
t
c
F~
l
~_;~••~j43--
E L
'T9 t~P° I2 AM 9:40
°S
ti
f
SQ01(~ MCE ~?~h1o
V
k
4