HomeMy WebLinkAbout1847 444061
. IQs is A Certi:ied Ex-at CoDr
oesrill• City eDu:, .~+t of Health
. ,._.SUE IERER
OrM / Regtstttr
OEC ' 6 114
QHIO DEPARTMENT OF HEALTH
431 DIVISION OF VITAL STATISTICS
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.,wn,F1..D.tN.. CERTIFICATE OF DEATH R~?•I+•-
DECEDENT-NAME fM MYM LFF SE7[ OATS OF OEATM IMa, Dqs Ywl
Louis Heuer Male , September 25, 19?8
RACE-y~.,Wtrw, Wc?,AwwE AGE-la.t E.ru+wr Uh R t vEA11 NDEA 1 Owv PATE OF IMTN /xw,p,, l'..) COUNTY Ot< OEATN
w hdsa e1IJ (sinyyl (Peers! MoI. I Oop Mow. 1 M.w~
White s.. 7 5 E0. ~ e•. ' Nov. 28 1902 Lake
CITY, VILLAGE 011 LOCATION OF OEATN . MOSFITAL OR OTHER INSTITUTION-Mywe (f/w r tlMn, pw awerw/ wMtJ If MOSf.OR INST. IaOrc.r JOA, f
ONErwa t S,nf/y/
Painesville Lake County Memorial Hospital East 74
STATE OF EIRTM (f/,w r U.SA~ weave CiTIIEN OF WHAT COUNTRY ORIG+N OR OESCEMT II W:aw, Wekew, Gewwle, EA,t./1, Ceeen, SOCIAL SECURITY NUYEE+1
,~"1Germany U. S. A, ; te~`Amer
can ,Q 282-05-9458
nJS Df_EASED fvER ~N U S. ARPEO FORCES, PARRIED, NEVER MAMIED, SURVIOING SPOUSE /U Wlr.pr++w•+r/+Me/ ~
/reaeaer~ (Urea preA.I.ayos.•Ir) IMDOWEO,OWORCEOISInViI
:~io Married blartha Meyke
uwAL OCCUrATeoN (e,., uw y.~we roe...+.r.eay.«trr yra.... yr.sr/ KIND OS ~usINESS a1 INOUSTRr
Maintenance Foreman 10. Machine Tool Industry
RESIDENCE-STATE COUNTII GITY,VIILAQEORLOCATION STREETANONUWER INSIDECITIIl1VITS
Ohio Lake Mentor I~7241• Hayes Blvd.e s'w'
fATMER-NAME FTrN IfifOM 4r MOTHER-MAIDEN NAME Fea Mt/!Ir tnr
,s Andrew Heuer ,a - Dora Unknown
hF011YANT-MANE /T,~,e a. Mep MAtIiNG ADOAES9 (STREET OR R.F.O. Ne.l IGT/ OR TOWN( ISTATEI IZpI -
Mrs. Martha Heuer 7241 Hayes Blvd. Mentor, Ohio 44060
rMT I. DEATH WAS CAUSED BY: (fN7ER ON[Y QNE CAUSEPfR L/NE faR /~1, /Ol. AND kJl t1ETwEEN ONSETIAND DEATH
tit. -
OiRYlE01ATECAUSE ul - Acute M ~ocardial Infraction
DYE T0, OR AS A CONSEQUENCE OF:
JK» Nlt ~ rw,etfien
,,,,yV OUE TO.OR AS ACONSEOUENCE Of:
bafa>eM 41t
fd
PART IL OTHER SIGNIFICANT CONdTiONS: Cadltlew/sewaYelle,MMee•wtee/releetd /eerfs,lre+rrhrl/Ie/ AUTOIM WAS CASE REFERRED TO CORONER
- ryper r/ /S,ecy, ra or Ham/
19e- 190.
ACC.. w1C102. HOP . UAOET., DATE OF INJURY HOUR MOIN INJ4AY OCGiRRED (Sear rre e)iy..Y M ?~vtlw ~ u New f fl
OR ?ENOtNG II.V EST- ISRerlryl /Jbwr1. Del. Ywl
20~ I00. ~Oe. 70d.
i'L'URY AT IMOttX 9iAr: JF INJJF:Y wr ww. famti sa..t)i: rarj. oU7ct iC^JITi_J!= iSisser.r R..°.Q f1- CIi~,K wKL(!. 14n. Ly! - s
(Sly 7a so eel ~h a'r- /SFecyr+
201. - 101. ~ IOe. -
e Ta be Co+wpMeed M ATTENDING PHYSICIAN Olllr Te be Colepleted M CORONER ONY
21e- Te tae DaIW w+r ~+~o+¦+se0e. sees, octvrree a ur true, am aee pew n+a ew w w walsl 72e. Q+. qr !wa p sae,w+uuow eM,or .meu.guwn, ,n wr, ap++we seas oooe.ree et Me t+we, efw
etena ~ ~ enapen a+d sw to w urteW tune.
(Sf,eew w! TIde1 ~ t - ~ ~ ? j/ , ~C • , - ~ ~ . lS;e.wmr ar. TIMr/
DATE SNiNEOIJIa. R OF OEATM -GATE SIGNED pi1a, fir, Yw/ 110UR Of O,EATM
110. t ~ ~ ~ I : - j1C- + . " 11 / M 21b- 7!a - M
_ - ~
,R ' ~ ' t ~ ED DEAD plw, Qrr. rer+ MiONOUNCEO DEAD (Nev1
!NAME ANO AOORES9 TTrw er I?rry (Sneer er RFD. ws. e/ry r rrryt, mr, +Ol
n. M. G~~al ~>M~ E. Hi h St. Painesville, Ohio 4407?
f WRUL,CREMATION .SAT ~t ~ TERM OR CREPAT011V IOCATIO.Y /pry. wlle,e, ercaayl FSru1
2,~uria'~ ~ A~: ~~9• ~ ~~tor cemetery ~.jVtentor, Ohio Lake Co.
~ NAPE OF EM/AUYtfiR°' - • ~ - - . it - ~ _ ILN:. Mel FUNERwt Ot EC70R- SIGNATURE - ILIC. MeJ
i -
Robert $ro~hur~t ° r_ _ 4966 A• - , ' ~ ~ 5061
~ a. _ _ x. t..' 1 ~ ~
~ fUNERAIFIRMwNOAODRE35-•. _ ISTREETNOI / IC~TYI LSTATEI MNI
~ MAHER-MELBOU:ItVE, INC. , ~ T474 Mentoi Avenue, Mentor, Ohio .44060
ATE RECD ~Y REGISTRAR'S SIGNATURE GATE ?ERMtT ISSVEO slGNwtl,gE OF ?EMSO•Y tSSiIING FERPIT ~ GIST.IIe.
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- 19T9 HAY i I JIII Il= 43
~ROti~~cPO RA~A,
CLERK CIRCUIT C11~.
FECORO VERIF!EO-~~ e
{ 444061
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