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HomeMy WebLinkAbout2792 . 1 .4465 CERTIFICATE OF DEATH - suREAU of ~t~t~ lt~ ~ ~l~tllt~tr~ VRAL STATISTICS DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF PUBLIC HEALTH EOCAI REG. G 4423 STATE fILE Plp. 1 race Or ulAer ) uwu e[S~O4rl:! h+~ eras r.sr. r .oawe...-.a. rs• .e..•y . cowry DEEA,WARE A s]•ts Dtlaxar• ~ St>tsaez C Crlf Ot TOwN M eaw••e• ca••ouur wr rr w s.•• r.•n• wl 1:. CMt p /Orwe M ~wuer ut.snw .n rr r .•.rw vy . Liaeoln - D ~ -C 3- J` o wan! or nosrrt.e w .arms c.+ •o. ~ .er.•« t a race vnrw. cnr u••nil o steer •p0eis t a ttsoe?]ce ern t trr)ir o.. YES NO ? B• D.~1 BOZ 49~ YES r+o ? ) N•rt rail Wpp! usr ~ O•r[ rorwN lM? RY a or OKIUlD pt•Tn Inw a wiw) i ses s e•e! ] wvee t. N1tWt1 • U6Wr OCC{M•i • N Cwr. a .r• sa.+• wsnu snuulp 14,Z-09-?14~ 8t . Tra as i t Dries r w.ertp U. S. n 0•TI fettrr h .fie F•r rwq • u•.OES . •!Y r 1?•Ote U 1) rIK! Or Yf/M M.n o .a.i...orw.) u s .li GrM wAs ~f Mn ae••• ~•-w• i..S paA1lr 9 - 2 - 1902 71 D~laxar• - rs r•rrrrs r•urt u rorrAe s wsr Barra Mor as Lillian Fitzgerald V rr•s•t p soya! t/ .so.r..n Mar Morgan Marl Mor6aa n was a a.T. - t«ra Oran Or! CYrS[ w u•e rOt W M? .r0 at wttMY telweta oralr ?•!1 1 tl!•TM wlli GUSfD h - ~ ~ •r0 Bt•111 ~ CONDITIONS. tF AMI ' wNICN GAVE lISE TO ~ 2 IMMEDIATE CAUSE (A) oartroP -y.cf~ l~~C G>u-7c-Lt• L-f~Q G-s.:-Ls~.. STATING TnE UNDEEt- ~ IYING CAUSE IAST. t out roar :J e L= ' ' _ V rut ' OTNfe LG•+rKun r•D+r•O•d CbneieuTSK. 10 Ot.~TM ~R/f wO~T It~,.rrfD t0 Twf TtWrur O~SF.S[ COT+Mipa OnM N r.1~ I y.; 70 Mu won. h.o..M f I ~ ]r.urioenreic » oexwe rgw.uwr occweto B ~ I W w COMt/tnK. fn• M N.1 rJ r ••1•r• .A.. ~r 4 » r.•! or .uwr ]s .uuer ocewao » •.o••e. r.cron. vettT. tx crrr a rosru sett rrOtrt rpnw psr ruse wnat •i woes ~ t t M rQT wIt! Al wOfl MAIn ~ ~ , sKr..ri,~~,r,.t;,G... ti v W I CERTIFY THAT 1 TTENDE THE DECEASED FROM ~ ~ 19 7 wuiKrsrrSrwllttrl Oe dt ~ TO Z 197 ~ , THAT 1 LAST SA THE DECEASED ALIVE ON - L 1 FH~C Jfa . ~~'4 ti ~ '7 3 M.~/SK'U,rL.Ii •ooeas a 19 ~ / AND DEATH CKCURRED AT ~ .M. ail! s~+~co ~ ~ FROM THE CAUSE AND ON THE DATE STATED AROVE. I ~ T 7 7 n rue.t. cetrwrgw. once p..c.q s psT! )r rurrt Oe s Twu Cremation Nov. 7? ~ ~ • _ ]r. rare or amen oe ewr•lon ~ - n ~ew tlreeTOrs woatss r Cape Henlopax -S ~~k :~S/ l', s tocwnw rcw.. w+. «.w•w] snn » wre tteenM n eeGSle•e y Nasaau, Del. NOV 2 8 1977 certif this is an actuol co ` ~ r ~ ' ~ ~ l~~~ Y P ~i~~ord filed with this office. fIlEO ANC kECUitQEO ~ Dover Delaware 19901 ST.LUCIE COtMTTY.F A. -ie Reg~t ~ ~ • ; ' - ' ROGER POITRA>; t • ° Place Issued CLERKCIRCUR ©~1~~I~r~~ .BoO.rd of Heolth I RECORD YER1ftEt? - '•~?`Y~,- JUN ~'7197g 446524 ~ :~}t~ Date Issued e P J'J•t~ '~~'s _ _ - _ - _ _ _