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MargaretEEKleinpahn e c Count y I-iealtli ~e artment
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' CERTIFICATE Of DEATH "'t MO~----- . ~ -
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»•11rs 1•:ar .aret Klein 619 North L. Street, Lake V;orth, F]a. 33460
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^ `'~1 ti' ~ ' ~ ~ I HEREBY CERTIFY THE ABOVE TO BE A TRUE AND CORRECT
• : $L-, , - f~ COPY OF THE REGISTRAR'S RECORD ON FILE IN THIS OFFICE
; t- o.~q" : ~ (Not valid unless the seal of the Palm Beach County ~
Health Department is affixed) •
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- ~ ,''f~+~- ~ -3, ' 1919 SEP 13 PM 2~ 19 ~
fILEO AMO FECtJftDED C.L. Brumback, M. D.
~ ~ ` $TA~ERPOi>iRA~~' Local Registrar
pg a.Ewtuscu Bureau of Vital Statistics
SEAL 60UKJ1~ PAGE1~ ; ~ West Palm Beach, Florida -