HomeMy WebLinkAbout0906 STATE OF ARIZONA L,
ORIGINAL DEPARTMENT OF HEALTH SERVICES -VITAL RECORDS SECTION D lOZ- V~1
57 ATE COPY CERTIFICATE OF DEATH
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:~t~~te of --`Arizona)
_ ~ ~ ss ~zte Issued September 21, 1976
Cotm~y; of Pima
~'h~s .cop~(~s. a- true and exact reJ,rcx3uction of the doctmnent officially registered
and!•to'~ ineorpoYated in the official records oi' certificates in the Vital Record;;
hr=arz~h, ?lr'i7ona1:,J1eplrtment of He-:ltli Services, Phoenix, Arizona.
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Iasued -.under the authority of AR'.: 36-?41 and t,y direction of : _
RQGFR P01 i FcA;,
~C~/(/'' ~ ~ f ^ 1 1 CLFnf C:RCI~ni CC/;~~ Q,~
4lalter C . Ro(°ers, P•i.ll.raizar~th i•Jarner
4, Director, i'im~ County Health UeF~~.rtment Chia.'' eTtuty County Tteg 46149
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