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_ CERTIFICATE OF DEATH r ~ 4Ei5146
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DKEASEO-NAME ruse rlte,le uar SEi DATE Of OEwTN ! rowrr, o.*, te.s 1
Hazel Margaret Abbott :Female , August 31,1976
RACE .rwta, weGq, WtK•r Irout•, AGE-us! w+oet l K•t u•wet l o•t DATE OF RIRM IrOr/lr, DAr, COUNn Or OEAM
etc. a weer. / Wh l to tenre.r / te.ta l /loa. D.ta , rows ee.e l
71 k 6-23-1905 Oakland
Itt, VILLAGE, OR TOWTVSHIP OF DEATH wstot eln lt•/!s /10SMAl OR OTHER RYS - Ir llol eN ellrlet, one steeet w rrrNn 1
seeun na a No
„ Southfield ,l yes Providence Hos ital
STATE Clr {IRM 1 r .rpr tr V. a. rare CITIZBd Or WHAT COUNTRY MARRIED, NEVER MARRIED. SlR2VTVRVG SPOUSE !u ~lM, Ens r•IDlr• r•Ir! 1
cowm t WIDOVV~, D ! setcn t
llaoe»ce , Canada , USA r. marri James W. Abbott
+e rt oK!•SeD
,~.ro ,t D!•nr SOCIAL SECURITY NUMREII USUAL OCCU?A11pM lave erro O. v.oee Dora owr•D rose w RIPID Or MISWESS OR INDUSTRY
oe,:.lrro w .rOeerwG UN, dtr r tenets /
;~;;;;,'~°';•l~ „364 10 9358 owner Deans Geo,
'0~'s''O" RESIDENCE-SrwiE COUNTY CITY, VILLAGE OR TOWNSHIP r.sloe con lwuts STREET AND NUMBER
L,~;, ! a?Krt ns Oe No r
Mich ,p Oakland ;N Southfield ,e, yes „e 25740 Shiawassee
FATNER-NAME !lest rwpe 4f< MOTHER--AU110EN NAME ela! r10Ole uar
„ John A. Green Lillian Cam bell
INFORMANT-NAME MA41NG ADDRESS /sneer O. e.e.D. •r0., Gen Oe ro...., state, trt
James W. Abbott 25740 Shiawassee Southfield Michigan 48034
rover I. ! )1 a:rn a»,et •i
OEATFI WAS CAUSED {Y. CENTER ONLY ONE CLAUSE lEl LWE FOR (D). (A). AND c Nt,+ur O»ser •rrD De•M
„ WDUI! UVae
IDS Arteriosclerotic Heart Disease 6 months
• • »YOV
CO»D.flO»a, rr ?»t,
.wrCw 6.re .Tae lsI Coronar Arteriosclerotic Heart Disease 6 months
rrrl D.•1! C•VS! a., ( ,O, W •a • CO»ilOVerK! W:
a!•rl Nti ire Vw0lt-
lttr0 C•Vat ufl
aI Unknown Cause
TART R OTNER 51GNIFKANT CONpITgNS: Cdgenora CotanWn.la r0 O!•tw sut rrOr tnwrie to C•VSe Gtreer our r Cal A~OrSY R= YES rle! rrrtltrGt COr-
1 t!a Ot w01 arOealD IM DETeefYwlwG C•YSe
a os.tw
None Tat No
ACCIDENT, SUKIDE, NOMICIDE, DA NJURY 1 rOrtw, oat, n•t 1 HOUR MOW INIURY OCCURRED 1 ewret rutuee Ot Iw1Ytt IM eat! 1 Ot ?•t! N, Rd• It 1
1 atreeln e
1M ~ 10[ M. TOe
INR/R7 Ai WORK ~ ?IACE OF RVIURY •r wore, t.u., uten, r.tlott, LOCATION 1 soon o. t.r o. ro., att oe tOrrn, sun 1
1 S.KIn tea Ot wOr ONK! elDC., etc ,SerKUt l
~ ~
CERr1FICAT/ON- +O»T~ a• •tu rprew o.t Teat •w uar a•rt wr/w!t •lere orr . ow/oro .Tor vure ewe OtwtN OCCUeteO •t Cove had, O» !rt
rNY31C1•N: TO rpr.M pat ttu tpD1 •ttee OEAM. IwOVt• e•n, AND, ro ewe tqr
e •newoeo Cove
ne oece.seD ttor S 14 76 8 27 76 8 27 76 did not 2 89 a °'r' eiOr"e°r''• °"e
nl 711 Tis f !IP !o *re uuseo: sueEO.
CERTIFIGlT10N-MEDIGI EA/1wPlER CMt CORONER. o» *we s•sn or one wolrt or w•er rove oeetoe.n r•s rta+ar..eeD ot•D
e,•r.w.nOw M !we tOOt .ro,oe ewe wvesr+c•.q», I» rt wwq», rOwiw oat .e•s wort
D!•tr OCCUetee Or sre o•~e .LAD Due ro rr! uvsllsr se.nD
2H M. T~ 1 M.
CERTiHER-NAME Intro of rbrer i SIGNATURE-- ~ ow.ee O¦ me OATF SIGNED rrp.n., wv, rwt
George Ritter, M. D TRl ~ r ~ ' t ~ H. D. 9/1/76
seAIIING ADOIIESS-cF.rrF1E SttlEt Ot ¦.r D wo I.9 tbru ~I Vi 1 i a e Michi an 4076
TL 2245 Southfield Rd.
~UMAI, CREAIATgN, eEMOVwI CEMETER>! OR CREAV\TORY-NAME ICICJ1110N CITY, VILLAGE, TWP. OR COUNTY s*•h
r a?Ke.t r
:a Burial re? Hi hland :a Y si !anti Michi an
DATE ro»rw, o.e, teat I FUNERAL HOME-NAME LAND ~ RESS are t o e l.D, ro 0 ovt s
,t T« 9-i-19; 6 ,S, HAp '~.t,'~l~u~ ~.ERAL ~O~;C/' I ~1~~GETR4lT, MICH. ~Q21~
&-b~ WNEi[AC'ELRECrOe-SlGNAturE = ~ REGISTIA ATURE .ZATC eE[E,rEO tt l ifv.574wt1
3oo~n ~ I _ i ~ - - T,. r~.. _ tG~1[.~/~~ ITat
- - Qn 7
CERTIFICATION OF DEATH
STATE OF MICHIGAN)SS ~ ROGFR r OITP.ns
COJNTY OF OAKLAND) cl~x ry''d~
I, Pat Flannery, City Clerk for the City of Southfield, Michigan
do hereby certify that the foregoing is a copy of the true
DEATH RECORD now on file in my officeD - ,
t., ,
11 - •
In testimony whereof, I have hereunto set t~'~~~d and af£ix~,d
the seal of said city. - - _ ~
r.~~ -
DATE: ~ + ' :•••.r~~
Pat Flan -ry, City Clerk
,.,.~;R~~ Q D~r.~t'7J~