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HomeMy WebLinkAbout0936 465918 ~ S)AIE Oi MARytAMEi • ~ ` ' • s~TE OE?ARiN1ENT OF N[AITN ANO MtN1Al NYGIENE j ~ ~ ncnuu CERTIFKATE OF REATM RcG No . ~ ~ ,L; ~ ~ 1 E lO1EDNAME 'a+t ~ A A raver w. w.e N IIOIIR ~ ••MI ~ N MI •rt ~ ; OOROTHEA M:ECKERLY T. . ^ ~ ~ fv ~ •.•ts.•.+u •.nrar,•.~. • ?-7 Cry ( ~ 1 Slt 1 RACE T OAT Oi RR1TN l A IMNaMtastrt.paq r ~r1 M?f .O/6 v1 ' r ~ r ~ ) ~,•,`.•.y 1~HITE 4 - 2 - nr rRt ~ ~ /t Ral.atOCE .vtuw•tar h COtlENOi WIIATCOUNTRY? 1 \ •J 1 EiAaT11MORE pTY Qe OD1NaTY Oi EIfATN pt <o..••.1 AIARREO~NEVERaawRREO O V w ~ wR>OwEO DNORCEO M t O IECtlsORIOWNOiDEAIN .NAME NDSt11Al,NlJRSRaGMOMEOROi1RiRRKSTRUi1pN Ite U? fION 1?{KNpCtiRUSNESSq~ \.1., IIrWe•StKalatar+.GMfMI1t.0ptlSSi I++RdwpalperoSlduOtt•4tM1 NDUSTR7 W RET R D S H OL TEACHEF . ~ ~ - V 4 t ) V l 1 S.d: •Orl p O~•a. MlaytpM 4M at/pK1 M•Oa wertSSp~ . ' ~ to Rl Iw STArE 1A COtM+Tr ik CITrOR TOWN It/ NSOE CrtY 1w1TSt qe STREEi ADDRESS DELAWARE SUSSEX SEpBYVILLf: rESp U ~ N iatMEtS++~IE iS MOiIIER'SMApENNAME rOOlt last +aSt •.OOII ~a~t ~ a ~i~EI2LY . ( z; t-• V. NOSDECEASEOEYERNUS ARMEOiORCES~ Iw sotulsECUlninNo. li NwRAUwT ~iAGENBUCNER ~ - _-_T `LY. '0. 1•N +Opw'•O+h Ia Mi6M wu O.0ut1) . - C,R.UfEOf~A1fl.Ewte.ewya••ecoateoe.aweE •.~b•.ewd.c~ a ~ u_ ~v1a1T ~ ~rstAllsEO n: 9?J~ ~ --l c3~;; '-~.~~y~_ ~iiE!EOa~uiEtAUSEIe /(-G? .~G~rl~~'t ~yll.: f.i.•,,,±1- ~ ~ ~ ,b t,. -C b tl/% .l:'l~LQ.~ .,r. h- 'C 6rat U~=`~S ~ . 4~ e7utF `+te~. - t.w~ : ~ ~ p{!E TO.OR OUENCE Oi Pr ~ • 1• j wr ~ HI "~~Lc~; ti~rtt.~:~.~tc-- (_c'.!!/.~C%. ~'%,<~tbrr -~•<a~u.., Yr. ~ ~ _ ~ ~ RARI ? OTMEEI S - ~ - LCM4DRIONS CCINTRMUiNC: TO DEATH E1Ui NOl REIATEO i0 THE iERMNAI 015E ASE OR tOPIDIiION GNEN N ?ARi llo~ ° ' 't :ti OAtE Oi CMERAI - , IN CONDttlpea iCM WNKHCIIERAi1pN WAS IERiCNMtED to AUT r? tN IF YES. WERE irvDNGS ~Ep . :.r~• NCERTRYlt1GCAlISESOfpEATM1 ' - ' , rES Q NOQ YES Q NO N < ' He.a,~rq±raustwoerT.+c Q tiailMEOiNJURY tlt-MOwNlIIRrCICCIIlREO Itr+t<w.lllaldetO+t+wtllrlaeaelloeran>7 - a 4 MOUR Adl MCMITN q~<dltiidl.+G ©~ayst a aarw OAr YEAR U ` Q ` ~ t ~knia+o+e?.eaca.a....an ?~N. 19 d - i:~• - Iw luRrOCCuRREO Tle rtACECK N1URY 111 ICKA . ~ .wa1 O •,pr +..y1 ~ lal rOrl. SltNt.+K1p+.OHCR1ara <KI S+a[It CPOt+Owl COIMt pq• - ;S - rl th 1 c Ib ~R UM +OII one Iat decaosed Irpr J .r,' ' - MiE'1' ~ ~o• 10- . a 19 1601 ~]re)It i w. the deceofed ol•.e ow _ ~ _ ~ nlw.r n c.e, ~ r dd • veer 111e 'TIH IR 19~. owd Iho? ~ ryl tow! oo•w.en deoM occwred ow Me doM owd Sw. owd I.ow t4 coo+es stoNd a ~r" ~ 7A SIGNAiVRf DEGREE 1/ 7k. DATE SIGNED a1.~([,L,~f,C ~'t ~ AiiENDNG OtEOKAI STAfi , ,4 !1'E.J II/rSKuw DRIECTOR~MITSKWa? `tfLY/ :`a q lTa MrSK1ANSNAME Irnep+aN~l tta ADDRESS . ~ ui ~ ; DONAlD WOOD SALI S BURY, MARYLAND :i. ~ F-l• ik+EUtlat.CRErIwigN.REOIpvAI 1RLOATE tkNAMEOiCEAtETfRYCIRCREMATORY )tll Ai1pN cn d Ipwt1 coiaa+ 3tON uz. ~ '~1~IAl. 0-1-78 ROXANA CEMET RY F=1 \ ~ Ta itiNERaI DIRECTOR ~ / DA O 2 REL:b1 RECi'eRiTRAR's - ,,.,,t ~ , R Y A ME L S h ,F i,: _ ~V , ~ _FRANKFORD, DEL . ~7 ~ - t t 44;5,918 '9~9 fin'; 14 "`i ',1~ r~~tc are ~.w[i'~F~ - ST-IUCF~ FQI~RAS~~ .r,~ G~ e~ 320 03~