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~ ~ ~ Z~IA~ QELT t Sd~'cF92 G8RTII1'I TH11T !86 ATT~C~ IS !1 '~tUB C~'I t~ it RECORD _
g~ GN FII.S IN T~ DfPISJ~T~~, "RYCA~S. L
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S1AiE OF ¦ARYIANb
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TE bEf ARiM~Ellt OF MfALiN ANb MHItAI NY6NAN - "
REGISTRAR CERTIfKATE Of REA1M REG Ho _
E ONAME aa~ ~ - oA ~ o.. K.. ?~OUR
Iru7l OeAwil
~ Tstella ~ ~rGLn't ~Pi~18crLi~•'?~ ~°cPM
i- SEx i RACE f DATE OF Rd!iM I. AGE 1«auasux eeaoq ¦ cota , .t v • r.:: _ • •aa
!a RRlTrMIACE s~.•t oawisv: Crt?zEN 0! wMAT COUNTRT? l lAlTWlORIc CITY ~R COUNTY Oi DEATM -
to>aaerl _ AaARRED ? NEvER MARRED D - - ~ _
U S Ae wR)OvvED DNOKEC Baltimore Cif ~ Mp,
C.'.TORTOWNpF DEATH 1- NAME OENOSMAI,NURSRUG OROTFERNSiR1i1gN ite USiiAEOCCUlATIp~ iii RIiDOf WSeVESSOR -
- i. ap «se~cr ~aca.•, owc sat[+.oowssl (1aE 0r 40t W.r06t O w7~rK R~ NDUSTRY
B r Oniversi of Ma land llos ital Clerk Distij 1~-=
~ •'AIRE DENCEt.was.a~o~+aaoi.aawaiw,o..ertnsaweeawc.o.atio.~
iie SLATE qE COUNTY ik CrtrORTOWN . qi RaSIDECrtrlw?ITS? Ue STREET ADDRESS
Ma land - Baltimore rES~ ~ O " 825 Stamfar ~d a 21229
tc- iA1MER S NAME If. eapiNER'S MARYcN NAME
John H, Sloan Martha-- B. Chaney
iN wAS OKEw<:D EvER N u5. ARAaED.iORCES1 IM SOCIAL SECURrtY NO. It >NiCRd/WT _
~•.~.o«~..~.,, ,..es~.e.•.aeee.w~ Finksb:-
Lio - 212-05-2512 R. Dennis Helm
tI CAiISE Of OEATN •E~+e• e.1~r er co¦u pe• L¦e la .e , ~b - a¦d •c - M -
iwRT L DEATM wAS CAUSE6 {s -
MMFDiwtECAtISE'o• - -
r _ DUE TO.OR AS eafeONSEOUENCE OE -
?we M i i
eak o sa?~i~p ~ -T~. • A ;COHSE NCEOF~e ' - t1
?ARt2pt+~EBS -t i iREI TED TO !ERMNALD6EASEOlCOND~C~.*:ENl/PARTIro~
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i h DATi O; I w wA5!ERTORMED iM wUTOESr? Mt ~ `=_S• WERE EtNDraGS USED
~ - . - s 4 ~ N CERTfY1NG CAUSES OF DEATM
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s Jia .cca.n ~ !4 NOW WJURT OCCURRED IE~Sae wluat ¦.w~..+~,. ~a eAet~oa..es 7? _
a tow*ee:~ t . ~ _ _
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w.• end N~eI iw I¦y~ deoN~ occwrad en Nr done owE aoa• awd /.o., tAs coves stated
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f A RE ~ _ OEGaEE 7h DATE SAD
- t! J = M~ ATTENORrG MEO1[wi STAFF ~ i ~ ~ -
T 1 1 MnSKUw ? WiECtOtD llnSKuw
alt rttTSKYSnrs NAME Itwt~oa,ew~ ~ ! i6~1V~ir~t~ E-Ai~Cfir1f R:JF..~G~'~~ L~CIv
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~r.?~JJSrrL. U+~IJtas~-cyoF~n+~:.~1 NrsC~~t~
- tie. 3s~RlAL CI£MA:ION REA+10'lIAE !il DATE !!t NAME OE CEMETERY OR CREMSfOPY 1![ E ATMJN t
IlRten - _ - - t+noieow - eaw+ u+u[ - i
- 0- 8 Baltimore National Baltimore Ci Md.
H FUtaERAt ptREC'TpR ~ Ik DATE RECD. RY REG6T iSat RE ff Ti~cAR'S S .a^ -
~..e Hubb rd 4107 Wilk
ns Ave. 21229 ~EP ~ ~y~~ ~""'T' ~ =
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- - - I~ JAN 22 I'~I ~ i ~
FILEO A C FECUa1k0
- SI t~t~CGU~ITY.FIA.
CLEF
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AECOIFt VERli~O____.(~