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too _ COMIMONVYitA>'.TH, Ole taENN9YL,VANIA ~ - -
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LOCAL, R$(~iIBTRAR'B C'1&RTtFICATIQl~ OF DEATH -
= $4
- - - - ~
FuU Name -
oI Dcacred
- t'iy Yt~ . fall _
v Cra~f~rd ~ Ng~r~erae
O,y~, ~OI6
t+,~p.. it~w tiry « t.w~ ~r ital.
warren Ta+tmshi Bradford ~ p~y~
car. s••a.w - ca.tr
-Dace of Drat6 ...r.__3..h-~fi - - Sec~t~ - - _White
-
f~4nrita! Ssstns :I9~sls~ts~-~ - -::sue F~ - - - ~ - _ _ _ -
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occupation ----------~i~+T~e BlrthPlaee ~:_Me~L:..t~eT~9A~_...
if Vettrart. which W~ _,z~_ _ T___.~Vtttrag's Stria! N~
I4IEDICAL CERTIFICATE _ lnoerval Betaeea
Part I. Dcat6 was caused by: _ Offset said Dest6
.
tmmediace-Cause (a)......_ Carcinomatosis~ 6 Mos.
o~ To (b)..._. - -Carcinoma : of -uterus _ 2 Yrs. .
Due To (c) _ .._....r......_ ~......___..__...._._w_r_._ _
~ Part li. O'T1~IER SIGNIFICANT CONDPI'IONS:: oantribtstins to death but riot related to the ioroodiabe cause given is
_ Part I (a) - -
Accident. Sddde or HatnicWc __Wow did inltuy otcar _
Name and T;tk of Peron Raymond L. Bennett. , M. D.
Who Certified Cave of Death (M.D. D.O.. Corotter) _ _ - _
sx«e ,
This is to certify that the infonmatiot? here gi~~ is oortectly copied from an original certifipte of death duly hied with me as Local
Registrar. The otiginal cettificste wi{{ t+e forwarded to the State Statistics Ot[ict t pcrm ant
~ 08-096
. c.at a.st~w. twrw arr. _
1 North_Higgina Avenue, Sayre, Pa.
- sr:u A.b..a cNf. b.....M. Ta~atwt+
3-~-76 _.._.t9..~...
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- _..~-T..-Zb.._._... .._...19..._._ .
4`780'78
198Q NAR -4 PK 2~ 43
FILED ANC fECOROf ~
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