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Leal Fee =2.00 84314
CONNECTICUT STATE DEPARTMENT OF HEALTH
Public Health Statistics SactioA -Hartford, Connecticut. U. S. A. {
Certified Copy of Death Record
DECEASED-NAME „tai root IA,T ~ SEA ~ .
MARJ03IE _ VELMA H_AYBLCK Femal :ta.a.~[.l,..a.
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OATS OF SIRTN ps6wtw. e•r. •e•r RACE - w.r/a. raLaD •wE?uv f ACE - U,r I.DiR •uR ,rv~IR , _ O?TE OF OEATN .rt:~rr par..u.,
U7M LTC IYEi,Th rRt«par PURI: ~ -YOS _T p+rf • ' ~d1~1S vnr
April 24,__1920 ~.__~~hite___ 59_ E. ! tx Feb. 18~_ 1980
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T,QUNTY O< OEATN TO[YN OF OEATN i NOSWTAL OR OTMA INSTITUT,pN - w•r•E r, r~T Gr..N Gve [tw[Et ,uW wulq[14
,a Fairfield __L_ Norwalk Norwalk _Hospital_ `
CITY A STATE Os BIRTH /CouwNe. /wJI US/ TGTIIEN Of (Countryr) uAAAlEO. NEvE9 4ARRtEO. Yri~OwEO, rLAST SPOUSE !If .rti. qtr. w..O.R ww) ~
New York City, N.Y. U.S. dYORCEO LEGALLY sEPARATEO
A. • , r;arried___ .,Frank B. Haybeck
• SOGAT SECUAITY Nlk[BER VSWL OCCUPATPON la r[ .rw a nrya trf www. wxr r - !_RIrK, OF BU3NE55 OA INDt)$Ti1Y Ds1 M/ae
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RESIDENCE-STATE ~ CWYTY TOWN SZREET A!lD NUVBER
.,.Connectie_u_t Fai_rfield Nor_w_a_1_k___ i,.. 505
'~testport Avenue
. WAS OECEASEO A YETEAANT IF YES. Olve WAR ~ UNIT Oi y!P
Is?ean ns a wo, !
No ,q ~ ,K
FATHER-NAVE E,rsT 1x00.[ la,f MDT HER-MAIOEN NAVE nRSt 1•:00.[ aAir ,
„ Theodore Flugmacher Mary Underhill
WFOAVANT-NAME WA1lINu AOOAESS ~Stwf[r OR Rr o w~ c:tr M tCwv Y+TE >?A
.T. lhr. Frank B. Ha bec_K 0 West ort Ave. *iorwalk Ct.068 1
PART t DEATH WAS CAUSED BY: (ENTER ONLY O!IE CAUSE PEA LINE FO,i (.T. (D). ANO /cl ' •aawaw•rE :vt[Rr•L .[nR[tr
o.xT AIID OEAT,.
q 111YEOU7E CAVE -
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6•vf a.,r T6 ryrE7yrE _-t ~ _ _
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PRAT I!. OTNER SIGNIFICANT CONO~TIONS' CJw~nuv, COVPalutuq ip OE+Tw ' ~T roT Kl•TEJ TO C+V\E GIrE+ a•ar r 1., AUTOPSY IF YES 11l RE hw?w6[ COrY-[AEOS-a.Eo
- # M, OR ..7, w DETEIVr'r-6 G11!! OF OE•rR
I~L:: A: IYZi i7V V L%/til: N/f j~~ (i ~1 1i- ~,`~_L: •'iar ( a ~ 11i~ •_s_ C_/_ )f. a ~r ~4~E. ,.a
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ACGDEYT_ SUIGCE. MOMICIDE.rOATE OF IVJUIIY rrc`r.. p•r_ ,E•RI NO:IA N'~MI INIUAY OCCUAAEO IirrER viuRE Or ,wA,Rr W1UAY AT WOAK
OA UNJ-=TEaMINED I,oEUrn I ~ _ _ ~ ?,ur , CII 1wRr u- ,rfr +fI ~drr .ES aI woI
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. PEACE OF IWWlY Ar wOYE. T•RII. srlK[i_ ~ LOCATION IsTREET OR Ilse wo, Pit ow i0aw. sr•tEI SURGERY RELEVANT TO C'.riDiTION REPORTED W ITEM
t•Ci.Twr, pr:,E 406. ETC I,R4n, t • j Iv1.. M aos.rv, IO.w ..'•--..I
3 ~ 4 x, i( xw ro.
3 CERTIfl rAi?ON -,'.aYSIGIW agwTw ur TE+R ~ town. o•r rE•a ~ aw? l•sT Lw M-~••aR •.h~E aw DEATH OCCt;RAED Ov M oatt. •.o, t0 1„E
' ~ TO t t YyTM Wr rf•R IK..'R~ TEST Vr N7Alf JfiE ~IlF ,
. wna.cto rr[ .1~ N- 2 r -h,~r _ L ~y,~~_.~ 11_ 22 ,AMr 1$E 1980 ;
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CERTIFICATIOY-MEDICAL E7tAMSNEK r• :.ry+•:+. Gw T+E D•tf •r7 .eww 0+ oE•r~ f Of_E~frT w. ?pv~N_'f0 OE•o
wrt ro it.f GuSEis, sr•TEO. Otwiw R[,ulrED O!. W •oa:r , gowr o•r .E.a wR¦ ?
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E tt• --I--=~ r' --Wit`--~=--~-!`:~~- f j - 2L>(
{ CERncIER-NAME Ir'K w a+RTI SIGNAT E ~ - oE~goR nrtE
L. Steinber~er~~.~. _ `I _ _ " -tai _
MAILING A7',ZgESS-CERfIF1ER [TREEr c. Rr o M oT• OR Tow. ~,••tE Srs DAT S~ ;NEO :vl~w7M D•• v[•Ir .
~ 166 East _4venue NorT~ralk Connecticut 068 1 r» Feb. 1 1 80
BURIAL CREMATION. - CENETEAY OA CREMATORY-NAME LOCATION c.n Ow r~av S'•r[
tT•EGs• ~~ti. ' ;
R Cremgt~t'~,~ ~,.Mt. Grove Cre~atorv~=K Bridgeport, __Connecticut _
GATE :VOwM.~pII!r. ' . 'iR/ERAI HONE-NAME AND ALK:RESS R*REE* oR Rs o ro. aTr oR TO••1 ;r•rE. Err, 068 K2
i I
Feb~2D~' $0 >b:~a~mond FJuner_al Home~Inc. ,fir.. Wall _St. , Norwalk Conn.
FLLYERAL OIfl - / NAME OF EII/BAIMER ,r •OOr w•S Ew;1,fD _ r llCENSE NI)MBE11
- I Chester C. Hatch ! 1853
• ! /7// !
TNIS CSRnFK,(1~_RECEIYEO FOR •ON~ RE
1 eertif~_ ~tl<st ~ is ~.tr~a, a traaroript of tLe(io~forea t5on oa the deatb record as recorded is this office. !
^ Atte.C: W........ R.si,erar of vitd statiatiea i
FEB 1 ~ ~Z~
1980 ~ ,t-
Dated To,tr~a of ...................;::.1.1.:1.':....:`.A..1::.........»».......».».........................
i
teem vs. a NOT GOOD WITHOUT SEAL OF CERTIFYING OFFICIAL }r
t
48~~3'74
s
1960 NAR 2 I A.I~ 46
FILED ~dC !tCO+In[ U
5 ROGER
PO~ITRA5A~
CLERK CIRCUIT CO T
~Cer~ Vf R(F('- Ur..~
~~:~~327 ~~E2863