HomeMy WebLinkAbout1417 •
• 483163 ~
STATE OF ALABAMA
CERTIFICATE OF DEATH aTATt rlLC M1lwtw
oteweo-wins r~wsT wooLt LAp a?tt Or OtATN Mw~*w wr, rtwq
Robert -K. George May 13, 1979
wwRS.. Co~a11 M11 -wsT Irwaw , raww uMOaw , over 111 pOYK?Y Or OtAtN
White M ~
73 M w"" ~r~-~2-1905 Jefferson
C1T1/.10MM~ 011 t+OCAt1oM Or 0~/?111 ,,Mr ~wlTa AL 011 OTNM IMi1,M,OM.Niu1! tr wot w artnaw. alra n.ttT Ave Nuwaca,
8i rmi n ham ;~--7es °a 808 South 20th Street
fie,
u
ie~l~'~" M 1wT w us.A. w?rt pT1>:EM or ww?t OOwtwv W?w~ Mlvt1? rc1a~
. tuwvlvrN Mwun tlr w,ra. ~wa.awtM wwo
Indiana USA . Marr~e~ Alma Brewer Geor
~pWL tt011wIT1/ O~R593 1
ot:
~'°`"''..w~"oc`~otr~p.-~~
.
°°?It «Iw t.l~ol.1~..~1111~I~.t1~
Dentist
t wtgOglCt-iTw Cltl?. TOMM. ar *ION wNOa cm ~IwTa /RRtR A?p NIJIIMII
' Indiana 1».Hamilton ,k Indianapolis ,`~"°w"°' ,»,10140 Springmill~sRoad
rnTllcll-.rlls naaT ~ rlooLt t.waT Ilot1~?wawwlrle Fern rloaLt Ke` ! se
C. Lester Geor a ,a y •
"""a""'"'""` '"""r' Coroner-Med. Exam. "'r°""'I"~'"w"" Alma George 46280
Aoow~1515 6th Av.So. 6'ham Al . ~w••s 10140 S rin mill Rd.,Indianapol is, Ind.
ry1RT 1. OaATN wA{ CwUitO w. ItNTaw Ol<r aIt CAYit Kw LIIR row Iw. pi..IM b1 . .
,s. w~,~,,~.,~
wIIIfO1wTt CA11it W ~.:QLC.~+ LC7,11L1Yr
Tr7 OIK T0. Ow Af A COMaawYfMtt Or. ~
OOMOIT1016; Ir ANV.
D wwpl overt was To a? arteriosclerotac Ca~'d117Va9Ctllar C11SE'aS@
1 YIYaOIATt CAYft W. OVt T0. Ow Aa A COMfaOYtMCt Or.
C STAT,IIw Tlla NI/Otw•
LYNN CwYaa LAaT ~
A
L MITT IL pT1QR pY1gfIGMT C01O1t1011~ CpNDIT10Mf CONTw/O{lTIIA TO OaATM AYTptr N 1/Et wawE r/MOINaS CON wwttNE11E A MIEONMICT IM
WT MOT RtUIT[O TO CAIp[ OIV[M W Mw7 1 Iq (ra[~Oyw~MOI Or DaATM OtT[RYIMM CAYat ~ NO. YIM~+)
C aw ,rs.
$ ACpOd1T, N,ICWE. MOIMCIDt, pAit Or 111,I,IIr lwo"TM-DAr, rtAlq I/0U11 IIOw M/A/wT OOOY11w® ItMrtw NATUwt Or IMA/wr w MITT 1 Ow MRT 11, RW ,h
rt 01, uNOSTtw111NSO afrtelm
T ,,..l3atural la
1 a11w,wYAT110wK ~ M.ACEOitrlUQrwTMOra.rwwl+.sTNtaT. LOCAnON LtTwasTawwsd.MO..urrowrowM.sTwTq
F IfrtClrb its ow Mp rweTOwr, arrM,a w~no~ tTC.,aKClrr,
~ xi. tai.
C Ct11t1r1CJ?t10M- rpnM over- rpw IIOIITM over raww LwfT.blwMwyMtw OIO/OIDMOTVIaw TNOOWwRtowtwrwaa,Mwave.,
To ~i~o~?M over rove arTaw oswTM. _ , r"a„~»„yw, a~w,~i
w
A TTwtMOto T?It
T t,a oatawsao rwor a,w t,a s)a =la ~ alrllq wr.a
I CaaT1I1CATIOM{0110waw oA IIaALTM orncaw. Ow w ~ HOUR Or DlATM T,It OtCEOtMT wt MOM01J11CE0 OtAlj
O arw w w r.wwln. ae w •rar rw.• w rrlrwlL. r lOlf1M over rtww Marl
N .,,...~...M..~......w..»...«.»w..~..w..Ma 1979 3:00 PM
uwTTrsw+Mr. eowoMaw ow IItALTM wl/caw 1Trrt Ow rw1IIT, was ow TITLa OwTt sloMw pIDMfM, over. r4w1
AOOwtai-.C[wTl~l[w ~w[tT Ow IV.0. M0. CIT/ Ow TOwM fTATt Lr
t,a
aVRIwL. CwwwTloM, wtrorwL C[YtTawr Ow CwarwTOwr~.wwra LOCATION C.1Tr ow TOwM sTATt
Burial ,.Crown Hill Cemetery ,K. Indianapolis Indiana
5
5i
-199) Alab
ma~Mort ry Service"=~3 ~A~e~~wT~ns
~,`~~ham, Al. 35218
rwolw T , aawlsr w owTa waeslvto wr wewL wulsrwwa
:r. Ma 29 1979
STATE OR ALABAMA
COUNTY OF JEFFERSON ~ .
This is to certify that the above is a true and correct copy of a certificate as
permanently recorded is the Bureau of Statistics and Vital Records, Jefferson
County Departmeat of Health, Birmingham, Alabama, and b issued under the
prowis.{{iau
o~?~tk 2Z-9-8, State Code of Alabama, 1977.
i •p : , t ALthOIlZed Bllrea0 QCT1C
- -
;u'`, '~~k~<:'" May 29, 197.9 -
~ y, - ~
r: _ - Date of Iuue
s+~'o~'-
JeP1' tm ;~Alsbama
. _
IMPORT ~=~his ~xrtitlcr?te void (a) without the embossed seal of the Health
Of$cei of Jef#'et:on County, Alabama, (b) ff it contains evidenoe'of erssura or t
aitentiom:
433163
19E0 APP. 16 ~i ~ 53
Flt-~0 J?KC r~t:~ll/l~i v
Sf.ltiC~
R
POijKa~~
KpGt;
6lERK GiRCL'i' LCCR~
32~ p~~E 1416
~ Ir,Y