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LEGAL FEE $3.00 CONNECTICUT STATE DEPARTMENT OF HEALTH /
Public Health Statistics Section-Hartford. Connecticut U.S.A:
Certified Copy of Death Record 489139
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Anthon Calvin Mate fi.n.rErwEr
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V OATS OF itAT11 Portr_ ar•..rrea RACE- rfrr•. res•o. •r[.tr ~ AGE- awu ur•[r i .W airoE¦ , dt a?TE OF DEATH MOrM orT, .ut?
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OOtI•tY OF DEATH TOMI OF DEATH 1106MTAL dt OT1171 tNSiRUTgN- reef r roe r Emig c.vc sirEEi rro r~reEq
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Ctt1r ~ STATE OF lIRTIt tC•r•'1. Iref 03J C1tREt/ OF ICOrwr/ frN111ED. IaEYER •tA1rMEa. t•IOOW~, LAST SPOUSE 1M w•r, fw'•.E•~Oiew e•w•/
DIVOwCED. LEGALLY SEPARATED -
~p,.aeE•~eert[ Stamford Connecticut ~ S • Bra uha
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y Daniei De ruttoia Theresa Perne -
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m Vera Degruttoia ~
PART L t7EJ1T1E srAS CAUSED sr: tEtrtEtt aar OrfE CAUSE PEtt tflAE FGR let. 1?1. A1aD Iq rrrrwnif?rE .rrErw erirc•r
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.f CARD 10-RESP 1 RATORY ARREST ~ 0 ~ ~ ~ 5 ~ 1 MMED 1 ATE '
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eus,a r,. a 489139
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i ACC>DErfT. SEeCfDE 110•rC10E ' DATE OF efA/1Y r.awrr_ w• •r•lr ~ tiOtA 110N NJ1itY OOCtIRRED R.rtEr rrrWE or ewer tNJUR1/ AT IMOItK
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~ ~CD~ Ink- PEACE OF r1ar11wY rt rpiE. r.w sirEEi. L01J1T1pM Ri•EEt a w f C aT or ipr. 37riD ~ suwc.trn RQEVAHT TD C01D(i10N REPORTED RI 1TEY /E
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CERTiER-NAME li..• a ~.m sfGgATUwE ll' ~ oEC+~E[ ow tmE Y ` ---r_ - 1
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ERARIIG ADOwESS-CEAilrrtw s*q* Cr rr o b un .r tur rE re DATE.QDI~D:•~pi1y~~-Mt%t[•I11
VAMC West Haven Connecticut 06 1 r Y ~ ` ~ -
tlUR1At_ CREMAT1pK REtrOYAL ~ CEMETEMr d1 CREtrwTORY-NAVE ~ tOCATpN tm Or iOrM y ' , ~P.`c. y~-
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4 a s A C s i .roA.y's ~ .c. c Fat,~~,,~5 wit t .ri ~L t~ L 7- , -
DATE aoa. o...u.f ~ fuNERAL gOErE-MME AND ADO~ESS si•sn ow rr o ro. an or tore. srtE. ens x}%14 f¢~Q ~iT . 0~90?`Z.
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T Ti1CATE RECErvEO FOR RE gY REGIS ~ .+r• o: i
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1 certify that this is o true transcript of the information on the dwth record os recorded in this office.
~ SATED 70eV OF 516NATtIwE (Rr~aftrer of tl rat Sletaslars)
MAY 2 91980 ~T ~
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X332 P~2~364
NOT GOOD WITHOUT SEAL OF CERTIFYING OFFICIAL
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