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VILID Q~IJ[ ~ 1 8~$BY CS~TIFY SAT THE ATTAt~i$D IS A 1ROE OOP? OF A R19CERD ~ ?ILE
yid - IDT TRT: DIVISION OF VITAL FECORDS.
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SEAL .HATE ISSIiSD: APR 17 19$0 ~ - STATE BGI OF VITAL REt%JRD
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Fot OETARiMENT Oi IEALTM AIN rEpT~l MYi~
~ ` S~r,t„R CERTIFICATE Of OEATM REa ~ •r~
1 EASEGNAME rsr b OAt A M nOr.w O•r Rr
t~`p••••t i RENE E. BAGt~lELL 4 1 f 80 •
3 SE>< i RACE f OAFE OF ~iN 1 AGf rrr nrs r.sr.to0•q • v.p• r n.. s v-0r. t.
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a crtr a rowN OF oEArN t t NAME OF Ft05?nA~ NURSNG ttOME 01t oiNER NStduT1ON tt. usuAt OCCU?AtrpN 12. t(RaOOF WSNESS
• TOWSON GBMC-Fi~01 N. CHARLES ST Admrin Clerk 1 CoT.r Go ~ o
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` It FAtrrERSNAME If MpT1ER'SMAOENNAME
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Geor a Te Whitel Ma Estelle o 1
to wwsoECEASEDEYERNUS ARMED FORCES' IN socutsECtMtnrNp F) NFORAUWT SS j319
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! No - 4- - o Ft. Lauderdale Fla.
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,••t•w Ma ouETo.a.sAcoNsEOUENcEOF W. WA
?ARf 2 OtrrERStC,NSKA4T CONOrtrONS CO'•rtRt{utrrG TO pEAt?r Wi NOi REI.fED TO TIrE TERMNAI ObEASE OR GCYvDngNGNEN k CART :•o
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f. wRUK, cREMATON. REMOvAI ff1 oAtE NAME OF CtiMErERr ORCREfAAT - • atiF cprn. srw
~tt~ial Apri118,• Dulane Yalle M >~i.,Gar. Balto. Co. MD.
. FuNEUa o.rcTO~ Jf. A C:
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g William E. Johnson 8 21 Loch Raven Blv •
r R~G~I.UBBERS, IR., LAWYER
's ~R u~ P.O. BOX 58:8 ~
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FORT LAUDERDALE, FLA. 3' ? :