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HomeMy WebLinkAbout0193 ~ 49l~5~3`7 Phis is t0 Certify that this is a true and accurate copy of he re ~ h.f' on file in this office. ~ - Robert l~~Ia~~~.•~M NoAtH CAROLINA DEPARTMENT OF HUMAN fiESU1J Local ; jt-i ~i stre'r, ~ O/JJ'V-J,tC/~,ON OF HEALTH SERVICES VI(A~ RECUHUS HI - - ti' ' f ^.••1.11.1^. / CERTIFICATE OF DEATH - - IN•1wflU /mfr IfaAl lyl '1• I•.•Il Nld w13/ Irp?IN trrnw_' • 1.. _ _Wi 11 iam _ _ S _ Valentine _ Male Sepk'~:.i!$,,•''Jg] ' I•YI•N 1r••Iw.• .Iw111M NINN•MtO1U1• Ia11M1/t lr P1111N iM111M N1••I.1 ' • .wt1HIII •IAOtlAiIWI&fl f.~t(MO(M^ trF>w (a11N1MI ' 1 •\I \•11N1• . yh i to _l.. New Yo_rk_ _ Westchester _ 1. May 29! 1 y_ 08 l . 71 ~11"`""~_- _~°'~'~~L_. ._7 . - • 1 ~.11 1N 1.1 wl•r •?1 _ hAM/ •N M YII M/•/I.A /Ir,I .IMII MI/~Na1MA1 11 INf1/ /M IhS1 Ma•.•ll( l11? { WIT\ -,+.YI• ~ 1...\•, IwIJ-•Iwl •w •a/aAr1 aU?IrrM I /!/llYt .(l Qw 11p1 Wake. T __Ra1e_igh_. :`•"p1i" 3231 Oak Grove Circle _Y_e_s_ - H/S•IN1111 \1.11 Ilr'h1• 111•M _ ?11411 •hU MICIr1 N•MI NI I• - q• 1 • •MI 16/l1:• t t{l O11 NIN • t'la._Gs- _ ~(ak _ _ galeigh. j231 Oak Grove Circle. _ _-_Yes__ V f1.•AI •IwW111,' V..1••..11. 11/`.•/. MAtw••l 1. ••....I ....1 r+M/ •rA Wf.NwHll• tyllw •t111• I.I.. rvI 11• ,yll.r U_. S. A. _ „ Married Frances Greenla_ w _ _ . . I•IYIII•I••.1I1.111---- _ .••..ar•r 11r'w1•.N rr.lr p.l..l/7.1r/M.Mw1 .•.1•.H +•rr~fr•If.. NA1 INIIWhI'I VIN /11 trf ~ ' OP11111rr11.1 111N/y1.lp w••YI'll /1M1/1' 102- Il. M Ilal,•..I?./1•w11 Yes • .I••1N ShAW 11.1 r••. V.'.•1.••. I l Geor a William Valentine Elsie. Williams ` -•.•••NMAh{ShAW ANO AINr11 S1 ~ IIIIw111rh tl•1.111 ••~t l• • • Frances Valentine 3231 Oak Grove Circle Ralei h N. C. 27607 Ir. Wife • .41 . l1(AtN CuulE0lt lNIfN (1N?11 cM([ CAV1l flN 111N ItMI .r 1N •1 •~M~•tt wlN wy )M 1 •.MNw11VhS I1 ANt t 1 ~ ~11j.~~/ . •.A~I wlst - i( Irlnonnuuea ~~__li_ L!'~~ fas C - 1 !~L•: f 2Li! - - 7 I uh/,a AUV 1A,1 ~ I>t 0111 rJ lrtlAa.O~UlO.Aw lr _-__{.ri.~i ~ ~ ~ _ ~ _ - - VI i s/ t/ul t0 OII Y A t(IMlUYelt! Oi ~l .>N111 NI N(M SIGNIf N,ANI COhOIIUr/S [,gtMlltb tq qA?w FptIOI ~Iwtq. t0 rlVyf /NAMh/MUM al•IINYa MAt IrION4l ~<rbul~(p f r 1 It(t VII h01 haf llrrNNU aI •t.• j]7 _ ' JL~ ~ •~lr(Il Ni ll•t hAtuwA1 IFI/lt.Ytl Ii Af l111f N11NSI.Rl11/ flNllAt1•(, Vr.•r•, r..ll•1 •alllrwlr ••IY •i N1111NN1 N11Y/N MI •1M IIQA ` tf• ~ 711. :1. ,4• i II AI'l Of Atwwl! IAA1 it/!~t I.CNftlt MIASI ASI N111 MN1U IO YIIw1 AI-- r ~ .c[IplNt p/tl too l1C l+gorn l4AYIN(R M/lC.t Af OAI.q hl1iKE S1AIt1Aft M•>'nNIS INAI All INAtNS I/III t0 tNAIIYA ACCIIIf NI r1aYK'llil SulClp~ • !fJ 71. NN l/tl(IlN S1Af1CHNp •tNlJjllwl 1111 Vh//A IfWAI CrfN IIYSt ANCIS~ Rl•a111101U ANp IIAII f/l0 •t AYIINCAI l¦Alf/hlll p/A rl llll Al.trA11/INkf1SCIA f1/I[Atf W plA1N .IMII/w l)h M/fN IAh /ATtltOlO /It olC4llP/I</. N ~ 1' /Ly . • :O~~I.~AlO W/fr1~ALM ti- •~Z..~_~A/N hAW Ah11 t11110111NINIIN 1/gr-1•..A - ~ u Izlwleo wr ; ~~i al nli wn furor Avow ro r filar r.~ rw~(. stueo _ - - - - w•.TF •.i S t NA1lN1/ Ir ll rIf LIP - - {IAIl SN.N{1 AINr•1 - [ _ _ ~ _ _ I< i~ t/ - frUwlAl CAIYA/NMI 1N[P W11 MAYI I//(Irt t1 M. VNI NI YAI•W• I•N AIHr. N•~~ 1•lr/, •.Atvwrlttl Al•tll ffrtc~n ~ Donation _ 9-2,9 __D~t._of _Ana_t_om_y_____ . H.. Chapel Hi 11, N,_C. _ _ _ - - fIINI1tAt N(1Mf /y(P A/lawl.f III.NwIVN11N 11WINA IuN11 trIN q/lr\I M1 Brown-Wynne Raleigh, N. C. Lester S. Sandlin - 712 ' ~ . f~•~(gliNa: ~cf[1Qflt~ s.(,N.rw(!(1?wF,...111A[I. s~r.ly.~Iw., .N ,u..~iN;•I- .+(rwwf, Iw ~Yc/•w. - ,r 5 7 , 'I//'~il? ''j/(!•/''~jW-ll_/ ~~J{/• Lester S. Sandlin 712 I~ ~ - 1980 SEP ~8 A!1 s~ ~ 9 - F1LE0 RNO F~GGRLEl1 S ROGER PO 'fRASA• - t - CLERK ClP.CU1T CaU ~ - - RECORD ~ ERI~IEO~.-~-^-- 4918537 X338 p~ 192 _ _