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HomeMy WebLinkAbout0919511144 WARNING: It & ill~qu) ro dt~r thi~ copy or ~o duoUwt~ by photostat or photoproph. y~ N~as »2 ~oow- ~n- _•» COMMONVV~ALTH Of PENNSYlVAN1A ~~ ~"'' °" b'Ow DEPARTMENT OP HEALTH-VR/1l STATiSTKS N O i 6 5~ 6 i s s~ roe nns ce~uTe u~oq LOCAL REC',~SI~AR'S CF.It'i'fF1CATtON OF D~A'I'A ARWaei 1~1s. ~a;,w ~ ~]~m~D ~ KulaD . ~ 130 Summit Avenue Langhorne Bucks Pa. Nurb~r lh~f ~Mr M Trw • C.wnry i1eM a~~ ~y~ 1~~~PtO~j„1 TWD. ~ ~ Male ~ ~ ~ ~ April 2,~ 1~0 ~~ ~ White nae .r sr~M?~y~~ ~-.~-~ ~ E~3II~ ~ ~~,a. Ma rr ie d ~,~ ~~, ~„ 162 07 6~F82 ~~e,Sal.es & Repairs v~..~ s~w rto. MBDICAL CBR17F1CA'I8 Lkrral lel~wes~ Pa~t L De~ wir a~e~ iys Os~et a~i D~aW ~ 10 minutes i.~eaw. c..~e h) - ~ T~ n~ Myoucardial Inf arction D~e To (e) ~ u on~e sicn~c~xr coHnmo~ c~ ~~u e.~ ea ~~o me ~c c..~ d.~a r tm t (~) AceWe.t. S.kide or Homiciae ~ How iNi is~r occir ~"1D'~ "'~ T~ °t t~''iO° Thomas J. Foote w~ c~~s~a c~ ~r na~ ni.n,~@~a~e~o~) ~~ 444 South State St. ' Newtown, ~a. 5~..« _ cHr Tbts is to cartify that t6e inforwtion ~ere ~i~eo is correcds trom an o~larl of deatb dsly 6{ed wif~ :. ~e as I.ocal Re~. The ori~ioal certi~ wW be tarwardd b Stste VHs! fa~ ucat filLy ( ' P NE-X O1ly~ • • u~il~5~ • ~9~~.~ ~ ~~ ~C l~cal ~ aw ot V:~al S~olirti~s District Ne. ~ J ''i ~ ftn~t Addr~ss C~tr, brouqh. Tow ~. April 3, 1~80 I ~ ooa R««..e br l«d boistru. { Ati~* ~ , 1980 ~ f Oat~ of luv~ of Thia Cw:ification ~ 1 ~ 511144 i9~0 QE~ 19 At~ 11~ OS F~~[r ~~c ~~cc~+; rn S T. LUt!~ C.OJ`i' ~ i t A ROGER t'Oii~nS CIERK CtRi,U1T CCU~i~ ~•'~f'~^ ti~~ ~ir,: ~ ~~"~7 --- J ~~K345 P~~E 9iT ~ _ ~_~