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HomeMy WebLinkAbout0083\ ~- , _ _ _ _ ._ . . _. . __._ _. _._ _ _ __ 1 ~ COMMONWEAITH OF YIRGINIA - CERTIFICATE OF DEATH ~ BUREAU OF YI1Al RECOADS ANO HEAITH STATISTICS - RICHMOND [O/r ~ 1011UA! ~U Of viu~ sur~st~ts ~ DICtDlNi ~ ~ ruce o~ DlATM ~ ~lWStA~TiOn AAlA NUMIlA DEPARTMEN10f HEAITN- , ce~ruK~ie MEDICAI EXAMINER'S ,sr~rt mt NU~R NUMIFA Z1~ CERTIFICATE ! SFIt (,~~~~ ~ podl TI1~o~ Np n N UMOjA I YlAA +.~Y~q{~~ ~.~r.~ i CO~On ..~ i Ten~h~ ~ dari ~ hwn ~ n~~nuia ~~1~ 53 -.~~ ~ ~ , ~ f COUNTY 01 {~1 indrp~nNro ary, Iw`~ Wan1) 0lATM Tol• 1•nwb ~ ~ ~ • ~ •a i wu Nuet p~,i or oea~uo ~a ' ~. o~r~ a ~~~ ~a~ri ~r~«i ~ AOt~CEASlD °`~1" 07 16 75 0, wu~! 0~ MOS1rt~t O~t '{il noro, a xan) "~"f`~'~9'e`~~i~' Hos~ital t. CITY OA TOWN (II rwd, w ~~ohi a oe~TM Norfolk 10. SUt! ~OA f0~lIGM COW~IAY) Of oea~~~a ~z. «<r~~ °f "~SD~oY£olk ;, 8 ; USUAL S ~ AlftDENC! ~ ~ or otaowr ¢~ ~{ ~ = j re~son~t ~ 3 DATA 01 ~ i ~ ~ a oeceo~+r ~ W } ' ~ ~ , i W I W b } ~ Z ~ ~ ~~~TO ~ `; ~uau~ z • ~ [x~uNt~: a ~. ~ ~ C~MWN~ W o~. , .,m~.~i.«, II .wn 71~ W ~..~ o~ ~ f i.r~I+w I.i+~r ~ /~ ~ ~ ~ ~ , H MWMM ~ ~ ~ n,rW ~M~ ~.y.w, W ~S u r ~ ~ ~,,, ~, ~ ; .. ..i~~ti w~o .,J~a~1Y M1~11 '~ , ~,n« d e~w W ~ N~ wM w MM ~~ µxlN ~,,, . ... w Np~IERA~ , ~ ' ~IAICIOA . , ~ ~ REdISTAAR ~ ~ i~. r+M,e a ~~n,e~ a ac~~gh Thompson ie. acc~sc~ cmaH a wNAT CO_IN+1~ v 19 fOCIAI SlCU~Y ~uMuR421~18~0981 ~~ USWI OA UST acur~r~+t~ E~ ~nrd~ cih w ~wn wm~+~ p SiRlET ADDAfSS OA Ri, P~O, ~~ no OI PUC! 010lATM n Kin~slaX Lane I I, COUNh' 0! DtClASED'S UI ~nd~pmdmi aq, I~oa bb~M~ AfSIDlNCE mrd~ dh o~ iown I~+~a+ r~ n ,~. ~Rm~o ~ N~nR M,,~a~o ~ WIDOWED ^ qVOAClD ^ 70. If vt1lAAN~ noT~ vior, a il p W Wony4w MoN Ii s~ ~uno a wsu+tss o~°"~r".~ Na~ . I~ SIAEET ADOMlSS OA AT. N0. a pas~a+xE 8164 Pace Road IS ~iDlN NAM! 0~ Mo~ne~a °~"raac~ i1 ~f tMRAIED OA N1D0'NlD, wu~e.a srouu. r avo~cec, ~t~ve u~u, Valerie $1 NATMIIAC! (ud~ or tounlryl pf DECtASED Alahama 43 INfOAMANT~OA SOUACE or Wio~rbn ~O. CAUK a~AM I~~~N ~' OM iOVN p~~ N~~ ~a (A~, (I), 0~ (CI~ ~~rt i otaT~ wA3 uuSEC Ir; ~CIlt~ ~~H11i~5- u~tourt t~ust w out fo Cond~~wM, d oM, ~hKh paw rn~ ro wn~nklau <o~w (AG ~rohrp ~h~ ~~ rkuq eewe ku. CU! TG MA1 N. ~~~ , I~i OTNlA SIGtN11CANf CONDI110N5 CONTRIW~ING TC OEATM IUT NOT RIUifO TO IM! TlRMINAt qSlAS! COMO~iION G~~lH IN 1AAT I(A~ ~ 111 CODE ~ 235is Dennis Thompson at c~r! a a~rN (~+0,1 Iaori h~oq 01 D!ClASED April 30t 1922 INTERV,Ai IEiwElN QNSE1AnD DEA1M : .N ~ ~ ~ ~ '~~~ • ,,;.1~~~ ~ ~ : ~' ~#:'r°. a'+~ ~-; ' `~, . " ~ ..+yK v C` ,ti`~:c~~ '," r e ~YC r~.~~.~~r ..., ~,,. v~l- ~ ~ •A~r',, =V~rV ~~~~~~~ ~ ~ ,~ x ~~- ~ .' y,~ v ;~ V -I~l V .. i'~~ ~ ::'~C''' ~^' ~ u,~~ v V ~''n V Y~ ~ rZi , c,^~ ~~~t ~ ~'~CG '+ ~ (~ ~T, w ~ O ~ • V . ~ ~H ~~ N E ~ ~ ~~ q • ~A ~~ ~ 40 ~p ~ ~ ~p~~ ~~ ~ EZ H~ ~ ~ ~~ ~ A ~ M O ~' ~~ (~~ ~ N p ~ S Ll `l, ~ ~ G E+ Iy-1 O ~~ a°o ty ~ ~~ ~ ~ . o~ ~~~ -' EaM ~ ~+~ ! ~;~~ ~ a yli~ ~ N ' ~ y H ~i)O r~ xE~~ ~ H ~+ x ~ a ~ ~ aea. ~utors~ ~~, ,~ AUTNOMZlO ^ ~ IT: ~~dy, If 1(AIAIt,WASTNM! A IAlCrNANCY ~yC. !%TEANAL CAUS! Or DlATM WAS 16d DlSCRII! MOW INIUAY OCCURAED i•^~~~ ^oiur~ ol iMury ~n pon I a pan Iq D11AST ~ h10N1MSf ~ n~ n YIIIIqMfln ~~~M.~~ n o, ~~,R~s~,~~ n, ta, flM! 01 INAlA1' ITO 1 Ido~l Irior) 701 MUUA1' OCCUARfD ~~ ro~ ory~~NL ollK~ bbp' ~K I;~~ (O~r m iown~ I<wnryl I~roMI A.M. .~d~ noi rhd~ ~ . I.M al wo~l ^ ol weh ^ t ~a. i ct~nnr ~,n ~~- ~~ro~ ~~~~,•^~~~^~ ~~,~a'~°•~~ •i~^~d ~M bodr, Tod~ inqary ond ~n Ty eymwn d~a~h rnulpd o~ or obour j~~~~NWIM) Irom: .~•-- r- NATURAICAUSlS~ACCIDtNT Q SUk~! aMOMK10t UNDEtlAMINlD~ IFNDIMGA..."""„""~'~"•'1 ~i'~ „ ' " r~ac~~ i~~ « ~ni Z , ar~~:. AC1UAl ~ - -~ .. _.~_/ - ' ~' i~ ~~N {A~ _ N~r~'~~~Ct Ya~____~~ ' ' ;, °~a -~ uoi. ~. WRIAL A! 110N ~~1.1tACt (nonN ol nm~ury a cnnwrorpl ~dh or cwnbl I I ~ ~ p AtMOVAI,lTC Woodlawn ~emorial Gardens, Norfolk, Vfrginia ~~ a~~"~""' Holiomon-arown Funeral Home, inc, ~q t I+q^~,~ d 1 ~ol drMa a aran odini a xxAl ~ AND , ~ ~ ~ooass; Norfolk, Virainia p~T! AECO~D' lL n n ~~C ~~p I yq~l ~~ nnor~~ , IIItD JV G G il \. U/~^ ~ - i i , c i E 1 ~ ~