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HomeMy WebLinkAbout0151~ / PS-3544 51~195 This i~ to certify that this is a copy of the DEATH RECORD on fil~~ in the Sandusky City-Erie: Co ty Health Department. Datc~ lssu~d -- 7~ :•• ~... _ ` . „'•.,~:it .~ ,,• !~ ~ ~ - ~ ~.~ , ~~'. ; ~. Rc6istrar o ita atistics ~.~ . • . `~ ' r'~ a '. . . ,~i+ ~: • '~ `' >- - ----- - - ~L-;• e~ i _ ~ • . J;>` ~ . :~ ~ • QHIO DEPARTMENT OF H~ ~s.l'H ~,f,~ ~ ` ; •.+a«G~N ''~` DIVISION OF VITAL STATI5~~1`T~+'~'• ~xr''~~~`~= ---- ~,ry u„~ ~ _ _ 22 -_- ~~ ~ ~~-... ~, <<~H 2201 ~ 38? ------- - ..,~,U~NS ~....N..w.t~... -- CERTIFICATE OF DEATi~f~'~}•.,~!wd~.:~~== ~ ~ ~ i~. ~ rn•.~ vau~ ~NU u.ua ~... ~s~. ~W~l IN W A11/111... fM/. I~a~l t CHArtL~:S FKA~h~.llV ..U'PT Iz i~.ale __~, Jul~l 5~ 19?8______ _, .~„~{ ;~.q.yy~,~~.gyc~,w~w~- wGE ~a+~ B~u+a.r ~ uhDER ~ rEwN I UNUEH 1 DAY _~DATE Ui BIRiH~V....LV~.Y. ~" TCOUNf~ OL DEATN .~.em.r~.etclrSMqrl' ~Im~l ~ Mo~ t Dn~ j Na.n ; M.m. e~ ~ y y 1 i~ ~ ~~ ~k ~J~ 6 Jan. ~~ 19G f)~ _'_Yrlp. __ _ '_ _-___ . Wh ite s.- -~- ---i----+ ~- L - -- -1 - ~ Z' - - U 1 ti. V I l L AG E OH ~OCAi ION Of DE M N t NOSPI i Al ON OI NE R INSi I TUT ION - N~nr fU +~I w ttlh~. fur ~Wt~ M! +r~4t/ IF HO$/ OR IIiST IM~cip DOA. i OPlEnM~.~ Irpat.~n~IS/~ct/1/ i ,,, Sandusky___ _ _ ?,~ -r:emorial Hospital _ , __ ~a D.O.A. 1' 111EN Oi WHAI COUHiHY !ONw~k OR UESCENT U~a+~ W.ar.. /,en.an_ E.q~M. C~r~. :SOC1Al SECURITV NUM6Ep ~ .rti~F .:~f U `.~,.. .` rtL't tf r ~ ~:11 11Ary li! L~PiH~rywu~vl S.~ +r.~ il~ . ~ . ,~ r. ~ ' ~ Gw. ~o Nar+ e~c 1 NM. 4 ~: K, Ohio ;~. 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Fred ~9~~,~M1!.:Nf MAMI ~l.pr...Y+~w~: '~~ s~lf-~ouRloJsd ~ ~ -- ~iNS~r~ air u~~Ta ,CII~ vqlAOtlN~IUCAL/Nr ~1HEkIAHUhUMbkH ~ , t,s...,~, ...,...a, ~,~ n~~, '~w ~ ~35 brookview t~~ y~ yv,yf ~~~ 'MOINFfi MAIDEN NANE F'rt~ y~~ ~~ _ ~6 Grace ~MAtIIN~ ~IH:NtA IS1H[EiUNNf O tb1 ICItV(N~IOWNI ISTATkI 1[I-1 ~aQ~ ~•. tvorma Jean Lott ~.,.~,i ~ DEATH WASCAUSED BY 1H ' ~ ~~~, 1"L35 tsrookvi~~w, Huron, Uhio, 4483~ i AY-ROl(WATE tNTENVAL : (tN/EHUNLYDAIECA[:~FPEHtINEfORl~/.lbI,ANDlcI~ '~ 9EiwEENONSE~wtwOOEwTH - ~ -- ---- -- IMMEUTATE CAUSE ~.~ 5~~~.~/ ~~ ~ • ? ~ ~'~-~ ~ ~UE IU. OH 4S A CQNSEOUENCE O~ ~ ~ . . .' ~n. ~F..h ~ `~ „ ....~ 7.. ~•om~.lYtf ' If.l' ' _ ' '- _.' - ~ .... ,.... ~. trt. ;snJ.• WE TO. (~H ASACON tHCE O~ . .. . _ ... .~.t ~ ~ ~ Fi-t_.~~~ a P_ Na~d~~.. ~n. ~~r~ Ce~.nQ.. 1z-~ Ns;i~s A~~ Sa.d,,.~~`~ , e . ~ ~: . . ~,. r.;.~t~~rti `f~A/f •/NA7JF (K CEME ILNV uRCH MA1Gf/Y :IOCAi~ON ifnr..~~ •+..~wry: IS:~u~ ~ .i,u~. -.. ~ ' ,t:rF~mati¢n 7/t~l7~S ::~. Cleveland Crematio~fw Clev 1~[1d, ILIC No 1 ..t+• n t~6ttlA~YEH IUC No~ ~~UNEHAI TON'SSIGN ~ ~ ~ ~ ~ Id - _ _ _ + _ _ - _ _ _ ' _ . _ _ _ __ rrp.~w.w/~.~I.r. ~AViU~SV :WASCASEREiERHEOTOCONOMER ~~~+~~n4trJ~o vANTU u7~~FHSIGHIFICANTCONUiT10F1S l.w~t.~+.,w~cw. rr.Y~.h(( . .Ie.... n.,, ! ~SPn~/r Yn..• ~.., ' ~1Y~ k~ ~1~ yQs _ _ ...~. '.~'UUE ~u~1,t UNDtT, fUA1E:KINJUNY-'~ ' ~fNWH i '~~OM/hWNrOI,I.UNNtUitnr~..u~r~..,r.wiw~.+Y..1/.HY~.IIl.~f~f,, U:~ Vclu~hii ~NYEST. IJ~rnJ~/ !IN..+M. ~~.y. l"rol ., s~..~,aQ ~~ - 7 ~' _ ~~Ur ? - ~ ~'•-o,r~l~~F~ u nd ~A-~qi h~ i ~_ ~_~~~e,-- - --- . _ _ _ ..... .. Ai N:OHK {VIACE Oi IhJUHY .u!u.we. I...~. uK~t. Irnv~. ~~JJws , ~IACAt10N .~~..ir..• N F O ..u..r uLjp ~uv. iy~ .~ - •4r~ ILLij t1_ iSt!(IJ~~ ~ I ~ , i ~ ~n t ~ ` n,~ ~~- ~-~.o+n~~ ~ _ ~1 -~ ~ :~rnnKV~e.w ce. • ~,~.3~ . io b. 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L i~~rm~n _?~~_„~~iLf~~ - '_ C _ ~u_ ~-- - IC1TY1 ISTATE ~M~ . ., r-.;, ~ 1-~4 4ND ALJNEaI iSTHEET h01 r~ he lanc~ F ral Hnms . 41Q_~oai{~ _~#.reeL* -~ii,iron~ ~~~i~t ~,~~ aST ~ +~ ~ .'iH• ~NEGi- HA SS~ti(+A~urE .DAiEVERM~Ti EU 'S~GYATIi ED -~~ " ~ ~r ~ ~ ~ ~ r~ • ~~ ~l;'~~~ . . ~ ~~ ~~'~~l~-. ~~~ z• ~'~~~!~1` ,., 7 ~„ . . , ~ ~98f J~ly i 9 PN 2- I 5 514195 S' !vc ENrU;;r; Y i~ a RCGER f'pIT(i,1S CLEFK ClFCUt? C; i;ii; ~ r;: r'(~- ~:::. ~ " ~ , Br1nK 347 F~~~E 151 - , ~. ~ _ ,~ ~-:~.~~ __ _ - __'- - ~ ~ " ~ , »y~