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HomeMy WebLinkAbout1719MINNESOTA DEPARTMENT OF HEALTH 5~5~~~ S~cuo~ ot Vital Sqtiri~a ~/ _~c~~ s~~! Nu~r~Ew CERTIFICATE OF DEATH S»rE si~E Nu~~tw + OECEASEO N~YE ~~~sr M~oO~t ~~st 1 SEx a pATE Oi OEA/N M~ o~r •w GERAlO P, OFFERI~AN MALE JANUARY 4, 1981 ~~ AQE ~~w ~N•~ ~e wov o.~ •~~. ~s ~rar J..~ Q~r ~~ OATE Oi ~IRTN V~ O~r ~w • 11ACE ~io~c.~vi l~ COUNiY OF pEATM 62~YEARS ~°"'~• b•v• ~~~• ~~~~ SEPTEMBER 28. 1918 CAI,'CASIAN HENNEPIN `e LOCATIpN Oi OtATN IC~b. V~d~M O~ T~wwM~Il ~c ~w~~ Co~eo.a• -s NOSII~AL 011 OTNEII INSTITNTtON - n~~w~ nt ..o~ .w ~.~~a o~w 5~•«~ ~.n..~~ Sa~c.fr ~w N..rov~ MINNEAP~LIS ~ •ESO"~~7 ~~TROPO~TAN M~DICA~ CENTER •~111TN1lACE Ift~a v ~~.~yn Ca.warl f C~~.ia. o+ww~~ Co~w~~~ ~O v~r..w N~•N VM~.tl. W Wo~r~O. 11 ~Q(jsE • N~4E ~ a.wc.o ~so«~~.~ MINNESOTA t~~A ~ MARRIFQ FRANCES M, OFF~RMAM ~zw~.o~cwwa~.au.uS ~.~+~e U SOCIAISECURITYNUM{ER ~N USUAlOr76W~ilON~G.wa•m~~ww~aw ~a~.K~+rDOS~uS~~.ESSO~~ro~i*~v -wcw ~So~a~~ rN w ae1 .e•~ Tost e1 wor~.~y ~~~~ ~.a. .~ .~u.~ai Y~~ 469-10-7158 M~PIUFACTURERS REP, SELF EMPLQYED ~ ~s• qES10ENCE - STwrE 1SO CUt~NTr tSs C~TV, V~ILwGE 01~ ~OY1iNSNV ise ~~•a• co...a•.• l,T•t~ So~a~r M N~f ~SQTA NENNEPI N ~~,~,[~ PRA~„~ JA( `E' = ~° ~6• FAMEII - anatE t~e O~Nt~+~InCE ~Sr~~~ w~o•a~n 17 AODRESS OF OECEDENT SaN~ ~we ~.~.rar ~oa O~~•c• Cou~e. r: ~~tNARD OFFERMAN MIIVYES~T~ 9738 M~LLCREEK DR VE EDEN PPAIRI~. MN +8~ MOiNER - MA~OEN NAl~IE ~Re ~~A~~IIACE ~5~~~~ w~o•~~ 19 IUilJRMANT - YAYE ~00•~u ` ~ CO~+~~•yl ~ t ?I MA ~,j,~,Q.N SWEDEr~ FRANf,F~M1 ~FFFRMAN 97~8 ~tILLCREEK DRTV~ ~ l0 ~ANT t- OEAT11 NASCAUSEO SV IEn~ owrr oM ctiaM wr ~.o~ iw~. ~~~ ~m ~G ~ . '~ oi~ .lr~i~5 DE ~ f ARE'J aowo.•T~i. ~~w.a (~ • ~MMf01ATE CAYSE G~c~ 90• ~~ww~ Onwr ~nO O~~a+ W R . ~ ' ~ _ ~ e OUE ]O. OA AS A ~ ' ~ CONSEUUENCEOF ~ ~ Q • J r . t . c ouE TO. ow n5 w ~ Z. CONSEOUEhCE Of • 0 y N _ z PART 11 - OTNER =IGNI ICANT CONDITIQNS • A Kr 216 U vw w hm~wp :en ~ O ~ ~~~ ~~ {~ • .l~ MOK~O .~ a ~nry c~uN ol Y S~NO ~~~ ~ ` H < ~2~ ACCIOENT, SUICIOE. MOMICIOE ON UNOE TERM~Nf ~=Zb tN1VA ye. O~y • • 2Jt /NJUR1r Ai WONK SMC~~~ +~s o~ No v ~i DEFERqED - ~ Cn~c~ So. ~ ~ ~' 220 •~ACE OF ~NJVRr IA1 Ho~~, FMw~, SvMt. i~cro~r. Ou.c~ 8~0~ Eec 1 ?T~ IOCATtON Saw~ w 11f0 M , G~~. V::t~ o~ Tow~N~O Co~n~• Suu ~ x W • U ~ 7i~ »OW IHJU~1v OCCUI~REO (EntM N~tw~ of ~n~w~ ..~ ~~.~ ~ w~re o. tca.. 701 _ - Q . • _ J V O z7~ CERTIFICATION-~M~1~ r~s o~~ ~~M ~e r • 2~e CERTIFICATION-MEDICAIEXAM~NfNORCONONER - "' ~ anenoeo ~n~ d[cease0 l.om 7~ f0 ~M On IM Gl.t OI IH! fa~m+M1.W~ Of tNt bOAY J~d ~M 1~e ~~ylf1•q~Tp~ .n m~ ~7p•n~on 7!~!h f • y Ow • ~aat w. n~m~Ae~ M on _,.~ ~ 1 tOd. Od notl .~ew [h~ OoOy aircr dea~n occw•M at M_ on ene ds~e anO due ro ~ne ca~.iei ~taua ~enve ~ne Oeceden~ Oe-~r occwnd a: ~ M at pM Wac~ aM urae v+d on e~e date suted aoo.t x+a ro Mo O~r v~r e~e Oe~c ol mr t ,. ~.e ro cM causes ~u~M. +ws wonwncea dead on ~~ M 2x MYSIGI -S~ NwTVwE Zb MEWCAL EXAMINER ORCORONER - S~ati~r~pE Q W ~ 2b -Mr5tC1AN - NAMf IT~W w ~nn~l 21~ MEO~CAL FX47M~AEN OA COi~ONEp - NAVE ~T~o~ w-^..U ~ W. D~niet Fiory, u.D. ~ JJ~ M/uLING ADONESS ~~v~~~^ Mw.cN E.~~n.n« w Caon~r J~~ DAiE S~GhEO Q 4?4 S~u±.".a3?e ri~ica~? Hl_~' ~. ?•dir..3. !~Ii^r., 5~+35 ~ `~~`~~ ~81 ~w ~ < z~• BURU~,CNEM~TiON, REMOVAL Z~e tEMETERY ON CREMATORV vavE 2a~ ~OCw~~qr. ,Gc~ v~~~.y. o. Co..~..~ iS~.c•~ > B~~2'AL ,: $~SURRECTIOh CEt~IETERY t•tEP~DOTA MINP~ESOTA ~ ia.~ Oe.TEOF BUw~AI.GRE41~T1'0 ~if1~1Ff~~~ OMf ~- v...~• 75e ~U"~f~i4l ~~vF ~aavu s J~tN~~Y ~; ~Q$_l~~~,"~ A~~i~S~rI~RQ~HERS 3500 W. 50th~ St. Mpls, MP~ 55410 ° :6. ~?arE ~~~EO :~~vNE~EYHAIj ~C~l G1 ••• ]7 M TtC1A1~! 0~1 fUNERn E )R S~p~~~..• Q J, Q ~/ ' J r S: t1:t --~- - - ~ _~ ~ V wt:tir;l~ .~'-r-.'~~., ' `~~ rr`5 __ - . ____~ - ~ i : r , - . `'''' • ':. - :, : I heretty,~cer~£i'ty. ttie~~~;t,}~s'~~bove 1a a true and ect copy of the official rocord ~p~ fl;~~ tt'~~ ~the~:$~tion of Vital Rg~orde f th nne o 3~p Health Depsrtiae~'' '~`.~~ ~` ~. '~ .,` .l-.; - ~ ~ . . ~~. j '~i :~~'~%. = %~=-~ : / ' ' '~ p~ '~- _-~°~. "r~ ' ~ . C!~ Dated; " ~ ~r ~~`'~ eputy Local e~istrar . `~~~~~ ~i Mi eapolis Health Department Ar~y alteratione shoun Were mnde under,the 9uthority of the Minneeota Vital 5tcitietics Act and the regulatione o£ tha Minnesota Department•of Health. NOT TIAT.ID WITHOi1T IMPRF,SS~ S~tiL 515193 1981 Jh~1 29 1~'~ ~~ Sg fILE'C tkf. ~': ~ur1~i U 51 Wr,1[ COU.rtY.Ft r- ROGER POITRt~.`- C1.ERK CiFCUt1 Cr•:~'• ~ ~(~OPry ~~~ r. } " r ~ ! ~'~ 347 Pa~E ~.713 6onK F--- ~ °~-~-` ~ '-~ay^t.~u'ts .;: ...- :: ilu ~.._^..~.~,a` a~^~!.~ ~