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HomeMy WebLinkAbout2898- COMMONWEALTH OF VIRGINIA-CERTIFiCATE OF OEATH ~ ~ ~ OEPARTMtNT OF HEALTN-BUREAU OF VITAL RECOROS Ah0 HEA~TH STATISTIt.i-RICHMpiO " i cor• ~ ~ -- _..- - - - - - - - -- - - - - --°--- - w~G~3~wwibw t~w~~ntwr~ Nw~~ nat ` Al1EANYY~(11 MVM~l1~ ~~~1~ ~ ~ ~ f ~~ ' ___ _ ' ' Ol~I.Q1YlM? MIA/ M y"_ _ '~ ~ _ "_ '~ - 7 ~~.~a~ _. _.__ t~ _'~_ ____ 1 ivtlM~Y! ____ _„M; _~_ ~ '_.'_ _. iw..MM/ l {~i .+w ww~M ] iyCl °`°"`""° Elizateth vricea Furgson Gillie o~ White - • l DATI W IM~ /~A1 I~MI ~ AO~ ~-_ ' ~ ~~ uuOlT~ rt~M ~ 11/wV;OT 1 M:~~~ N TN Iw~11~~11~~~ 1`~ µCU` M7 ~ y ww..aosowc~s~~ O ~ _ ~~ ....~ ! I 1 3~8~~Q ~~ ~~ d K~.~ ~ ~t NAW W NOi~IIAI OA ~M~f~iYT10M 0~ W~TM IH yr,» ~Yrl ' ~ W~ r~~r~ • OOYMTt W OlAM IM sN~. rw~ aw) _ ~~ ~-TM Ginter Hall Soutb ! o O ~ Chesterfield Co. , u arr ow toww or pcwTM ..~ swn «w.. rwNt tt. tlwteT woDwE~s o11 wt. MO. o~ -awCS o- olw1N - Richmond p ~p 11300 Mali Dr. Court f ~~ ~t ~~wu ~ow sowaareourlwr~ os oectws~o~s waawNCt ~a touNn or Wtews~as w[uoawu ~M ~~w ~.•. Mw~ F ~E~~~~ Virginia Chesterfield Co. Y ~ i Of D[CEDENT ~~ t~tr o~ TowM os w[s~oa~ct ..~e. ~~,,.. r.. n.~e~ u sTwt[T ~oo~tfs ow wr. No or ~ts~o~wa ~ iM coot -~~ F.ichmond p m 11300 Mall Dr. Court ! 23z35 _ F= ~~~ 1{ N1~YE0tlA~Nl11MOEC[Nl0 17 YAIOlMNAYlOIYOTM~/~Of WC[Af~O ~~ O~TAOi Jay Furguson • Editb Brice ~ ~ Y~ DECEOENT _ 1~ C1i12lM O~ MMAT COYNT11r tl ~111TMlACE I~vr ~r swMr91 7~ Nf YE 11 YA1~1~~E0 ~ WH01~CE0~ 'lt.,~ Y~~M~ O~0'~ ~00~lO, NAYE Oi irOU~E ~ o- U. S. A. Ne~- York ...~~,EO^ ..,~ap Charles Alexander Gill s !~ s~ tt fQC1Al fECUMTt MW~E1~ ~i ViVA~ 011 LAf1 OCCIM/~~~OM Jl 1uMO0i ~Ut~NE~s ow ~woust~r M rM~O~ANT - OqlON11CE OF IN~OIM~ATIOM I ~~; f 076-16-071l~A het. ` Vill~age Clerk Robert J. Gillis I t > + ± = i [ ; ~ ~ _ ~ ~ a rtwru urw[ew ~li. CAY~t Oi.O[ATM I~~f~ fNew~swr~ rMAi~W ICJ.~ ~ ~ . _ • I " '. _ "_ ..' J ' • ~ . - ~ " . ' /~w0 OI.~TM ~~wr ~ oEwn~ wws uwaarw~ + I - - y ~ ~ A ~, i.~i ° wrcaw~e cwust ~ t s • ; Z i. , ~ _ ~ WE TO 1~1 . ; < < . '4 ; Mri1CiAN: C . M wr. wwlcw ~~ ~r w .... tw~. ..wy +. ~ , «IA~ tM . C ~ • = 0 M 1~ M __ ~UE t0 ~ ~~ j3 C.~r~~~rr~ F rar~A~ ` u~.. aY w.~r V ~1 - _-_._.`_ " _ '_____~_- IAlIT11. OTMEIIS~GMIfK~N~CONdt10MSCON11~1/YtIMOlO0E~1N~{IiNOTqEIAT!~ O1MET YINAL 'l~~AUiO~{r1 ~ y AYTMOIYZEO ~r: ^ /7/ 10N G11IEN IN ~~IIT 1 tAI / / / ~ OriEA3l CGwDI : \'J ~ a Z w~~~rti.~ ~..~..~. ~ V . `' ' ' -~ ' ~ ~ ~ ~ / / . ' , - /"'~ .l : : ~ -~~ . ~ ~ ~~~ w F < 7N li ~Ew1~~E_ wAf ~MERE ~~wEGNwMC• ~ic ~~ EiT[wN~l Cw1lSE, ~~ MIAt 7N OltCr11~E NOw INIVI~Y IIElA~1MG 700EATM pCCYN1~E0 ~ z .~..~ ~ ~wrwsia~onTMar .....w. p .c>....~,.w Q ~ ~ u ~o~«« e. ~... ~~~ M~ ~ti~~w~ ~Ot~ ~~~~r~rcw~~.~.Me~~~~r~• ~ ~ C z l! J < M01! ~. M {~ Ma TwE O~ ~MAl11• ~M ` INR~ +~w~ ri1 ~Mx~M OCCU111~(D 7N KACE Ot ~Mluwo Iwrr, ~rw~ 7M /a~ ~. ~~1 k~Mll 4~~ ~iq/-. Awl M~4~ My. ~f-1 ' t 3~ ....r ~~~r ~ ar +a. .«...r. •Y M~r\^ MN~ ^ i . ( 3 r~~~~~~~~ ! ~/~M~rY~ s ~/ ~i ' ~ ~ + ~ - ~ = •••••••• ~ / / f~' ~-------(ain.) b.m.) on dw d~ ~nd o~ao~ ~nd tran Uw cau~bi sus~d. aa To dr b~s ot my krwwl~dpe, d~atl~ oocynid ~t -z-- - ---~-- - ~ - ,e ~ .-- - --- - TowrE ao. ~cTUU " / / ~ ~) i16NATY1IE' , ~ ~ ~''~:/1 . / / ~~v ~ ' ~:(} V ~ JC ' ~ . .~ '_-^ ' ~.~r~ - - 1 - = - - -~ - - - - - - - - - AT-~MOlMGM11fIC1AN nr~ TAOQI~ENO~ ATTlM01M6M~f1C1AN ' ~ ~/ ~3 ~ ~ ':~' -~- ' - - -~~ ~ ~ ~ ~`~ ~ l ~ ~ . -- ~ - ~. , ~y~ - .-- l - - ~ Z7. Ml1YK 1~EYOVILL CwfYATqM J~.-~ACE Iw~.nN . ~. 1 ftlNw . 1 I~W t ` ~ ~ ~7 ^ o "` °""~"`South Perin~ton Ch. Cem. Yictory# N, T. = _ s. a t .r ~....r .. rr. wr s..w~ww ~~ o~uiuww~ ".. Bliley Fcichmond -=~FS h ~ ~ ~' ~' r ~' ~ "°°""~Joae ~ /Z ~ ~ ~ # . ~ ' ' _ ~ ~ 11EWR1tA11 . aa ~' •~ ~ j awta waoowo n ~j,l - - ~ ~/ q 1 /~ ~ ` f \~ _ "^r _ nuo: ~ ~ " O~ ~ O V v~ ~ . :J ~~,~.-v7 _ j ~ • . _ . _t. This is to certify that thi~ is a~u ~nd. corrcct reproduction of the original rcoord 6kd with the / ~~}••~~~~. ~~ RFIELD Department of Health, ~ A-`{l ~ •~i~~~~ Virginia • . .. ,, . .... . ~ ~ ~ . GL..., . Date issued ` ~ ` ' '' - ,! '~' '~ r ~ T ; ;lt. - ,~. •f ( gEpl,) ~' ' _. . ' ' : ~ ~ ~. s ~''~. '~~ ~ . . • : :-~ . ~ .. ~.-~-•• ~ ~.. ~ .,~~. ,~. ~.~~.~.~.~~ _ , VOfD IF ALTERED OR DOES NOT BEAR 1MPRESSED SEAL OF REGISTRAR CHESTERFIELD DEPUTY Re~istru . g~347 PaGE2891 . ~ i ~, _ ..~ - =~~ _