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Home My WebLink About0154.~«, , ~ ~ ~ ~ .~ ro u . ~ ~ ~. M L CO ~l t0 ' r o = ,C: oi '= ro N ' % ~ +'; ~; c ~ , - ~ ..,, • ~ Q • ` ` • /"~ ~ ' C ~O : •. ~ V i~ ~ V L C ~ ` .L ~ S .: 0 3 uo ~ ~ . . ~ ~ ._ ' ~ L i aJ L ~ tl r+ Y LL' m '~.. .. • . O' 4 ` ~ ~r ' O. ' : i , :r ' ` ~ r~l: ' y ~ . ~ ~ ~, ~ ; a ~ : - - ~ • e ~ j ~; n ~ ~ '~ ~ ~ ~ x` = ` o ~ "• ` E ,~ „ r/ ~ ~' • M •I • ~ ~; ~ S ' ~ ~ : ~' ^ ^ ~~ r . ~ ~ ~: ~ C i ~' ~ W ~ ~ ,~ ~ ~ = ' ~J. +~ I~ . u ~~ ~~ ~ ~ y . ~' V ~~ , ~ U' Y /~I ~ r • • i ~ UI: . ~; S Y f~; / / ~.~ `; ~' .. i- ~ ' .C '' ~ 0~ ~ ~ . ~ C~: ~ ~ C~ ~ i i. 7~ _ = ~ • '~1 ` ~ ~. ~ Q ; C i. ~ ^ u; ; z~ N ~ ` ~ i ' a: '-0 ~ ` , .n i n' y fi+; ~ o" ' ~ ~ ~ ~ . ~~ ` ^ ~ ~ p; o ~v ,.~,~ ,; r ~ w ~ w ~ ;7 ~` . ~ .y .~~ ~ ;~ ~ ^ ~ ~ ~I; ~ ~' S w ~' ~ 1/t A 7 ~ 1~ Tp~ N 1rM1 in IOOM~AEV.~I~1 ~" -amon~y p~ STATE OF WISCONSIN ~1 DEPARTMEMT OF MFAlTM AND SOCfAt SERVtCES •o+•~'~~~ IOCAI fllE NUMS-EA' ~ ORIGINAL CERTIFICATEMOF DEATH hr Instruci~ont Rdu OUtASEO-NAME Iml Midd4 lo~t ~1I i~~, o a«'~~o~~~: ~~, ~mt,l-t~- ~1,t,Stti'n2Tfi fIART z, ~ta2e o~a ,v.ea~ca~ t~omm~r~~~ ; qA(f-WAr+r, N~pro, M+~riion Ind~on,EU Aq~ ~oi- b~~+naor U~dn 0~~ Yeor unar On~ Dor DATt AbnIJ~ (oronu'- noncDOOk , ' Yean '- Of OIATM Mon-e Der Ywr . r 9, 1974 VTM Of DEATM R~ctne pf wi11, Giw MOIdM NoiM) art~l STA1! IIlINO OATE STATt DEATN 110'* ~~ ~~ ~A~ u ~ct '~ 1Vh~iC (SOSifr) 3a, ~~ ~sb~n~ ~~ ori st un M~nutu a J~Uf!U5t ~1~~ is9~ ~p vAMf Oi ITY, Y111A0F pl N~irher, Nome TowMhip) ~~ude t~tr Of NOSPIfAt OA OTNER INSTtTU110N-~i!~ N~ iloca~ion of Dro1A Ydloq~ l~m~ts ~if Not in E~iA~r O~w Sir~rt ana Numar or ka1 ;W lp ~Rncino ,~~,~cr„ pMo ~e, St, tuke's Ito~rftat ~ W STA~t 0~ /IA1M ~IT12EN of whoi Country ~',~(MO~~Ib ('~ N~wr Marib ~URYIVINy 310USE '~ IO~~'~f hol in U,S.A.,Nqnf COW~Vy) '~.~ ;;.a, ti~'{ccnnsnn ~o, !I,SA ~~o, 0 w~aow~a ~ Olrorc~d ,,, Irenc C ; SOCIAI 3EfUA~~Y N0, USWt'OffU'A110N Wrl Kind ol Work Dui~nq Most of Workinq lifl KIND Oi 1USINESS 0~ INI ~ ~ N ~ ~: CD 1 ~ Q~! ~ 0 ~ A ~ '9 ,~A Y, M; r •, :: ' ,1 ''~~~.i.~~ ~ ~'' y ``/ ~ , .' r ' ~` ~~'~.,~ ~ ~ ~' ;~ 1,~~u~ ~i WwI A~tilEenu Wh~u ' ~~ ~~) l~fi l• 3n~A ^ ~ Er~n ~ ~~' ~~a. A~i~nd at~to mechantc ~~p,automobile repair P, sorvice DrcrofrOl~ree, i~OroiA OctumC ~n Inyhiu~~on, i I AESIOEVCEi STATE COUNTV NAME OF (ITY, VI~~A~E ~~Iid1 ily Of ~ MAIIIN~i AOOAFSS (M01~1 Add~l{10t TIIM 01 ~IOIA) L r1 AH~Of11t1 Of1071 ~m~„~o~ ~ „~,, >>{cconcin 1e, RAC~nc ~If Nt~lAfl, NOTI TOwnfAiO~ iV~;109~ l~Rl~tl i,~~,Calednnia tw~nshr ue,or~aa~o ~~3~4~ ~~orris St.~FrAnksville ' f~1nEA-H4NE i~nl M,OO~e lost MOTHEN-MAiOfN NAMF F~nf Midd1~ lau ,W,,s' 1V911fam S, N~rt ,e, Au¢usta ,4, iHfpRMAN1.NAMf MA~IING ADDAESS StreN Or R.I.D, No, fily o~ Ydlppf Slob 2ip WAS DECEAS ~«~~~'` '~+re lrrne flnrt 13~t~ ~~orris St, FranksvilIc Wis531?bl,~~, "~ ~ coe,n~ no ~ -- i~e ~~ ~ - 7~ re ; noti0~rol ~;~9, IAAf i DFAix WAS UuSED !Y - Enru Ln+r 0~~ Cous~ -~r t~n~ For I~I, f11, onQ (Ci ~~ fenE~i~oni, H M~, rl, imm~0~ate fou~ti Q ~~i Y/~ , ~ ~VA~N Gaq 9~ff 10 pue 10, Or ol 0 ~~rN mmed oi~ fou:+ l~)1, (on~rouwa ah ~Q ~~(`i yt f Q!/ f~7~,/gr~ Mt„~Gna ~' S~ai~ny in~ pnoer~ 'a ~n~o fous~ tos~, Dw io, or ai o i ~u Velson IN U f. ARMED F00. War or Gmn ol~i~ ^ u~M~owe 11twtfn Ontll ond CK ~ C (On~eCuenf~ Oli I ~~~~ Occ oo}~on ~~- ~ Mtf n QTNfI SI~NiFIUNi ~ONOITIONL fondci~on~ Coni~i~ut~np ~o Dw~A bui no~ Aeloik to auti~ ~ AUT013~ (SpKi Yy WFRE FfNpIN~S CONSi0EAf0 fN py~ y ~~ G~+en ~n -ari i 1+11 n li~G7~'~~ ~~ 0/_!~ a qy o ~190, ~ DETEAMININ6 (AUSE Oi OEATMf 19b. 0 Yf~ Q No x ~~p~.~` ..~ n ALf~DENi DAit OF ~ Monih Doy ~eor Mour MOW INJW1' OCfUAAEO (EntrrNoluroo~ Iniuir+n Pu~! oNa~l II,llem fq ~.uCy ~0~1 ` i Z~ f.I SUiUDF ! ~N1URY M , ~, ~= W ~ ~. .' ~ a 100~~ HOMif~OE i 70D. , 9Ue, IOd, ~~~~ ' 4 ~~ iH}UAY A1 WORK ~iU(E OF IN~yAY ~NOmf, ~onn, S~nr1, -oalofY, Elc.j~tOtAiION StnH or R.I,D, No, GIY or Vlllep~ SIOt1 Ii0 y~.rvW ~,,• '-h `e'', i ;• ~u~ ~ a' ?Ot. ~ Y~s (] No ~ ~01. 13Dtei1rl ! ~0 , ~~' ~(E4T4i(AfiON.MO~i~ Ooy Yror Mo~iA Oo~ Ymri, ~NO :AST SAW NtM,'}kMAIWE ON DIO YOU VIEW TNE DfATN pCIU~AED A1 h/~ ott,~~ii •~ PMYSIGAH ~ MOnt~ POy YlOf i AllcndRA ih1 T ~u ~ 7~~~ OOD4 ~FTEA DE~iN (MOV~) 601~, Ond, TO TA1 !!If ~ ol M Keowlp Ow `" W , O , i Oacaosc~ kpm 1 /V 7~/ 10-..5-73 ~ 9 ~ q , y l ro rn~ touel-I Smioa, ~ r~~ ~o y a i ~ I 7~Q_ 111b ~1tl, 1h, PM ~ p rfai'iifAfiOH.MfCiUI EXAM~HfA 01 (ORONEA: On ihe Ea~~ of TA~ MOUA OF DFATM iNE DEtEDIN~ WAS -AONOUNfED DEAG ~~. E~om nel~on of Tne BoOr an0/or ihe InrtU~pu~~pn, In ,Mr OD~~~on, Dw1A ~ MonIA Doy 1'tor NWr :•. . '<~ Oc~u/I!C 0~ 11f 001f Ond Ouf 10 1A0 COaSf(~I S~OilO. ~ .;:,; . ,~ ti ;R , w 1?a. M. 720, M, ., ~,~~, , `.. ' q~ (F41ifiEq,NAME (1YG~ 0~ P~iM) I{ '1 H K i M D l ~~ S16N TyA -((Ai IIF ~~~ ~ Tlrl~ DATE Si6NED Abm y ror ~~ ~o • Ty ~ /~1 ~ me ~Y . er . . o ?7a. ~ ~, a,~, `~~ ,,~~,~y ~ ~ MA~~IN6 ADOR(SS-([RTUrER Lreer ar a,r D, ~o, GW or v~uope f~et~ i;p ; ~~,M~ IMI ~ i ~~~~ 3~01 '~lonarch Drivc ~~ Racine, Wisconsin 534Qb ~ dUAIAt ~flMiTfRYO~~EMAfOAY-NAM~ ~~OCATION il~ 1011 ~ fRIMAiION I + ' ~tacine, h'iscons{n n R~MOV~~ ;~~rst L~~an '~'emori ~1 P~rt ~ . r~e ~9~c, K-OA1( Month OoY Peer fUNEpAI NOv~F-!lAME AND ADDpfSS Snai oi R,~ D, No. ~ty o~ Y~itoq~ foi~ ;0 '~Ct~tiCT ',?,;~7~ a~,^+~f,V>>s~~ ruvrrn~, i{nlir ~nR !?leventh Ave,,linien ~rovo~ iVisc. S31R2 ~ 1~,~ ,~..,:.~.r., ~ .. ..~.v .~.~. /_~.. ....._.~.-__. . ._...__~~. :6t+ ~ ~ W i 4 ~ g .m „~;'