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CERTIF'ICATE OF DEATH REGfSTRATiON 4 3 r7~~
STATE OF IOwA ~
County of Yarshall } as . ~p ~
_ I hereby csrtify that the records ot the office ot ths Clerk of ths Di~triet ~
Court of Yarshall County~ Iowa~ sho~ s record of Death as follows:
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NAYE OF DECFJISED ..~..».....k~~ET_ LEE Sex Female G~
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Dat• of birth oa~toi Deceased......._~Lf~dJ!.4,...~923...._ w
Date of Death ..............~c~ber_7~_.1982_M..~.._.~......._~~.~._
Placs of Death.506_New, Salem.
Road~..Marshalltown Yarahnll County~ Iowa.
Uaual residsncs...506.,New..Salem~._Marshalltown, Iowa W.~ ,~,w,µ__..._..~_._~._.. _ ~
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Causs oi Denth Ventricluar Fibrillation due to Coronary:Artery~Disease_(with Prior Myo- ;
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cardial infact. + CNF =
Book No._.»......1L_........».._...»........»..._......_.~........Page No._ .Serinl No. $388~ 1982 `
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Date of Filing........IJ6ec~mb~er._L~.:.12$2.~.~..~..._.__.._.. ~
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. In_(~tnees whereof, I hnve hereunto aet my hnnd and aftixed the aeel of said ~
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Cou qaly ogf3ce nt,Yershalltown~ 1[arshnll County, Iowa, this..... 23 -...day ,
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o .....'A. D. .19 83....
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o ~ Cl rk of the District Court~~
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~ ~Q~K 410 PAGE 981 . ~ .
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