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HomeMy WebLinkAbout0864 ~ OATC NCGIgTGkCO ~Y STATC kGG/S;~A~ STAjE OF COLORADO ~ . - - ~~~~:i; ;j CERTIFICATE OF DEA?h~ ~O"~~84e l.~t~ _ ~CHYSICIAN OR CONONEx1 ?OC~I I.\lrJY1~• ~ ~~I~~ I.a1ti~V~~• ' OECE~1E0-h~~E "'OD1t SEZ O~fE 0? DE~Tn e.. .a~.~ . ~ ~ Arthur {~f. SCHICIITI:L ~Sr' Mal~ , Ju:y_ 15,1971 ' ~ 4~~f •.•••t-~~a~e wa~t~ti~r.~~~. AGE-a~~r uNnrw.'.~aw ~tio~+ .o~. ~•c..v~t<.•.. •~~..Lo.. .~c¦r Di:w.OF ~IRTN •.w•.r.. o.. COUNTtI OI OE~fn ; ~ ~~1~1~.e . - So V7 . S?o~ e~.~ s~. Jan.~~17Q~1 ~•Denver ~ - t ~ ~ tlSf, i3fi J~ 1OC4110N Of DEATM .+.LDE C~TY ~IWiS MOSVITAi OR OTnf A 1nST1iUTi0t+- H~ME .,e• .~o+~„~~•. .~.~i.•. .~~o~..o• - o~~_ Denver yes Rose Memorial Nospital , . ~ ~ ST~TE OF B~RTM ro~ ~r v.s.... r~~t " - ~o~y~~~, C~it2f„ O~ rH~t ~pUMTRY ~~i4~E0. N[VER ?+aRqIEO. SVNVIVIHG SvOUSE ~r ~~r~. t.~~ .~~.p~~ _ j ~ • ¦EO D~v RCEPvtur.• W ; ~e~~ ,Tersey ' ~ U.S.A. ~o~°arr~.e~ Lillian Bernhart - _ _ ~ - _ A SOCUI SECu4~Tt „U~DER VSV?l OCCU?AiiON .~ro e• .e~a eori ~~.~w~..a~. o• KIND OF EUSIHESS OR-!l1DUSTt1Y • " ~0~4.N~ \~1t. ~~{h ~t Atf~1lD' - - - . ~ ~ ,~.140-05-22?G Errg~neer xnsurance ~ . - ~ - 4ES~CENtE - STATE COU?!TT CITIf. TO~N, OR IOCATION "'~'o~ STREET AND MUr6ER ~ olorzdo ,~enver - Denver . ~~~es 686 So. Pennsylvania ;C~ , - iATNEN~S NAYE - •~~~r ~~OD~• ~~~t rOTHFR'S MAIDEN NArE ~ _ ...oo.i . . . ` „ peter H. ~ Schichtel ,~Barbara Andr~ss ~ - NiOR~~NT_?~~~E ~ . ~ ~ REIATIOMTOOECEASED ~A~I~~L~pDRE3t ~~.~~a~o~~.•.e.ao. c•••o.•o%. ¦•.•~i I Lillian Schichtel ~tife 685 So. penns lvania Denv~Co~ord~~~g ~ t~.• - - u.. y m ~ ,11. CAUSEOfOE~TM t~ra~ov~•e.at•v~a~i~.~.~io~~~• 1~ •ro•t. - _ ~.a. c~.•~ ?AAT ~ . . . ; :n ~ _ a1..../• _ ! - ~ "C ~`r~rn . _ trrEOt~TEtiUiEf~f ( : v' . . l ~~~yl~~~ . ' ~~Vnj i . . ~ o.~• o+~~wa. ao r ^nr, - ~ co.o~.~e.~...... ~ ' . • r ,y "Ly ....c.. ..i• .p - 1 ' r:i : ~ r n? . % . "ic `~~rz*+ _ ~ ' . ..to~..c c.~~a {?1 i~ r~ : ~ ' ' ' r,~- - . .,,oi.. o~~ •o o. t COti~lOV~tit{ O• - ...w~ e.v~e ~.~e ~ ~ - • - . . . . . 1 ;~y~L,p~,~ :TfC - - ~ . . ~ , T_sYi~ - - -V~qi ~t.--OTf+ER S~G~+iFiCAwT COMD~TIOHS~- co+wr~a.i ~o+ri~~~i~,.s~ ~o oc.-i~ ~~r wor-¦=~a~ao tO CIY~I ~~~lA ~F /~~1 . - wUTOPSY S • .i ..+o~+s¦ co.. ~~~OAwO• ~ Ol Dt~! r~ ~~.OC~ut~~. ~ - - - ' - _ ~ ~ . . . ' . . . . ~9~. IJ(~frc/a.a~ ~ . - { •CC~OfHT, 1U~C~DE. HOr~C~OE O~tE tMOUNOf ~NIURr ~..o+-..o..,.a•~_..ov+• - V NO~ IHJURY Of.CURREO~a+~ta..~~u~~ e~ .r~v~~ ~r ~~wt ~ o~ ~~~~....~ir ' , ~ '~.ac.r.. . i . ~ r- X~~. 70?. !r. ]Ot.. - - - . ac~ ~ ~ u jN1Uft~ AT r~RI PI~iE OF IH)UNY a? ..o~[ •aa.. +••ea+ ~OCATION ~~*~i~+ ow w.r.o. +o.. e~s• o• •o•. e•~+~• - - ! y •f.ic....~~ow..o. .•c*o~..orric~~~o~.i•c.~~.~c~r.~ . ~ - ' i . - < 20~_ TO~. - M1. ' - 1 v _ ~ ~ERTIFICATIOM - VMtS1~lAN ~ f- ~ . ' ' . . • ~ W ~ •~~I~OfD ?~l OtC~~f[O I~O~ .~O ~ - •~O ~~~i ~`l~ ~~f[ O~. ~ ~I.O[~~rOCCU~eIO~f _ • F/• r.ptitNlOL/~{i~l[O~~~O~II~tiDtOer[K~~O~v~ tiO~t[06[.~A9r~w[t~V~t~~~~~[O. ' i CE4t~f~~~t~0!+•COROHER o+ ~•~~~or t..r~w~r.or e• ~~a wo. 'brv~*+ T~~E OECfDENT r~y oRphpuNCED DE~O ~oti.. o•. .a.. ~o~.i ' ~•o. -a ..~.,~s...oti. Y~ OSIti~OA o~.r.. oee~¦aao o+ ~~a o.ea .re - ' .Ovf ~O f.+t C~v~[•~' 1T~r~D. . ~ . - ' . - ~ . - 27•. - - ~ ~ - M. ]Ik. ~ - . , _ M, ~ . CEATIf1ER-S~GNATVRE , n~ ot~~c[ow ~~r.~ DA1E SIGHED ~..o..~,o.+ .i.• i . . ' . - / ! _ ` L•r ~1.~ _ ~ . . )7~. ' • ~ . • ~ . . . : 71?. ! - CE4T~FIER-~:1~.F 1~.~~ o• ~~•v~. - YAIIIHG aDORESS ~'•=c~ o~ •...o. tio. c... o+ .e.. 2~~ Gerald Milier M.D. ~~~3855 ~herry Creek North Dri-ve D~^.ver,C~6o`r`aco - ~ DUitl',+hC.RTaZG10T1E~OvAL ~~son~ CEME.i1V@l~S~.U~T~~~C~dEtO~ IOC~TCIii~$ County;~C'o°rdY~do i . Z ~ a,a.a~~~~ ti 0 7~~. 71~. _ 71c. ~ - i , 0 2.,TEJllly ~~~~7ll~caw. _ 2S¦.~I.O~AP1~Li.~d~CS'~~~.i~'~~~'cs ~.~r.rt.i~•. , F Denver,Colorado 80203 ( _ .°i+ Ft;hERA~ IAECTOiF-S~GNATURE UGEMSEkO. ~ REGiST ~R-3~GNATYRE DATERECE~VED6Tl0v~lREWSiRw4 ~ ' " p ?i ll~ ~I/~. ~Jti~ ~GV ?6~ .~j ~ , s~ J • ~6?. VJ~ 1 b 13lt - f=: 1= - - - ~ - . - - - - - - ( STAT~ OF Ct~LOF~~DO~ City and C~unt~ of Denver, SS. - I hereby certify that the above is a true, full and correct copy of - the ceXtific~te, ~.n my cuatody and now on file.in my office. ~ - . . . ~ ~ - - . • ,x , : _ Y,~+j~~tr~8~ ~ny~tiand and o€f izia7, seal at Denver, -in said State, this U~-- d~#,~e~= J~z1y~,_ •~~~::;1971 . ' - : ~ ' - ' ~ ~ ' ' - _ . /J , t:~ , : . " . °jF:`~' i-t . - - i < . ~S -s~'~yr' - . . ~ ~ . y~ , ~ ` - ~ . . 3 . ,~.~i ? ~ ~ ` ~o r . ~ M ~ ~ s ~ ~ ~ ~ ~ , ; - ~ - : ~ Reg st~rar of itai Statistics a-~ ~ • ~ i _'t ."i•' 1 ; ~ ~ J . . . . Cit~,~ and County of Denver 'i-~ w Qs . - - a . ~~1~'~ ~ - ~ ~ s-'=;~.i',- s-.• . ~ . . ~ ~ ~ 1 Y~4Er~'~~ ~ ~ - ~ . goo~ PAcE , ~~3 _ - - D uty . . : _ ;