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HomeMy WebLinkAbout2707 ; ~ ot~..,...~hT ~ 3~-n`~'7~ - . ClRi;i.lAlE y SiATE it:[ E ~ 1[~•tCR~w~• REGISTRATIGN ~ 5T~1E OF IL~INU15 +.~:µ[ta ? CE!tT~fiCw1E DiSTR}CT NOi~' ~(j ~ t~•~~ . RFG~STERED CORONER'S CERT(FICATE OF D~A`~I-i ` NL\15EF l ] ~-'lj ~ DCCE:,SE4-~~/AME r~AST ~•~6=1t IAST Sf:{ DATE OF DEAIH ,.••c•.~~, rtaa~ ; 7.c~o~r~...t.~ - . ~ . . . '/(R?~ANLNT ~NK - - FR11NK Ti. ~ GARDN~R ~-~2.male I?. Jul 12 1974 Se~ A AL~n. J fc~ - - Crc=i•s =~i ~qCc ti•Tt ~t~a AVI%~CA~: r.~.~.c.~ A'-E-t ~tT . UNl>FR 1 YEAC~ ~r+GCh 1 DAY~DATE GF 9iRT'ri w-,•:.. ~t•~,T FLACE GF CEhTH t-_ ~T~ - l..rc~c: C.•e:'t~! ttC. f: 8'FT~.^,~~ ~rtt! - . n A . h.C'+iDttk 1ts M~S • CA•S ;~tiI.GST M.•~ NOV• ~ ~70~2 Peoria ~ enST~iCr:t~.i i: Wtllt@ ISo. ~9 ~Sb. ' :5e. ' 6. ~ ~_~70. ' . ~.~i~.. C= i~.•~:~.51~•.,7 •.L~'6lQ '~•.<+Gf C~IY ^;nCl£.'~l C¢O1Ni3,•.t7~7~:~G`:-t..~uf (•f~:'~.INEITMER_G!~ESTt[ETA`'~NL'u!!): " ;:i(S:nC! ` _ Peoria yes_ _ - Proctor Hospital D.O. C. GIRiNPIACE .1'wtE :t ~t~t 6v CiTiZEN OF WHAT CCVtvTitYj~A1ARR!CO. NCVER l.SARRtED,-~ 1~Af.1E Qf S~RYIVI\G SFG'v5c ~.r~.~[r. ~:~..t ir w;tc ::_•.ic., I~ti•~~:L\'IEQ DI\~CRC[D:. tc•., ~ - - - a. v. ~io_ ~ Nave _ __S11]114is-- U~e------- IDarr.~-~d_---J-------~l~r~_~~~.-_ ' SOUAL SECVRIiY NUhtBfR l:SUA~ CCC:1PAilON CF Bt;S~yESS OF ~r:.r,'_SiRV ;U S. «jP. ~'ETERA"~~Y:AR CR DATES C~ S:RYICE - - 12.~48-03-2409 13a. Vice_.pres. ;~3h. aairv ~3~. ~ no :13d. fiE51G.NCE ST.~iE ' CGL~I Y ' C~'• iCw~:. T.~~ CR i::~ ~ STi'!: r.C '!h:1;,i C~IY i~.[tr f•.~ ti~ti_:a ' . . _ . ~vES : ~<a. • • ~,4b. Peoria '~e~.Peoria ~~.a. ,es ~;<~.705 Bitters~•:eet Ln. FATHiF-NA:VtE ~~~st ~Letnt usr M.OTHER-~ru4l~IN NAME r.csr N.i~~it u:~ a ~i ,S. Charlas L.- Gardner ~ ~ ~ - - ~ - ~e~~-~~.~-,, ~ C. Graham If~h" hT'S SiGNAT~ZE ~ , ktLATiOt~SHIP ~ MAIUf~G ADdRESS tSTFF[T A!.'~ M?. OIl R. i. O, :~TY ta zc~~+ s=wTi, ZiFy ~ ~~rife ~705 Bittersweet Ln.,Peoria, Ill. - > > z l l :..~Ft._~N . _ ~ , > > ~ !b lA , , _ . , .i ; ~ 18. LfAIH b:l.5 CAU~ED BY: ttN`ai r••:~ G_.E e~eS[ rt~ LUe. . . --r_ - - ~ ~ ~ !t:: f: ' Iti. :t~:.. PAAT 1. ~,:ve: att cf~'t ~ l-- . CIE GOtil! Y . ' = z ROC~R AOt;RAS ' _ - su~'focation _ _ 9~_ r ~L i.~Trr:inutes _ ' . _ .:f CR „s ~ REC4RD YERIFI ~D....,..~~~ ~ . `-`'.`'=:~'.S F"`- ~ lar~'/~~`eal obst~uct? on ~ minutes .~.~C-f G~tE ~.~E TJ J"S•--------------- •~~.vE~:AIE CA!.~F t~l - ".7Ai.•:, i~: ~.~.:..E~. ~ _ F 7;.G% _S!. C_'.~[:-f'.~_ ~ . . . ' ~ _ ~R..,< ; n,inutes . chokin~ on meRt PART tie'r~[~. S:G`:sF•'Ci.'~1i CO`:~lllC."JS: . 'f,l.iOPSY YES. - c-•. _ . ~ ` - . ~.~F: '.C. : ~:'•i'_ _ _ . ;n~-~~e~_,~~ ~es - - - - _ - ~ni:_cF r~;:'~r _ .T. - '~'r~,~2 - = :v~~=:~~ - Y c-~C~~:'-.-rrJ e•_-,- - - _ _ p,. : . ' " . . • C O @Ci ~ ~i l~ of.,:-rr t . . ' ~ _ , on iece . ea . acc~den ~ ; ~c~ Jt21Y 12 19 L . ,~-2 •00 P~.. ~ ;e~ _ _ ~ _ Z.___.... , , ~ )U:.Y A~ .GRK--- Fil~CE C% 1`11tiRY aT r., rz. ;r_;f- LCCATi0~7 ~U:. r~~ Cz ?~ev C+ n+~. GR a~ a;sr. np. co n:. s;t:[: - ' ~ C~r.ii t'_ ._~t:... ` . _ _ .r: no : ;o, Restaurarit Ueoria-city, Peoria Ccunt~ , i~ linois ~ - - cf~ re•. FAy:.^. " •.1r S~'•~ C=CEi.ctii \'!AS ~R~`+OV:~CEii ~cA~ G~d AT ~<<;==F; : ; ~~3uly 12, `19 ~ . : ~'ir 47~•. , P: ia~`.i.- :ia::_ .-.U Tr.aT - - - • ii ? 2~~. 20pr~+- - - -~-b - 2 ~ - _ COeZ::\~R'e e;G\A~~~ ~ _._TQATE SIGl~`ED ~,•::.TH. .e4; - ~ ;7 ' .G ~ . July 12, 197~- - 2io. ! i, ; ?~h. CC°C::E~'S F~.'~~ f~t`+ ~ I.Ol.ll e 1•i c211~ae ~i DATE StGtiEO .•.:~.-r. .tR: ~i~ '~-t~// 1 ' ;3h July 12, i971Y 6C~~~1. LrE~r~ATiGt:, :tE1.'.FTEk'! Q,~'~'.~~}~J~;}'~vE-V.::',% ;LGCl.TlCN t~-rL~,~r~{ s~~t[ ; DATE :4;•.iM, C~~, tEAG ~ RE.ti~p~; ~,1 ~~_c_;.,~ . . . Z.,_ -burial ;2<;_ Springdale CEm. ~2<~. Peoria lll. :z<~Ju1yl6,1974 FUNE2AL ti~~lAE • i`A!.'.[ ~ .~EEt ~:•:vs!a CR c•i. UTr C9'~~{~ 1iwTE - - - <<_e_ TiIE WILTCN AiORTUAP.Y, 2101 N.Knoxville Ave,. ,Peoria,illireis 61603 _ _ ~ fU!:ERRL ['~~~5~T ~ S!G\ATL°RE '•F~ n[uL ~?[.:o~s ~,i~.~.s ~,_c•.<[ ~.:.ve:x = ~ ~z/.. n~~ ~ ; ~<<: 3 f,~ _y- - ;LC.~~._ ~rr_~c? ,~.,F c Lr. ~ ~ ' ~P REC'D. 6Y LGChL P.EGiSiP.AR - - - = • ~ _ . ~ f r' ' ~ ?r~ 5_~~7~ - ,'ti i~.: (1571 r) Iflinois C~_par:men! ni P~b;ic Hralth -Cf(!ce ot Vital Records ._~~=J Cv ~se? : 5 5~~~~r:~ Cc?'.~~[+?_ _ ~ : k _ - : ~ t; - 1~ ~T _ ~l : . . _ I~i::~':!.lil CFR~~~~~~'.~~`1~~=foyre~Ql17;; IS 3 111i~ Cf)1'!'C('t fOjl\' Gf t~'.C c:eaiii YCC:•~'s~ t~iP il:C' (;CC'a^c:(ltt ''1~ .:i ::i111 , '::t ,'~~'~1-CS..~h ~ tl.~(. !?1 :11\- Ui~.CC' ':1 2CCl)'.'(~:a):CC ~\'Ii11~t~7C j.Pl~~'i~II~:S~ (li ti:c Ii~iil0:: i.:~, iI!i_ ~t~ :i'.!~ ~ 2'M~nS~ 1 t iiE~iPli .:111~ t.. 1 ' ~ ~ ~ c• . r; r - ti:c rc~_.>t:.,:i~~ ~,of bYr~}i~: siil)bir~~s;4izd ~?~•ath~. • c !1 v t. - - t ~ ' - . ' = ~ Ju]v I-S.:_1974, ~ + ~ - Stc~~.n- ~ - - ~-e~~-~-- - - - . -Lf;~-~ i r ~ ~5--=;r-~---- y~rr,~ie-~ * ~ 2~~Or1a: ` r'* • L'E%tit~% ~E~?SL~~~ ..7'_ _ _ ~~...'•~_~~.,.s__~-- Illinnis OFPICI_1L Ti1'LE - - ~r;~, .:i rrrUYC~'R~;t~s:~-"i'~~lh is ~.rr::~: ;c~::?:• 1:'._~l ~~,-i,li ;l~c )I.T.1\(lIS 1~1:P.1?:'i:•iE\'1' OF Pt~1;LIC HF:~I.'3':( _ Sir::~_-fie~u. CU::1?'\' 1-°.~_I'c' 41it~ ~CC?~'r~`r~'151i::i5 :T~ :ii7i'll~l':%~E~ LJ :1,:i.C l'i~l:ie~1C.^.~lCi. ~ iY~~:ii ~''ij•:i~ C•i t~i(' i~l'?i~'I::_~ recur~l. 1:...:~~:> i11iC_ { . ji7:, t~t` , t~iF C(•1'i:i:C2Ji.l(:.^. Ct~ :i (ZC:ti~l Tl`(UT~~ ~P~ 1~c~F:::rt:li!'llt Of j~U~"~~:~' ~1~: :~t~l !i1' t~1C ~l~C.i~ 2't`~IS}l':11' c,)~(•il~.: ~-iTi:::I_' C~C!'~ i :-i...7~ ~~n ~i7i1.;:i 1::(.-iC M'i~~C!eil' 1;1 l(~li]'t~ :~21~~ ]`.i,^.~'~•i ~:f ti:C 1: (~l>. l~'~(•`"C:1] `.i:.'C+.~. . . ' i ~ i A{~ ~ ~ ~ BOOK 2~l! ~E~7~~