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HomeMy WebLinkAbout0942 • ~ 4 ~ ` 1 . • ~ - ~ '7~b319 ~ " ~ This is to certify that this is a t~ue copy of the record which is on file in the Pennsylvatiia Division o!' Yitat 4ecords in accordanee with Act 66. N L. 304~ approvM by the Geaeral Assembly, June 29, 1953. (Fee for this ce~'t~ficate,1S3.00) ; ~ ~ , ~ If~iRNING; ;tt is illeg~al~toiiuplieate this eopy by Rhotostat or photograph. Chules Hardcster ~ ' Scue Regiscnr . • - ~ J~. ~~8~,' - ~ ~ ~ ~ - . ~ ? : Datc _ ~ No. ~ ,(~%i ~r' - ~ ~ • _ . . ~ ~ ~ . , . ~ ~ . , COMMONWEALTH OF PENNSYLVA[VIA OEPARTlNENT OF HEALTH F~LE~ • ~ ~ ~ ~ VITALRECORDS ROGER P~?'i + 1 ._:Rt1 " CERTiFICATE OF DEATH SL LJC~~;12i~i~'g (Physitian) ~ STATE FILE HO. ;.a~xolC~eeoeni ifrsU iM~ddki :l~ai ,icz Qs:eo~~+~~1lM,O+r.Y•3 { i,. Rose D. Viscomi z.female 3.Se t 25 1 Face - ie.g.lYttite. B:ac1c. /+~e {m Dirth~ If „~er 1 yr. 11 ~nAer 1 dsy L'ate o! brth~MqUiry.Vr ~~te a}atgn awndY ol County uf birth Gey. Boro, or Twp. OI artA I Ameriy 1 eteJ daY Moe. QWs ibu~t Mx~ b~M w~.f~~ s~ 67 se. ' sc. ' 6w. i ~ ea. P sc eo I tcu~!y ol dc~tA Gtr.Bwo. a Twp. of deatA NOSOdaI pf If~tl4LLfqfl (II TtpS LH11lT~ s~ ~r~~ 11 Aofp. or inst. ~a.tate ~OA. I Al le • en O?!El1, o~ inpaS~enl (tDec~lyl ~ 7~ ~,h y 7B Pittsburgh ~~Western Pennsylvania ~iospital ,o_ inpatient 1 Oeceden:'f Ma~l~rg Addrea (Sveet t• Rf0 No.l (GtY w Town) (Suttl ib0 Code1 Mr~rtsl5+itus Svhnnq Soovu 11~ wr~fr.lnt rrv~dsn rw+~el ; g. 1641 Ga,ee,ton J~r.. Je~eona PA. 15147 9. mahh,i,ed ,o. Samue,~. P. ~J.iJSCOm.i. ! G:• ~re~ o? Khrt carnvyT Was deeedmt etie* n U.S. A: mM Fweett $pe~at $eeunry Nwn~e. Uwa~ Oeevpat~on (Ks+d oi wv? donr dur ~ erast Kwd ot Ouye~ess a:~+Q~str~r j ~y~ oI «ak.nq Idel ~I ; „ ~iK Hows elvi. e ,.g. Home ` ` ~w~~.~ a:a . `y I eR~nt ~s~. sc,e~ Chd Aecedent i~ee tis~.Q rK. ter~e«» b.ee ___PQ IltYl Hi P:'A tow.~p. f ~ x-u•,~r I.ve~ 25~ ~~„ir h PPo ~h o„,. i~ a to+msA~p~ ~Sd ? lio. decedmt t~~reri w.s!wn acnrs~ lunrts o~ eitr a 6we. ~ I 5. ' ~~~r.e.'sr.~me (Frtit) (ARddkl (l~si} Mothe*'s+v~de~nams lFait) IM,dd!e1 (Lastl ~ ' ;6 Jad2ph No.Cde Jobeph.i.ne ~'uga ~ •,!o•~aei'sro~neliy~raR~ml Inlornw~t'ti lStree~u.RfORo! lG~r«Yvwef tStnd IbpCodel '.tn. Samue.L P. V.i~se~n.i, ~`igsd°'"' 1641 Ga,Le~on :~n. 6~e~cona, PA. 15141 ~Bvu: ~Remora' OateofDur~a~,et~. µameofcemetcryorvrma!ory loca~~m IC~~y.bo:o.twp.l (S:stel ~ 19~L ~~.r~.7iW.'1 ~~lhtr 19$. O/O`? 19C. ~(,(.C.V ~G~IYit•C/`~ 1~ P.i,t,t~sbcchqh ~ e__, 1 dKMf~Y ] t11rrC . Nx,v snd add~nt of Iv,nal es~aN~~'rnent :~a, ~ ~.r vv ~ 1 S eh.v.i,a 3 1 - Cj (t~.i,~X.i.am F. Gnobb fune~ta.~ li Ume i 1735 F~carth,~#ocun Rd. o~:~'-0~8~• P.i.t+`~SSwcgh, PA. 15235 21A. ~ ~ ' ?lf~ ?OB T- :n: Ge:: a,t :now's.;yz. ;ic.t:~ ,~r:eG ai 1Fi. C'T.f.ILi! illC ~ i[t iK du tu . ttt tavse(t) itated ~ Y.O. y ~ Sqanre a r 71A. a.~d ~rtk OA. i E~o Wu SQue 1-. .7ar. ~ EI~T ~ - De A.M _ = 228. (y ~ G. o.M t4:~*v in0 ~ ~s ot rulr n~scd.al Esamne. v Cor:rurt {P~m! o~ T 1 Hare ol Mtencl~og R+rwc~an `:C Jeffre t;~i ~ ~5~;,.ibeYty Ave pgh Pa ~5224 n.GonzaleZ-G-E-O . ~MS:EO~AtE CAU~E. . fmn ont~ one ex.se prr Lne Io. iAI (BI s~O (C! ' knerql Detwee++onsn ~rw desd~ T1 a ~G ~ic,~s~ ~ _ ~ Due to. rx ~i a consevxnct of. - , b~er?a~ betv?ee~ onfrt W de~tA 3 IB) 7 ~ ~ ~ ~ART ~~,~~''-C-_ S~C~?[' / ~~~/~l ~tirC.."~i4 ~ . P..~ ~o. a af s consequence a1 ~ ( NunA~ Dch.er~ onxt ~~d ae~0+ ~~~'^~`1 C ~tS~~ _ ~ ?A RT 11 O~!,rr S.9rrr t Cono~c~+s - Cono~i s eonena,:~. ro denn ~v~ e.euiea w c,s~ y„m„ ~n ! lal ~ /w:oasr ws~ ax rtlH~[G w Mee+u~ Er ~ti ~ yL ! n Q Y~ a+~.ner a Cpone.? ~''-c ?s. ~ r.s L~:a+.~ ~a.~ c ~~.~o ~ U ~ ~ c.. S:t~C:. H•,m.. lM•.:et. v Dste of ta,~.~~~ 140.. D~~.'Ir,j Mow ol DcunCC Avr. ~n~wy ottv~red: %r-:• ~tartit~;. vnl5~tG1Y) trryvry A1a. .3a. ?3a. ?9C P-M ?9p. ~ u..ni. P~xe o In~u~~ IM bnrrK. lym, yuce:. c+c.) l~v~r~ Sucet w U (G~y.. !wp i IState) (+c ~NO ~YSt ~3F. `II~~~ ~~~_i