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Death Certificate - Boyle, Fred Sr_5/3/1965(�ERTIFIEDICOP.Y:OF A DEATH�.RECORD• - STATE OF ILLINOIS - nuA+aieF H°,`�o.' - • _MEDICAL' CERTIFICATE .OF DEATN �;sr�ici �o �j ,O Nu;,�;EQEo PIACE OfDEATM � _ " . - ' 2 USUAI"RESIDENCF��'��edad�osed�;.ed. il�su,a,m,.esde.K�be�a�ad.uawn.�� COVNiY . ... ' . . . " . '; a. $Ul; b.COVNtt - . -� 4labash couNn,��NO�s � Indiana Gibson Deoth look Platt """ "' -- �- ' " "- ' — . " c • Residence was - . . ❑ OUi9�E �ry 6va� aid in ...................................TOWNSNIP. OOiSiDE anv 4�m cnd+...................................TOWNSHIP. �I iu510E aih Amm'vM m iA� �n�, .Jlvye; o. ea.n nomed n Ic � � � rvSiDE <+y 4nnv�ard m �!e afr�, .iMga..o ro..n mm�d oi Pd CITY, VILLAGE,�OR TOWN -' -- .� d.tENGiH O� 5inr iH tl: CITY, VIIIAGE, OR TOWN � � e:IENGiN o14E510ENCE� _ __ � _ ... � •Ib cr Ic ' . ' " Ai ]c o� id' ' - " - maaNm.p;.ev.eei IL IENGinUfSUT �II1. SIRtEIADDRE55 ; - ' I9�ON IN 1� ' NAME OF a. �Flesn DECEASED Fr d . SE% b. RACE ' 7: o IUSO .- . Id. DA7E QF �.NONiHI .. IDPYI DEAiH DATE OF 1 �wr'MI undee 1y M.. o�rs ovvzi �n. 'PAiIONIGFebndNl�pb:KINDOFBU5WE5S021NDU5i2YlI1.BIRTHPIACE (Ciiyc.�dsm:ealoreigncoumry)�� II2GhzenolwM1at wn d..atuw 61e. e.en ..�..� .,.z ' VO fll6 Cl �v V U i3.�'FA7HER'SFUIL - ' - - - - - - � - le. MOTHER'SFUII ' - ? NAME � _ , , � MAIDEN NAME . . Z Jam H o 1 a IA Was decea:ed eJer in U.5.7vmedForros2 ' - - �6. SOCIAI $ECURITY V.• INiORMANT ' � - . ' � - � nm,no.o�m�na.d plY«,p;...w�e.dmne(sa•ie1 NUMBER _ � o. SIGNATURE„' � - ' ' - m M � ' - '- -- - --�- � b.ADDRESS cR,LATlO SHIPTO ..°1. � DECEASED IB. CAUSE OF DEATH � O ' PART 1. DEAiH V/AS CAUSED 8Y: [EnteronlyonecavseperlinelorlAl.181, ondlCl:� � ' � � � �' ' �NTERVAI BETWEEN' F � •......• IMMEDIATE CAUSE.IAI... . .... . . ..;r , ' � . ET AND DEATH 3 ' ONS Coronary Heart Disease . T � - o . . . . . ........................................... Condirions, i! ony, dve ro IBI . .. . : . . . ~ Z which gave rise ro . ... . . . . . ... . � . . ' . F Qthe abovelMMEDIATE ...........................................................................................:........ .'..... 3 QCAUSE IAI. s+aling . •••:•:•:�•... Z �he UNDERIYING dve ro Ip� '� ' ' - V mvz=bst. , ., . ; : _ . . . ' ' ' - ' ' 'F PART II. OTHER �IGNIFICANT CONDITIONS CONTRI3UTING TO DEATH BU7 NOT REIATED TO 1HE TERMINAt CONDITION GIVEN IN PART IIAI. �: a'..'_ _ _ " ". .. � ..........................:............:...I�iabet�s::Me� lit3s......'....,...:- :, .:.................. _ .. ,v. Aurorsn J 1 - . Q . _ .. . . .. . . . .. . . ... . . . _ . . �} j � " . . YES❑ �-NO �J. . V � ZJ. DESCRIBE CIRCUMSTANCES OF IVJURY, IF ANY, WHOSE NATU2E I$ MENTIONED IN PART I OR PART 11 ABOVE. 1 _ . — _ _ ' _ ' 21. I here c ni(y rhet I oaended r5e deceased (rom �- 1 � 19 60 fo 2 9 , I9 60 ihor I losi saw ihe deceased aliva �on ��9 -; 19 ��'-,�ond deo+A-«cuired at 11.. 3o P IN., Irom Ihe cavses and on Ihe �date sioted abora . ' � DATE $IGNED ADDRE55 PHONE DISPOSITION: BURIAI-REMOVAI-CREMATION roaiEi ,� L �� COIV1Ii;.8C,-._ O },,{OT}, Ll, � � .t]Q.... FIRM.NAME... ......... + 5...�..i'!. 4..�}T.Y.....'..... Whi�e ChuTCh ....:.:: w�ADDRESS.... pI'l.A.L�.�.VOA.f...J.i1C��.�IIs� ................ CEMETERY .................................�...�............. IOCATION......PI'�71Cet.0I11..121Ci18I13 ............. jo . ........................................_uCiN'sE::....J..... SIGNATURE F � i N v, Recened fw - ($ipned) . �ilina on . . . ' � - C 11 1 OV VS & R 200--BUREAU OF STATISTICS;;ILLINOIS DEPARTMENT OF 1 lIERL•B}' CERT/FY TNAT.the /oregoing u a true and carrecicopy o)'the death �record /or �he deceden� nnmed at iiem 3�and--that this�record mas estabGshed and Fled in.my o�tt in acco�dance rcith the psauisions o/ the /Uinois statutes relating•to the registrotion�oJ 6ut/u, s[iUbirths and� dco[hs. .- ' � ' D.�TF -Februarv 15� 1960 � _sicr��" ' �R�� - - AT Mt. �'armel- Iu,,;ou oFe�cla�.n�r�.FRegistrar, Dist. 93.0 The odpml rccvrd of ihl. daih 4 pemmev�� filed wi�6 v6e RLI\OIS UEPART1ESf OF PU6LIC HGLTH n �p+i�fidd. feuvq�derb .nd Ioeai rqi.tr.n �rc .vihori:ed �o mke arvificuiam fmm copia o1 �he oii�iui rnord. The Illivou .umiea pro.ide �hn �he c rtlfimiav ol � dea2 rtcord h� ihe Ihpuwene e( Poblic Hed�h a� ohe local �qiaru m�6e covv�) derk .hdl be pdva (�cie eddevice.ia.dl. cowu.ied�Pl�cu of eEed�co Wertiu �umL . ' .�.• - }+ —• Y580. NI.I DEPA0.TMENT OF PUB40.HEALTH—Buruu of Stati�fics. _ .. �yPrinted by f8e AntLority,of.tLe Stnte of'illieo'v'