Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Death Certificate - Battram, Mahala Elizabeth_5/16/1977
� � ..�- ' - ! , � �. ; . , � � ��, . ��'. � LOCAL . ' RECORD OF DEATH � . . � � ' u1BSUiv i;UU�^i�T1= �Ei'=i�ri3�iLi�T ur riEtiLTri � F�si�cerov. ivoin�.�. ?fLIS IS'IO CEBTIFS", that our record; ,�. f . — ' � � . �%G�/s�'i�i �..�' -._../.�Go... �t./.�.��...�..... �t,4<�...N.%. . . = ...... ........... .... ..... .................. .. . Y ....... . . ...... • . moncn da y°ar hour oi dea[h street, �iia�. ital, rural � � cy f . r � � �% . ii�@ 8� death.�'f..... Seh:. ..�rr.:..:.`J...�� . COfO'.../�!�y/.� .......................... ... ...:}./..�� 6.F-.CSw .... ......... ................ � - }'BZ_5 C'LI.B iC�:CI:1C7 R:1LI3C(� OI Jlllol0 ! . ��/i �/ • � , . �J � .� � r.: .3 . ��..�:�-c�. � Primary cause c, cc^�n �i�en «�as_CLi n�-'r:..!,.....✓J"�t.�-�....�::..,__.<.... —.-<_.. ....... ,�J ................. � � G� .....:......................._ ......................................................._.._.........................._.............._........................................................................... � � � � . �> �) �/ � ;� � � �!�/ ?� l % B �' y i /'r { �_l,..:....�'��i''-�.—f .fiY'J...........—..��' �f�J%.!T�.�.:� � s�.'�s?Y.•....... Si�ncd by._�_.�.t�i7/ �cN -.�t......� .,�.. 1�.'...�.---. �. . � p!�psician or e��i:a= addre� i .= : , , .. �. � . � , `„ .. Piace of b�r:�1 � - -�� �'�...:�w� ......._......�� _ . . . � " ' ../� 'll.....����� ...r �• J.����... ��� ^..�... - : . - lluit:f 0[ �^t2`v:�� '/ ^ /ffCI4LC55 i , �� � .. / /� . / J Da.e of br.-i�1 ���.(�. �vJ6 .li!�� i �jY'�,� v`..!_. ���r-�.'.�i��.. '� �—�� ................ . � -' ' / f F'�u e > >i�:c: o �. addr��; ... •- � ,.` . ' . � f % �a � . _ . . � — ' — - — � - � - - -. `e� ! . {� . � .. n _`� -��. i � .. � _. " � Jtonec!_...'.�._�:....._.r.....�. _�..�L;a�4r.::.,�' ....................�..... :l , . (SEAL) . . .. ... . •�/ � . GiS;as Cam� Health Commi„ioner .. . l'".z.c,� �-��, ��,-.-`.�. `�� -- ." _...... . � _.....�. � �t.....��... �.-�-...�/. � � � � ' adctress date ,. . '. . _., ,. . / - � Recordefl local!p in Look \o. �:....�j.�.. j , Fage \o.... �..�....... . �3 � � J — �O O •. . . � .. ', : �_-{ .�, � _. '- "`i 0 • ;' PaF": \�,. -� l'r••p:v:_d- i,,: i:i�:\'PO\ 'P�'1'l.l: �'OGi'OG�'Pf0\" . -" Pri:uctan. 1uJiana r3. � - . , . - . . . . . . , . . . -