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Death Certificate - Davison, Roscoe O_3/14/1958i ^ . p..� ,� . � .S i ��,�i � �� '. •1�. � � i I�.t � � �� +� f � ��. � � a � ., , i . •L�C2�L � �� !a � � .� A ^� .4�' �� t .•t� �- �i il' RECORD-0F DEATH � � , F �° '`` � y a `,�� ,� /��•^ 4. .� i r� .Y . � .1�-� r �' - ° , �;� '; :, �CITY�DEPART➢1FArT�OF HFALTA� � `r �< ~� ".� � _- , `t - j�;; ,' _ '�!PRINGETO� .IVDIaVA-�� -•' '.� ' �� . � . � � .. a� .. 1 1 — . � ... � _ ° wu y, _s. ,''� �. -t .., <' � �i '� _ THIS;IS TO CERTIFY•; that our�records sho« Roscoe 0 Davisonr' �° �_ _, ,, „'t __ _ di�. � , , � `. �i - �y� 'c. 5�' ' . �' � `.' � 47°' �lE B_;Pine� St a ��z � - > ' --October� -23,, pl°57r��.';... ,t_.at13 05PPd .,,px'inqeton; Ifid-'' ` , montH ;`��.. ,: day Q�� y,ear �� hour of death'� �- streef hosp�tal� iu;al �' <� ua r � �. J'r. < �. .y �� w,�:F � � �J ..� ..�- _ , ' ' t � -- + *"' - "'� �L7e19 � �t �-..iYtilte. '_ '. � IiQ3Trled � ' A�e:at DeatR ,, 68 ��'Ser — �. ` Color _ = -�-� . ' ',, 4 . .i�Sears .. g.�� .• ,� �•.- t�-�� ', -� � - - � -«nte;ihether marned.or,�.°s�n%le r.. .: ',��.�.�<-ei ..z .- � rr �.�:�{ �t.-� s� , c �,..� t _. . ,.�. ,t � ,i, � .� �:lf - f _ . �. '=� � 3 r .. �- _ Pririiary cause,,of deatli gnen ��as' Aoute'Myocerditis "'` � �t = ''W � trr_'_, � _ _ - r i r � :o, t , e , ,, - y . ;' � �F � 7 _ -� : �1"� v �-[�. ,.. ,� .o�. r .t�. �o .�f:"` .>. '�.. -c:ll . . .i _— r L � 'Zc ! . . 4 !s � ': a � -. . � �y. �. � t _ .�" s �•0 �.d ;i�!I'24E3. �1d D i. s �z . i r.. ,Princet�on,'Iad.' i� ^� •'v " _.�.' �� S�gned by . . _ i . . =` . � � .i-� physicitn or coroner�� '' � . " • �-» -addre s ' �' � >� - - � " � � , .. , _ ` � a ', o. , j � �-;-. S � �-` � Y , . � - x � ° ' � ^� * _ . � i' � j�� N]hiwe:Churcn� �Cemete�' 1 �Prsnceton, TA(�. �;: � .� � F • : �. :; Place�of burial.or removaL — s�„ jt . '. �-.:.+�.S�name'of cemeterv �, .t � .�y�, 1 .` - addre�s -.' � �� t ] - � .,a i �.-: .�.^"�"�'r'a '� e ��: t - `. �� i �S . .7 p 1�:+ . o` . rt ,t.'.t r rf �.6 '�i'- yi' t�H ��..�` C_ •y �. TII(�i.S� `� t}�� _:.r � DaEe of buriaL•��L`'�57{� p, �oi��n t& Son , in eton __ ,� " - , + � . �,"?�: s � ° Fiin2r81 .TJu�ector. '' ' r �� .: � . � ' � = ; . ad �, � ' � 4 � `- � � 'y� � a.� �1 � .i_:: �� .� ��`� s�' � '° : �t < ' �$' t\y �'� , : _ � . �'$EAL� �•r�q� y< ;Fi°, ' ..�}`�;� ' i•:Slgn2�� — _ � /��i� SPCy. � .= � � ij_ r� { a _,.r =- a ', i'"� " '`- r_ ''.a�. �. t',_�::�i'�inceton;..lnd. �..��,-r,, � ,,11/7/57�' " �' --- � ,.a; y- � '� �:' � F.-1� � � ' � . . ' - �.: _. - � .'' � . la addresa�.dF �. � ...:..:� �� ..: v � . dateT <-� t + r.,=: , _ � ,� , -• --. '? ,.r..f^�,, c' . ,^, : , , • �-- � "..,,.,�,�3 . � _� } ;-` ` j� ii d? Y .�._ ._ .Recoi'ded locally m book.��o � gn� �paPe No;,220 :i � , - r _. ;, " __ �,.,�o-� i � . :� �, �� ; , - . �r� r � � < < S ` +"-�- '< � �I � i _ s -t' . ~�°% ..it+-'.�"�` .. � . � '�.� i ��1 J' T....f ; � iY � ,� _.. , � r � � . i �.' �+ � � � y • 1 � t 1 �' ' ^ � . > �-� � �� ,. s �' �P i - � _ . � e.�. ,.: -V. il•� 1 ' .y ! ^+1 ` j �' ..,. • � e { "�� 4 �+ � �,.:� �e- ^ �. a.� ..:t.. . , n..1:n .. .�.. i♦ ..�. � �a,.. . . , .�:f:.^ ..�. .. .7' , �,} . . .. � . '_.