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Death Certificate - Henderson, Manuel_7/29/1975. _ ... � - � � ..,�...r . . ..,:..a^v . .- —�r...a...-.A.;t-��AOc Rf4(;Vicu Vr"..r:....� . .. � . . . . . - .�.::.- .,. - G� ` '0\ COU\'CI'' DF.P.1R'P\I1;\'C OF `tll::�T - -- • -- ", - ----. .. EP;i?fi' ;�0. 61 i rri�ci:�•n�. ��ni:�v.a �. . . ,� TIIIS IS TO CPRTIP'I", that ouc record; �ho�r-- ._��iiD:ti�.;' •L�n=���'i�Q�:__-' . ,� died . � �,.. .::-.-;, . . , . _ �ul:� 1� __�7]--- -:�i__ �_:.i..5�rs__2:>CiS�z�_ninar.`l_::r_ince�n:_SY,�_._ �nonth ' da�• year hoiir_oC death s[reei, hospital,.rural � , � Age at Death 6� Ses---N��-°--Color--- !'1n_C° ii3rrlPCl ' . years � . ' . . � �crite u�Fiether marrie�l or single . � . -• �`• ' , ' • ' ; i � . • - . . -iT. ,�� . ' . ' Primai•v cause.of deaH� given �cas._—.'_'i�°t�stat_ic carcino*;_rz of lan�i �y�-•- �- . - . � . i� Si�ned b3•— 3ruc� 9Tink�._�.0•----- ----rr±nc_eion,—Ir_d. � ' — phcsician or cornner ' �ddre:s � � . _ , Place of but•ial oi• remo�al-------- .S.,Q..C�. i-'- -. -_--PrinCatDn.__Ird.-------- � �• n.tmr. oC cemet�•rc �ddre=s .. . . �.. .. ].il �'jj -_j-i_'-i�C^u�-L:1•'71tiE7'ul—i':Oii?� _ ' '_T'TiiiC:��i.^vi"i�'I:''id• — Date of"6w•iaL---�/ —�--- - - - --- ---- f . T'anc-:il Ilirector � � :'l 1 �ddre� . . , (y�i� ��) . �� �:. ( . . /" � -Y� ��a-�L_ __ --- SL�1L Si�ne�i_ l2�" ft_it.� :�• /j(� . . Gih,on Comrty Health Commissioner i'.1"=rCEtGYi> _T.T`Cl. ��Z%%� address . Date Eecorded locall�- in hool: \a-- �_Page No.- �`'•---.--Filed:_ i/20_/%1 ---- _. .,. , m *..>>'v,..:�a,.!�nYtiA � ;'%fa �c: �,•i'i?.��`vi�".�-� i'?�-a--�z:{... .�.n._ ' '_"'- . _ --"' -- �---: �� �S� . { .� y ^Sa��