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Death Certificate - Luthe, Beulah Mae_4/13/1993�#��� 'k,� "3 . 1,,.,� _ ......... ............. - _ , * � ., i/y -� � s�± "��'�� � �`�::���j�'� COUNTY of SAN BERNARDINO '' � �� r�' DEPARTMENT OF PUBLIC HEALTH '' }�� 351 MT. VIEW AVENUE, SAN BERNAADINO. CALIFORNIA 92415-0010 Z�' ,�s CERTIFICATE OF DEATH 3 9 3 3 6 0 0 Z 4 I 4 �> STATE OF CALIFORNIA �' . ��� STAiE FILE NVMBER USE BUCR IHK ONLY LoC�I nE�fTO�iqv dim4T vn CE�nrK�R r�u�eF+ �;�" lA. NAME OF DECEOENT—GwaT � tB. M�oott 1C. 41i IF�w��l 2A DwiE OF OEATYI—MO. C�i. Ye�]H. Mpn � 5� . ��' iGrvF+A � r Beulah i Mae Luthe � Mazch 21, 1993 �2055 F �E 4 PACE S XIN�NiC—S�IOA 4. J/�TE OF BIRTX—M0. O�F Yn I. AGE IN '• �rvOEV 1 rt�n IR tmOC� 2� WVw! YEARS i uOIRNf i DwA Wllef rvNf9f j�� L+Ti[e v.e R„a February 25, 1910 83 � OECEOENT B. STATE OG G. CTSEN OF WXAT IOA. FVLL NAME OF FATHEN MOB. SieTt 01 I f A. FULL MAIOEN NAME OF MOTNER � 11B. STwi! O� �',�`�� PERSOMAL BIHTH COVMRY ; O��TV BuTI x� IN USA Fred Davis Stevart i I� Mar[ha Aldridge i Iy Q OATA jt� li MIUTART SEPV�CE 1J. BVSw[1f ' 18C. UsU.LL Er�IOVEM i 1lD. YGRS IM t%. EDUCATION—YLVE C-0�R2Tm � � ow ir.ws*++ � Tea CO. � occ��wnor. � Cierk i Retail Grocery i Atlan:ic fi Pacific � ZS 12 �f IeA Fum[MC—siwcci wrm Nweu o� Lx.non : � t69. Cm �faC.'JP Cow I � usuw� 13073 Mon[e Vista Rd. =251 � Phelan � 923i1 ��� RESIOFJi<E IBD. COVwTV t8E Nw�cw d Ywf IBF. ST.�n M FonE�GM COUwiw� 30. N�uG HMiqeis�u�. M�uM AoOw[sa I W�> ���y � uID ZIO COO[ O� INIO4Y�M �� San Bernardino � 0 � CA Lavrence S[ewart - Bor[her � iaw. puce oc oenrr� '+aa. ir woa.n.� s.ec�.. ' �aa cwnn 13073 HonCe Vista Rd. �2A � OwC IP. ER/OP. DOA � Phelan� CA 92371 �p1'`OE A[ Hoae � -- � San Rernardino � �F IVD. STREET AODRESS—fTw[Ei .wo x��eG O� IOC�iw� ' 1GE CITY 22 W�!'JUiw FEro�TLO'O CMOnFw ' OEATN I u[IVlEPVwI EFC1�I1aLMl�CP �y � �EfwEEMOV� rE�93-1591 RE �o; `p+4i 13073 Mon[e Vista s251 � Phelan •�ooE•TM � ❑ g�� 31. DEAiN WAS CAWEO BY: IEMEN ONLY ONfi GUSfi PER IJNE FOP A B. AND G 2J. w�a Bq�lY FGroRVeu � I I iMr,eo�.re Cardiopulnonary Arrest �� 3 Mins. I � yE, . ❑�oi �� uusE cwusE i z�w. ww nvro.a. vuro�uco � °F Lung Cancer � i 16 hton[h� � res � r+o ��[ OEATM DUE TO BI __ ___________ �� I 3aB. wnf rt Uece w Dciu�vm�o Cwua[ ' Os L�FATI �j DUE'O IC) �� ❑ YEf � NO {� 21 OTMU SGIUIICAKf CONORqMf COM111Ni1M6 iO 04TX BVf NOT REL/.TFD i0 C/.US[ GIVEN IM 21 I 26. W�! OIE'1ATlON VPiO��FO t0� AM COMOf}IOM W IiEY 21 OP 3S � V�ES. YST �V �6 Of OIEMAMIM .W O D�TL ;(y� Rule Out Colon Carc.noaa Heeaicoiectony 5/1/91 � � CE9TT T4�T �O M{ B[ST OI M� NMJM1EOGi DFJiM 270. i�GM/.T1R6 WO DECNFE OM TRlB O� CCPTRFA i 2JC. CGTFlEII'S LICWSE NVwlFA i 2]O. O�Tt 51CM[O PHY51- aCw�[O �T m� NWw. D�T� u�n PI.�U S?�iLD F�Or T�lI �' ouH�s �.��ES s..,in. ► L'Vt/�s-� alZ— r, �� i F� ��b'•�' ' 3' Z?ii9 � -`z�w. occmwr +m.mm au.c�� o�crnar wi ac� .uvi CERT�FICA- MO'rM. D��, Y�ww � MOwiM. D��, YU� � nE TTPE wTTEN�ING GMYSICIAN'S NAME ANO AODFE55 �� non 1�8�9J i 3/L/93 � Vir K. Nanda, M.D. 18523 Con+in Rd. TC, Apple Vailey� CA � �� I CGTii� TM/�i IM M� O�MCM OGT11 OCCVP11f0 �i ' 3BA SWMANNf �NO �RLL O� CONOMG 011 DFJViY C0110NEP � 288. DAi[ 51GMFC TM6 HOV�, o.n ...o vuc� sr.icn FW� T�� Ci.Vii! � ?� SY�iFn. , 1 1�j S� CONONER�9 �K. MAMwtll 01 Dl�T1-1R0.} CC NIRi� NOht( 30A VLAC[ O� IMJYPV i 308. INNP� �T M'OPM1 i 30C. J�TC Oi IMJ{A� 31. NpP i� YSE am�S �..*mR �41m w w4 vel X trlavrC uorrtw, o��. �u �1 � ❑ YE] ❑ �"'� � F�ONLT N � 31 ICC.�TOX IfT11ER �10 MWK11 0A IOC�Tqw � O CrtTI 3]. DEiGNIlE NOw IwNN� OCCVPMm ILV[nT] WIOCw PCSKiEO IM IXJV11Y1 � �� J1A DISPOSITIOV151 3a8. I4C� W niul OIfNfTOM—w��[ �� �wwEl� � YG D�TS MO. D��. Yn. ]SA S�GN�iVM! O� EuewtuU �]S8. L1L4w3� Nf ��� °1HE^w� � Dese:[ Vie�+ Ple�aorial Park � }% Q i ,�.�, DIPEROR BU i 11500 Ar�argosa Rd. Hes eria, CA i 3/25/93 (�{qN'wi j��i'h- � E7838 }� ANO 36A n��t O� NMG�L W[CTOII 10� rttfON �C1wG wf suCq �]BB. tlCENSE NO. 3l. SIGNATUFE OF LOCAL FEGISTRAfl JS REGISiRATON DAl" � LOGL � p � March 25, 1993 �y, FEGISTRwq Rern lfeoorial Chapei � FD 1094 �T.d.Prendezgas[, ID by/ � _ ��'�' STATE I'��� �-,JO B. C. O. E I F. CFl+5U5 :R /�� ��' pEG�STRAq - G 1� SI I WEV. J-99 M/JtE NO ENASUPES. WMITEOUTS. OF OiNEP ALTERATIONS �6 Z J CERTIFIED COPY OF VITAL RECORDS 39�179 } D�.TEISSUED (1(1 ST.�TEOFC.LLIFORUTA APR 0 6 �J73 ss ����������1 COUNT'OFSANBER\ARDI�O : ���.. � ���� �,(/� Rti3 is a fNe dt1O efncl rlMOOUCbDn of ma aOtumeni ot:iCN1y reg6tefeG azW pldclb /I�iS�� [' " iH Q on fJe in t�e VITAL PECOROS SECTION, SAN BERNARDINO OEP4RTMENT OF PUBLIC HEALTH. THOMASJ. PflEUDERGAST, M.O. COUN i V HEaLTH OFFIGEfl REGISTRAP OF NTAL STATISPCS iThis coDy not ralid unless Orepartd on engmrcd bordcr dis0��)'�ng scal and signawre ol Registrar.