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Death Certificate - McRoberts, David O_3/21/1974
i•� ry(� N• � � , 4 sr��•ri: or vtttci��n I , , l. To.v,.�u.. �� . . l:OUN"C]' OP FA1:Li�AX � ' i .-. I, 'I'HOh7AS {�. CI'ItAI'A{AN, jR., Coun;y Clcrk of Pnicfax County, Virginia, nnd �Gx�Cf.'icio Clcik o( thc Cicaii[ Cot¢[ o( sui�_I � Coun[�, dic sanu• bcing a Courc ut Probace and oE Kecord. :�nd having a seal, do herl°b, cer[ify thar ie appc�r; of recotd in m� � o(ficc pursuanc co Lnv chat DOROTHY �MCROB�RTS ) NEWELL t�2 S becn duly oppnintcd % ' :1ll�I1\'IS'CRA'IpR on ali and singular ch; ES'tA'I'Ii oi DAVID 0. MCROBER^1S - � �rho •s:; lam of saiJ Cauncc, and �cho, as it is ,�id, dicd "I'ESTA'1'L on [h: 9th ciay of i�'ebruarY , 196� and thn[ ghe hqg duly qualifiecf as such by cakin,G the oarh prescribed hy� law and b}' en[erin� into an:l ackn:;n�ledging ',;� �'�d n IIpVD in chc pcn�:r�� of P1VC' I-lundred �. . , , lloll�rs, with justiGcd and :ipCrnvcd surery. .., . '. ' I iurcher certi(, .hsr said :y,;,oinnn;:n[ and qca!iGca[ion ha�-e nnt been revoked and are s[ill in full forcz and efFeet. ,� �yi � � � �'f: . .I� 4 � . . 7F � E � f. 4 i"�1'_�,� �' . ��% <;;,.�. � ,�' : : �„ „:�n . " . e: �' � 1: L. :' .:f��� � .k} . ..� .':... . �'. � r �_ ',4 . �:. i �� � � . . .. � . � 1N 'IESfIDfOi�'1' \C%HfiRrOC t liavc hcrc�m[o ;et my hand, end �:'ii��rd'tl:c sr,il of said Courn c�rcro, :ir I'airf:�x, Virgini.i, dii.a 28th d,,y of September, 1967 � A C ::: ;,:;,;. i., . ��/ . j: t:'i (//I / �.///�- �t.. n'�'�"/ I Clerk. i *•; . : ' , , .. , . : �I � t : , • - , , ��� . . Py../:�:"�.��ti(/--J.:,�.', -°�::.—���GC-�'4'��X jt!.a --- ------------°--°°- - Depauy Clerk. ' '"+: ; �:r�. ��..�j �,'✓�i . , � ' . . � Y.!r'�. ,A �� - t. .. ' . .. . � . r... __ . .. . .__ . . ' ' .�� �s4 � . . ,�. ' rX j`"1.r1 �\�' ' � . . ' , � � I . .! } .�� : i ' Q �� .t,� R ` r�y ..,i y � � ... �,.' .. � _ . ° - -ii �. . . � _ . �' i � 3'+� � r t � e.i' ) t�• . '+ {� ` , . , ' 4� � lnL . 1 t I' !`9 r A . f R ' f 4 ' 4�.R. Id'� . F�� .. { ��::''Y � l•.r. _ � ..; f ' ' . _ �,,,r `. .�' ?' . . �.• . � . . •. ° , ��� .i � '�: ,1'.. %� . �'. . n • . S�' . ... +, s: . ' •�. , . , . .. . �. � �1 COAHI�iVWEALTH Of VIRdIPIId — CER�iCdTE OP �DEATH ''� '�". r � " DEPAA7MEHT OF HEAtTH-BUREAU OF VIiAt RECORDS AND HE....M STATISTICS-RICkMOND � �' �' � COPY P qa5n�;roN�; � cumic�te-. - ' . - ' • . Nu�[ vnE . . ,�'_i i0i 611iEAU CF vve:v ' � VIiAt STATISTICS �`�G MJMlE� �% ��J MlW[i /`� � . . . � . - �� v 1. ML N�ME .� ` • Ilin,) ' l.niddl.) - - � � 0,,•1 .- _ ]. Y% �. . � �?�. ' a o[cuvo ' . ' �av�d .. _ . 0. IHc/?ob�-�t� �— x� ,p z ,; , C'.C[�E:rt " . f o.rt O� 1. 1. <eorl bw,l �G[ O� ' . F'n Y=o[r ui. : vrvo[f � owi i rOtoe , _- � pU(X - p/ •• V2C4w:[0 . ' monm �� xeur. ; n.nn.. y S O t 1 .� , . . .�%n.%i �l� �IV/— 9�`� ' _.—,�� = ' llit.L.°C { ' . ♦ tlAVt p 11OYRAl C� (1 n uuwl . 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'r . • ' ' {I ���t{ ��t�.wfl. .CI � (i � bi it � it ?� :�j MADISON, INDIANA �� +' � ��. f- � � �., � f, S . _ _ I` ' r 1 ` { . ti 7 r • ,. • t r 5 y i 4 ± i "C :Ff _��,....:1 Z •?e i� y �1 t� . .t. ij-. : .1 t:;' • �� �7 ! � ' i� � �:lE:; :fl:9t $� E� t� ' ti iE el 1: 'F y� ' ` " . ` 'a s C '` : t= � '_ , II � )f !� �, Ji S[ � 4:CERTIFICATE OF, DEdTH + ' 1 �� `' j � � . C )f � � it d r r ' � - i �• �� �� , � `t•zl �1_{f y� '. � bi.:'� � �� ' � k .1i�. �� : a . i:. i „ S� �.i j� i � �t iii . .. , . ���....»��:��:�.df �i � ii r ' �1 I {f � . , . �� / . a , � ' �� {I'==j THIS CbRTIfICS 'thu� lcco'ri1m�, to� �hc% recordi) nfR thc �cfferson County Hcalth Departmtnti ��� ' 1 S� ''�;• � 1� 1 i ;. (' i�i '.S :,,, y. �� � a; i (=�,i ,, ..� � , k , . • � �"'�YLa?t'C.1�'•_:�Name�-Y .1c '. .�S f��o�'ic!��P�cR�Fserta .�,�..: � � � f;.� �� ! t� a .�t , � �,'. e i • ,� j jw• � , . � . ' : .�j,..:,.lt..._:�� �' ,�i� . �� � �� i � � . °�' �� EDT ' � �•� , �, Fs. ,. ` ���.,. t � .' �i I1: I` . . 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