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Death Certificate - Morrison, Martha J_2/20/2001r.I , .:v ., _. , � � STATEpbF ILLINOIS (.�.. � r �� DEPARTMENT OF PUBUC HEALTH = DIVISION OF VRAL RECORDS ��u� � .-�.. F..9.. � -� R GIS1iATIQN ST�TE OF ILLINOiS °' '° � DIp41C1 NO. S7 O I x;c�srz=�1$—�} MEDICAL CERTIFICATE OF DEATH � p- 0� 3 9� 4 ! hVM9Ei r e �.ir � DECEASED—NAME " t SE[ IDTiE OF DiAiM �•o'�• n .c.,� � " �. �iCRT• • i:foP.pl'oc,T -� �z° � llecember 26 —1�?0— "� CACE.•�.c•a.o..+cnc.+ �.o�.+. �G:—i. r 'VUD'.:1 YEr.• VNDER^.I DaY DAIE OF 812TH wo.�-.o . o-+i P:ACE OF D:>7N � [::.IVCar.� mrvo.. I:.s.P �os. .. •�w.s . •�x � wiiite so 83 :se. � �k d��ril 11 iS�7I�a���ord cn.. �o.�. �.r. o..o.o onrua .e e�. ,smc c � o. nr.n �.enrvco.-n'�e+F u•.o� i� ew . c�.. : vu . .ac•r � �i.esi.ci` 1•oa.n. � �b. Robinson ���. ves ��a. Cra�rford i•Iemorial i:osoital _ B12iHPUCE Ivn o. �onm+ CIiIZEN OF WHAt COUNi¢Y .�1nRSIED. NEVF2 MTA:IiD. NAME OF $VRVIVING SPUUSE a.mc...•E. v.�:u ., cp,,,,.� �viDOWED. CrvORCED �s..c�..� �� -- e. Indiana s. U.S.A. �o. r(idoi•;ed n. nonT_ __ S S SOCUI SECU�RY NUMBER USVA: OCCVPTTIOh '���D O� tivSwE55 O: mDUSr�� .S. WAd `/ETE2.�N . N.�]. O: OtiES 0: SEaci�E �,� � • .+o-•.� ..o..o.co, c c�c��• ,s*o.n.w. -�. �.aai. � - Y ' co . a.. o. i �_,. Indiana '�.b. Gibson �u<. PaLoka ��+e.no ii.a.Rural P.oute # 1 $€ - FAiHER—NPME ^�s� ""'�E �•" MOiHER—hINDENNAMF ��omc i•�� L p=' , t,h r Anthis I�s. Isabelle Be.rrackman : � �s. L.z e_ ., . ,. . . �c ;FEUIIONSHI? 1MAllWGADC2:55 Irece..ao.>.a ..v..c-.<•ro+..su[..�+� e � IW^—p3M>M' SIGNAiV'�: � ±� ___ ��h,/l�,�i��ntn✓��nA.Lni`.(%��c SOri �i�c 12 17 't;1 ?Grkville %�?O. 6�i�i_ .•.� � 13. � D:AiH WAS CAUSEO BY: I�*:<a a+:.OMC c.usc.n i .oc IaL ml.. o�.i1 I��r.cwo.•sr.r r �•£ - :Aii I. i..min�c.us� � � �. .� I .,00c•' aG -_ �a� / .i5 • � . _ ' rq O'L H —[�,'Yr /� S = ov� o 00 .. ca•ssaac•cc o� J / / I .'.._ � I /y� , '�.� � � �. cn.mno.s. o .... (i(i ! t 'LL ``<1 � � N r � I � -. / S � __—_ �/ $TNS ro Dy� '� Y m. ivec m� [n � m o. n. o�smv<.c: o.. C� Li C r C...�I' r.- .c u.o .. �(`C v�.r. c.use i.x:. �� 1a1 .�y r�.e. n. r.a. � p� AUTOPSY YES. • o,ndf II. OiH:i SIG 'IPCAhi COVDRIONS: : •u ee+.�na � e ve.e. �v. ' �u.*v �o _ . . .�..��,..� �.�,� I.ol•oi �.:°. �_. �o�no - . t+c • . .••y� • • �'� __ \ I /� / J �� � / Gi � S��J'�< <�Y•iJ� �Y� i CG An�lli-��c iso.YlO isy", C ��'C I DArE OF OPEdAilO ' ANP h�,�lOa FI.YDIM1GS 01FRATION v � __ � � 20a. �—. !70b. ``� _ ro.w.o....nn . o-a.,-.:....e.n : � :isis.. �.i �.o.��.o....c.n :HOU3 OF D61iM 1 dii:NDEO TM', :�i: co.,� . y DECEASED F:O.M: i0 - � �q�d. 7:�7 ? bt. ��'� zi j�,_ i'I - 7 o zis. i . ,._. _zi�. z- L: 7 �G - I CF,KTIF}'TNAT TO TNF. BEST OFDI}"K.�bR'LEUGETH/SOh:AT/(OCCUNI:F.0 NOiE: li AV iNIVRY WAS INVOIV[D IV iH15 DEAIH. �G OP' TllF. DATF,. AT TIlE TI.NE AND PLACF. ND FR0.9 TNE GAVSF.(>) 5TAl'F,D iriE COiON:2 MUSi BE ht7Tli!F0. �` b S�GM1aiV'nE / ( � ,D��E S�GN;D �•�+^ o°�•"^ ,�«I.VUIS IIC:N$E NVM9:� 3' � �J �' yr=_� / � �7 (`_� T..I�- -.z�.. �%/ ins. T�- � 7 -7�� '.n-__1_�._�--=��:- �. ...« � � MAIpNG AD7RE55—CERfi/IAEB e - •.o .v-en o... •. <�+. o. ra.+ L. � � "'` v. y: � 7SG �K(•S� � ���G/>i��,CC�l♦. /J�l r2�/�s�� �'�G BURIALCQEMAiION. �CEME7iRY0'tCR6NA702Y—NAM:' ;lOCA1�ON a�.a.�a+. v.rt :DAiF �o . �"�I REMOVrt u.oc,�» Q j0 4��� s Bub'/fiL �� Shlloh Ce*�eterv �+_. 'r.azleton Indiana ��+�. Dec.�,� FVNERAf HOME NAM' sn�c. •+ �rv n... •. o. /.�*o«• snre "' �� ,'tl`' G� �e ,(-' SDI� I�/1^'�/S �s��_ �• 45a yJ � �yy��N �aL ��l E 3U��'-/1/�l✓ !J_Q _ sUr:ix:� CixFQO�'S mwC�i UCF�g •:U�•.ni: ��FUhERAL DI "'OR'S SIGNAiU:E , :C zs5.� : � � — '.z�<.J/-9337 _ �Y`" lOU!R' i5i�RA2'S (a/�A �°7 ;�Ai'f:CO.BYIOC�IfEGliinoC�.a+o..ov,.c. ��� Is � /Yi�.�'.N /'l��n/.i`-�-�n''.�7 'zb5. FF ,r �/ /`%%��_ �T� � o seo o eF i s� c o e ��n: yp ]9��p5dr1 pUNVR GHA�iMFM1� O� W.!l4 H,AIIH BJ�E V O Y t t ECO Dp :c � � � 2� 2� 2 TtfiS is t0 c¢rti%J lhd: L7is i5 a Lu? an0 cOrt¢ct COpY 0: Ne oL'iCial re<ortl (YxE vri:� N¢ Iltinois DeDartmem of �' ,` PuClic Heal•Jf. ' '� , ��� 'a z.<-.., oC r-� � .>..,.,q,, ,���"-'" �ryr� DATEISSUED - . � ��`�� � E_ t�M1�r. x STEVENI.PERAY i a, � '� - DEPUTYSTATEREGISTiUfl ���y z� Z:� FEB 2 0 2001 . < ; y. � , � �'- , ' s ��� �'Y ,- -•= a �,�„:, � : ; _ .d�4i�..-�.2 . e, — =Et;iraY� _ ..-_ ._. .,�01�St1f1�±�.�' -.�.,a_`.��E�HIA��