Death Certificate - Pleiss, Delmar Irl_11/13/2000irPE/MtV:i
IH
P(AAANE1tl
BUCM WR
� aea �dsa
inc�ry e��6)
LF 4OJ � y.`�'� ^" STATE OF MICHIGAN �
{�� DEPAflTNENT OF CANJAUNITY HEA4
� SiATE FILE NUh1BER
CF L�� CERTIFICATE OF DEATH 18 6 4 7 9 2
1 DECEOENi'S N�ME (PoSI. Flqple, tup
Delmar Irl Pleiss
4�GE-lasl Bu11WaY <0 UNOEF ! YEAR <c UNOCF I OAY 5 DAiE OF BIRiH (MOn(q pay,Y<iq
Y
SEx 7 D�IE OF OEAiM (AIOnM. Dq. ✓e�r)
Male October 21, 2000
6 COUNiY Of OUiN
( u�sl MONiHS � DAYS HOUA$ � MINU�E$
a9 ' ' October 20 1911 Macomb
],. tOUiloN of DEAtN (Enter o4ce alLculry o�onouncM aaa m)a. 1e, ]c)
MO$%IAl Ofl OiNEfl INSIIiUiION - Name (ll nol m b(�H. erw slretf In0 numper)
3905 Hearns Drive
�
Ie If HOSP OF INSi inpauml, )c CITY. VIIUGE. Ofl TOWNSHIP Of DE�iM
Op /Emer aoom, DpA (SOeol�)
9 SOCIµ 5[CORIiY NUM9ER 9a USUAI OCCUPATION (Girebiqo( YQ
- 100 COUNiY
$IRE
Macomb
BIHTNPIeCE (Gry
Sute w �nngn i
� +or one aurmg mos�o(
.o.�mg bin Cb ro1 use rru.evp
Tool 6 Die Maker
48310 Patoka, Indiana
I5. ANCESiFY-Mn[in. PueitO Rpn. CuWn. Ltn�ml a$OUI�
�me�uM1 CNUno. dfe� Nnp�nc, AlmMnerun, MaG.
C�B�. f�encn. fmm�. eic lk�Y�ry M�.1
IB fAIMER'S NAME (lnsl.MqGlqfasq
James Henry Pleiss
l0n INfOFMANi'S NAMC (type/Rmq
Richard Pleiss
31. A!EiNOD Of DISPOSIt10N - Burul. Gematwn,
Removal. ponatm. Otnu (spenlY)
Cremation
tOGUiY flnec� me m. �ro scKM)
g] u+51DE Citt OR VrtUGE OF
� ""P °f Sterling Height:
11. MApllµ $L1iU5-fbnit0, 13. $URVMN
Never Ma�up. Wqp�pp. Qf rde.
P+a[ea f50H�fY/
Divorced
16 R�CE - emercan b�Can, Biac�, wnne, et
II ASWn. gne tuIqNY1Y �. L�int1l.
fA�o�ro, �wn Lqan. e�c �(Spar,ry peb.v
Sterling Heights
NirvD 0/ BUSwESS OF wDUSiPv
Tool S Die Industry
100 9REC1 /.ND tRIMBFfl
3905 Hearns Drive
c>nmx �a w�S DE[[DErv� F�[a
pre mme Delpt ��nl m�mM) W U$ ApMCDlORCE$!
(${Ytll� YM a NO) /
Yes �
DECEDENTT EDUO�iION (Speay
Ckmen��ry/SKyiyry (012I
:2 � IZ �
19 MOIMCF'S N�ME (lusl. A1q01G Suinam� pplde Insl marn[C)
Cora Ellen Pickett
Y ��6'M'+1 pbe ronpkM'! �,�.
fdkge (I� P S � I
I$OD. MAIIING �DORE55 (56<eNnO NumOn b Rwal Rwfe NumDeq Ury wVJhge. Sb1e.IlP LoCe)
3905 Hearns Dr., Sterling Heights, MI 48310
lb. VLACE 0( 01SP09ilON (N�mealCemele��.GenufaY. 220. IOCAiION-Glv a �d"uge. Slate
a ome� d+«l
CSM Cremation Services Canton, Michigan
23. SIGn�iUPE Oi IUNCN�t SEFVICE UCENSEE N, l�C(NSC NUMBEP 25. N�ME �ND �OOFF55 Of f�blllv
G/ C, rw�K.�:..� R.G. S G.R. Harris Funeral Home
rfl iC/
� Y� O' ���� 15251 Harper Ave., Detroit, MI
48224
i6 P.1RI I[n�n �pe U4easn, �nrynes. a cOmOLCalwns ��a� UuirO I�e deal�. Do NOi enle� 1�[ mo0t ol Cpn6. iu(p at Urdp[ or inpulory ��pMOnmtle
♦nol. fM[1. w nean btlure bs� only one caus< on n[n Lne I Inlawl Btl.een
IMM(DIAiE CAUSE (fiml
I Omel sm Dum
a�u,.� a�,�,a���, � Pneumonia l Weeks
�s�����Q �� O°���� � �UE i0 (OF AS � COnSEQUENCE Of�
I 1 Month
, Multiple Rib Fractures I16.Days
Seouemun� Mt conanony DUE i0 (OR e5 � CONSEOUEn[c pf� I
I{ ANY 4abng �o unmMah
ca�nln UNDERLVING
C�VSE lPuau a+yurv c I
inat wlutea a.eMt DUE t0 (ON e� � CONSCOUEUCE OFI I
�nwe� n eesm) USi —
a
PAqI 11 Qlne� LgndKJnl coMRMa cOninWLng lo OUI� tul ml �nWUng m Ine on0erlv�ng Puse 6�°en m Paet I 2)a W.1$ AN AUiOP$Y j)p WEFE AUiOiv fINDINGS
VEflFOPMED? I,VeR�BIE PFION t0
(Yq d NO) COIAPIEiION O� C�USE
Diabetes Mellitus or oe.r�+� �rr,a�a�
20 AQWI RACE Of DUiM (HOme. Nwvng 19. \VpS USE P6EFFED IO MEDIUI
Hdne, Hplqbl, �mWbnfl) ($pKdY) E�AMIN(fl! ($pK�fY��SWNO)
Home Yes
30a lo Ifie Eesl o� mr ���. Ueatn ¢cuieeE �t Il�e ime. mle an0 p4te artl Uu<
�o i� �,�t.>,�tl�a
i a rsrn.:,.. aro r,ne� ►
�U JOE OAiE $IGN(O (AIO. Oa�. Yif ja. iIAIE Di �f�iM
Wi M
a� �
IF OINCR iHAH CEFIIfI[F (f�Ma
No
31a � TOe c e 0 aM Oetvmme0 nw b Oe a .aen evnwnS use
(CnHA
m• � o � e n,�wn ,m o� n.xs��gn.. '^r °n�en occ�nea
°"M1l r�a pWCe am aoe m �� �se(sl ro m � valea.
�,or.� ntv edi Examiner
31G 5, D( . paY� Y.) IC C�$E NUMBEB
W; October 24, 2000 1165/2000
EW 310 PFOHOUNCEOOE�D(M1fo.OiY.Yr) 31e LME OI DE�IH
°NOctober 21,2000 11:30 A�•�
32a pAldE �ND AppRE55 OF PERSON WHO COMPLEiCO CAUSE 0� OC4iH piEM i6) (I�pe a Pivrq � 710 UCENSC tNA1B(F
Werner U. Spitz, M.D. 23001 Greater Mack, St. Clair Shores, MI 48080 030868
33a 4C SU�C�D(. HOM, NAIUR4 3]E OAiE O� INIOFY (Ab.OJ�. Yif J3c. iIME Oi IN1UflY J30 OCSCRIBE MOW INIURY OCCUfVNCO
OF PEUDibG INVE9 !$penlYl
Accident Se tember 5, 2000 Unknown "' Fell in garage
3]e INIURV 4 WOQK 331 PIACE OF INIUHY - nl nome. brm, iVeel. b[Iay. 33g IOCAi1pN -$irctl oi F f 0 No C�1�. Vnlage a ho 9aV
(5Mnly Y[s a Na1 ollqe w�M�ng. ei� ($pet�lYl
No Home 3905 Hearns Dr., Sterling Hts., MI
3aa lVEGiSIF�P'S 5�' ��URE 3ap. DATE fILED (Mmtn,pay.Yea.)
�� � � October 23. 2000
ciry of
s� STERLING
Y,�'� HEIGHTS
THIS CERTIFIES THAT the above is a true copy of the facts
recorded on the death certificate of the person named hereon, as filed
in the CITY OF STERLI�iG HEIGHTS CLERY'S OFFICE.
October 24, 2000 ��Q� �J ��iX�
Da[e �Val[er C. Blesssed, City Clerk