Death Certificate - Spain, Willard W_10/29/2003�.F�
aY
( � VEHSOHLL
�D�T� OF .
$ DECEnEMi
Fy�
�a
c �� — —_
:
o __
ef�
oq€y— —
a �g uusEOSOUn���
: a?
g9 ro
� � F n�rs�wh:
<` �
a s g coro.w.a
�$ .qn �uaa
. Y <wrscum
(awe � �
y � �wvn eam
S �Pa b luy�y I
•� b�Newy� O
j r RCiM W
� . �.am a <
��� V
YE ¢
MJiE:f U
�S ._���.�� <
y:
` J
C0,1LfI0�V{VC,gLTIIOF'G%' yl�
CERT/FIL•D COPYOFDEAT1�C01{�
COMMONWEALTH OF VIRGINIA - CERTIFICATE OF DEATH
DEPqqTMENT OF HEALTH - DIVISION OF VITAL RECORDS • RICHMOND
� m. m me axe ma Yo ma uen v` ouetsl aa
_________'_'_______
xED:
--��(S-U3--------
This is to certijy that thu is a true and cvrred repr udion ojthe original record filed ivilh the
�tlec�lenburg County Health Departm¢nt, Lioydt n, �tginia. /
Datelssued �� � � � ,�(
U
(SE.1 L) Reg�strar or Depury
ANYREPRODUCTIOR'OFTHISDOCU,5IENT/SPRONlI31TED11YSTATUTE. DOiYOTACCE'PT
UiVLESS IT BE,fItS THE IdfPRESSED SEAI. OF TH£,YIECEL£hBURG COUh'TYDEPART.bIEi\'T
OF HE9 LTH CL£ARL y,9FF/�Ep,
Section 3?.1-?73, Code vj �Frgipiq as a�n¢nded