The URL can be used to link to this page

Death Certificate - Whitworth, Blanche M_8/17/1982it` . �J , . _ . _ . ... _.,. �.. ... .. , �r.d. y _,�.. : �� rt4 , � � '' � - ��RYIFIED COPY OF A 0@A4i0 RIECOt�__ _ � {� ='t. . . . `, �. � " , �`, , , �`>c • { .�Y . ' l . STATE OF IlLIN015 tur[ ni• � • k "{' DSTRIR�W - �� 4 : . xu��c. � �� ':.` �. HccisrcrKO L...:r== - }CO,RONER'S CERTIFICATE OF DEATH � �;= ""�" ' �'' ., : ' - _ ,00.. ..., � DECEAvED-NAMF �`. ti SE% DMTEOFDEATH wowr.,o�.,.uq ^�� °�. -tBlanche�� sYi•:. ';mit�:rorth z.Femal 3. Auau�t � 1 82 `5�� nD��y� �4C� C�4 NIGIMONOCHCMT�G'-i • YXOCRIVEIR IINOCR1011V ��iEOfpIPTXI�o..n��.�[��1COVMTIOfOE11i• .. ' .{�C�1��<�r�l� � �`\ • �in «o .�I.��1 ,� ,: j: L� 4:.�--. �Y;' 4a. V�1StC ' 4b.- i �sa. so.�� s�.�� s.Jul 26 1 0 �a;lapasn LL�� HOSPIT�L C��.io�w.i��.D�w0�00�� ♦wVU�• .� OROTHEPINSlITVTION-n��[I��nn�u��[�� •6�v[�tni[♦ �� w�rvs�,� a � '• �r�o ��1 [w wl[.r � .in �r��.r�4r�i�c�.'.� �P� �- �o. 2dt. Car-nel_ c ,�"`"� i<:�Iabash General Hosnital �e.D.O.A. i� : �_ S,�TnpY'P�OwTr�'-�rne��r.r'�\. CIT�SEnO�Wr��TCOUNiRV �RRICO.NCVERMIRPIEO. •MCOfSVRVIVINGS�0Y5El��oarx��ra.��[I �� '-•- �^ •� WIOOWE�.DIVONCE�IS�[c�i�� , e. Illinois e. U.S.A. �o.191dowed ,,. CF�� • Cit�.�O+��+.�n�.o�wo�DO��tn�t�r�0. INSIDECITY COVNTY ST�TE . � ��[{�x01 �:; ,<a402 l9.Glendale ,anPrinceton ,a<. Yes ,aa. Gibson �4e.Indiarn iwTNER - N4NE ntOiHER -AfAIDfNfJANE �?:' ,s. Ed`ar Y.00`[ Leeds ,s. Eba.• Yoo� Li�her�a ��~' INIONYINT'S SIGM�tVR[ RELFilOM5N1� •ILING ADONC59 I��w[[��xo�+O.O��.i.o..c��Oniovn.�� [.a��l . �?�* . 17a, t� J. CIc'LU. i��?_O1 S.NainFt.B2�nchIn.4 64° . ��_ ; �jr-�. iB. EATHWASCIIUSEDBY; .ONEC n�d�,�A�. e�[�� PART1. �.+w�outcuwc K lel e " � caHOirions. i� �Hr, oucro.on.s.consmuu¢cor i � - . ' WNICw 6�VE NBE TO ' . , , IMME011TE C�USE 1�I (� �]1 ( �� I • $I�TING iMf UYOFF� Ib) l/arl11Q Res�irator,y Arrest tYING CI11AF L�Si. O V C i0, ON I�5 A CONSCO V EMCE Of _ ,- �� Ventricular arrh thmia j PARTiI. OTHEfi51GNIFICPNTCW�OITIONS:ca+n�¢++scr. ow.onun.�..r.mxu�mm �wyy /�wpy nu'or�3r •�.- �' I , . uVl'`3~�i�f11.1 1.� m 1 our. .•...�..n�cu�. COPD H e e "'� �� ,- ,�b. � e o.t�orva�on.�..u+....o.....,i un �owriuw.occoww�o�........�..n....�........o..o�. ...o.....�.�u i:.. �.:i' .. � o..... ��. �.... �.i ' soa. N a[ u r a 1 20b. 70c. M. 1d1. , ' INIVRY�TMONK lACCOlINIIIRY� LOC.�TION Ic�t�v��OO�O�nOntw�On�oo�si o[OUx♦ sr� " . . . . . . .. . ♦al 1�[a.n01 c�o��.err�c[�u��o�rc.[�c lar�c�r�l ' ZOC. 20�. ]� . � I CERTIfY 1M11 IN NV O�INION BASfD UWN Mv �NVf5i1G�T10N M1NO/OP T�� «.�.oqr. W�$epOrvOUNO[o OEeOOn ♦i � iM! IYUU15111ON, iN15 Ol�1M Q[CUNRf� ON leL ��f, �l iNF Il�" ' '' ��' 71d. 1NODUftOTMFC�IAFI51Si�TFD.�NOiN�T ............... .. ?�p.AU�jUSC 9 1982 Z�<.'j��s p�A. � cowo�u�• R T �1 CU\NIi� %i : o��cvc�co �..o....o....�..� : zza. ( epu zzc.Aug. I1, 1482 COROMCR � Cl/�N'SS P / ^ DM1TE31�ry � _ a�v� - 73a. 23b. (J L � ' avnu�.caEw�t u cx. cacwnroar-N4/.IE Wc non u..o+iow. a...a o�rc rvo+,..o ..u.i n[uovLl�vaV .� L _�s-� �aa. Burial �ao.'r.iahland:� +a z4�. �� _i T z4�.Au . 12 82 fVHCP�I MOMC N�M[ ir�[[� �no�uu�in o. � r.o c�r� O� tO�rv it��• t�• --� 25a. K871C1311 Z' E 2 �+Ou � ��.�c^ ' n + P ' L:7 � fVHCP�LDI 'SSIGN♦ RJ� � �uuaw��O�naCtOns�«irO��c�wf�nu��n � / 15b. / � /r . � � �.' � i 15c. 8fi$2 "\'�� ou�n i •n�svcw�rvqc /`r o�rcncco.e.�oc.��crosi.�n�.ro....o......n 26a. - _ �� .� 76b. . /% / O �- �. VP20IIRE.1nel IIIinOisDepart,ntoiPu Hzal[ -0jic olVitalRGtord3 u•s ��nos.sr.,.o..ocunnuru . :7".• . ' �' ' . -,,.� „; �I MEREBY �CERTlFI; �THAT �Ae kreqofng 1� o fr`va and corroct copy o! the death rocord lor �he decedent ncmed a� iiem 3, '- ' .'.t. --�c„d'rhar `ebls rornrd wat estabNshad md filed �ln�my o//ica:ln occordance wl�h the pmvisions oI �he Illirrofs stotufes.- �'� t� .. i �'. . .� ' ;yt �"DATF. � •'�� . �� /� S 7� � `• SIGNED �-�'�t^4.E�-r��G�e"�� :_:�: , � � . � � . . ' AT �� I�lt. C9:C�e1 ,� , Illinois. OFFICIALTI E Ke^ s ra � ''' ` _ � c�� G� '-. \ 7M od�ival eKnrd o! thB doW b perman�nW Nd deh Na 7LUNOIS DEPAATM6 O [.[. EALTH �t pr'. afldE. Co}nt� eur' ��d Ixt 4 rtyirtran an �aLSoAud tn'maL ttrtlEptlon� from oD7e� of the ori¢In�l neord. Tlu lllind� �4t�tn wld� tA�t tA� « If4atbn o! � duN �rord bY '�Deparwent ot Po6lle RultS or tM laeal n[I�v�r m t8� ewntl cl�rk �hail M D�L (�el� �Id�np In all eourta �nd vl�m o! N� heL LEaelo st� - VS 201A (1961 reri�lon) � BUREAU OF STATISTICS - ILLIN015 DEPARTMENT OF PUBLIC HEALTH - SPRINGFIElO I; � � _..,.-.... _ ... ' , . . � . .