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Death Certificate - Wilson, Herman W_6/6/1985r . OHIO DEPARTMENT OF HE�TH INMAFGIN � _.f9 ,- �DIVISION OF VITAL STATIS � VEDFOP .,�.�.�o._.y_i—' Suucu�ne. n Ai4CODING Mwv�Rry.On�.Ha. ��`InY . CERTIFICATE OF DEATH A�G�«✓�He� N��� . OKEDENT-NAYE` - Fvn - MW/4 . {�� _ SEx DATEOFOEI�TM�MU,Oq,Yeu� ,, ' '" Herman W. {4ILSON ' • , Male , May 13 1985 C � 0 e , CWNTY Of OE�TM - 7 ,.. Afont omer ,m..�.,�a�ru irHOV.� �>TdiEOt01XTM(U�/MV.3A.w�o CITI2ENOFWNATCWNTqY ORIGINOR�ESCENTIIUIian,W�iun,G�myn,E�q11N,LuG�n, a.� Indiana m. U:S.A. ,. ,o. lNESiCiACE h'�ISOECEASEOEYEHINU5.�11MEDFOPCER M�HRIED,NEVERM4RP�E0, AIXVrviNG5P0U5E/ryMje,�nele4CUwwi/ iE�ECE�5E0 (Yr�,we,r�mnewn�� pfw.p?dK+ejx.rlcr/ WIDON'FD,DIVORCED(Syevqy/ �.icoe�rn ��. NO ! ,,,.Married ,A. Grace Garrett +flEOIN fUt1UN,GIVE �VALOCCUVATIONfGI�eftNeJwtCerOUrpjironof�ortlrytlft.twnljnrtrtl/ KINDOFBUSINESSORINWSTqY �EHCE BEFOflE � � -�� I ,n.Truck Driver' ' =" ' ,,,Trucking- � ' ' �� RES�DENCE-ST11TE COUbTV CITV,VILt�GEOPLOCwT10.V STREETwe�DxUNBER iNS�OEUTYlM1T5 � � �tpen y Y�� w No) �o Indiana �.,Gibson � �k.Owensville ,,,, R.R. //1 ,,,. �Jo F6INER-NA4EL . ifrtl H11Ch !y� , MOTNEH-MAIDENN�uE flm " �bWlv � lo�' „_ Howord Wilson ,�. Velma • Cobb l:FORM�MT-x�YE/ryMw/��I • M��LINGADDRE55 ' �ISTREETORR.F.D.NO.I ICITYORTOYINI' ISTATEI IIIPI 1 � ,,,.Grace Wilson�'.�, '-'RZ;'�',,;_ R.R.�'4i1,��Owensvill'e;..;Indi6�s;.;�;4Z665,�", v�qii. � R DEATHWASCAUSEDBV:IfNTEqONLYONECAUSfFER•LINEFOR(sl,lO1,AN0/cJ� � `BEIwEEnOn3ET��NOOE�?N IB. ` IMMEDIATECAUSE 4� � ' � WETO,OXnSACONSEWEMCEOF: , , ; Cav6mu.�ryaY..+u�n . . ., � .• �. a.. .�,. ro rm�.emn r ro' . . ��, �C� q� �„ t OUE TO.OR �5 � CONSEOUENCE Of: :rv�if'dYml �, . . � i�i i�RT11.0iNEflSiGNIFlCANTCONOITIONS:CatllMettew�MUtlyroOnNMrro�vYeb�eempvnWPon!(U , �UTOVSY W15C�SEHEfEHREOTOCONONER - ' /rn..rf fsprnhrn«ttq INNRY Ai WOfl[ 15D«11Yina+al iJ�. � . � 1ia. To m. en� e�. IUIp.' •ND , _.:,I�. _ _ .__ . . I� M L�CEOFINqFVA��amr.� .rtnrel mrY.eR�e LOC�TIO tlp. rr. (Jpecyy� ]f. iUi ComWne by ATTENDING PHVSICIAN ONy �InYjL OuN aCNrrqll M� �m.b0 aM pl<� aM Eu�-�O t�� cs�w01 Of CERT6�ER IPr� nald E.: OAiE .._ S_1�_ ,�..Yes ��. Yes HOW �NNFV OC W HHEO (Enter rurvn oJ upury N Pm /ei An O, Ixn I!� }W. . .. _ �. _ .. __ _ .. - . w,..., o....�...o. r�.r o...w...o... •ai Wa. Lby, Yni(/ � is,.isss DEAO /.Ya, Ay, Yr�r) e2vrry N tM Im�, 0�u �l T.�.� a NWR OF DESTH m.' 10:45A ., ��]O.ON Y�6y 1J � 1✓VJ �'Y}e.�T NORCOHONERIIlyvo�P�^V /S�miwN.F.pna.uryornuyr.�wrc,ull af-fer MD .-. 320.Zeigler St. Dayton'Oh �•'NANEOiCENETEHYOHCREMATORY '� . � LOCAT�ON ° �- '-�'-" I5:«.Maumee Cemeter ,.,. Owens,ville, In . � - IUC.NO.I FUNERGLD�RFCTOR'SSIGbOTIIRE Thomas A. Routsong 7774 A ��. �. �J. /�t.t.t�(/1 ERILFlNM�NO�DORE53 ,. ISTHEETNO.1 �[ITYI . Routsong Funeral Ftome � 6-Oakwood Ave., Dayton;' 0 45409 IING�ERMR � . . . . . _ . , , � _ � . � I t� ' • • ' � ' ' " . I HEREBY CERTZFY THE 1180VE � BE A TRUE ��D COPIPLE'I'E PHOTCGRAPHIC , REPRODUCTZO`t; OF THE CEIr1'IFICAT`E 0[d FII.E I� 'I51E OFFICE OF. 'I1lE , �� CO^iBINED, i{E]u.Tti DISTRICT OF MC��'IC30[-1ERY CO[NTY, DAY'I'ON, OHIO, • �s:a8-�.s ; .. : THIS CERTIFICATE IS NOT VALID UNLESS SE.qLED BY LI�CAL.REGISTi2AR, . . �_ � . : •, _ - . • �.�_ - �nw.� 45A ., 45422 - 11ye. m rounql ISUrq lO ILIC. No.l 5034 %