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HomeMy WebLinkAboutDeath Certificate - Deckard, William, W_7/2/2018 I 4 r (.- •. .<•owc..7y'-=,:.iioravaa:' • <ri♦ ♦ove :it09gY0ii/=:-s._m%4e•e�,:°`_=`• F' 9 , t ! 40�t0'eeee0'*��#VV."�C1IOiF r- i t%. 'im pI� STAE OF TENNESSEE fir_ "o°o°o�o` 6 e;.���.�&!4!:!�0�.�••••smoa ,t li mg );tof;ve1'Recordsic Fe°�oito v „ v .a/ 111 /e. .- a/ ®is oir •.• _ r fe . .a a/ 1,; ttt 11 <y <Sdt.r:-1>t fsers!' •axv »j141•T�1t. }Ir^xYi •& } trer>x O ^i~tti+7 r*i,r.tearxy II xf C ^ iTa? b•ok t <, •ice'i 'F�a `1TEhnE55EE DEPARTIAENT,OF HEAiTHf.s '!�t �tY'-tens Pt f�.: rt^ 1 -I fi l4 J pJ hner, r T r! J T i s ,• E C F ,.°t rb S 1, si2eir'AatiN' i 1 4 4?'a „ ` °�"E' ° e ti' - odCERi1FICFEOF DEATH.'s' ' "� M1'u"�'-Ri. t S `'-!�` ;es�.,,•:6.aa OU v. . aR Q3..,° a Qap °t• v .. Qa• et. ♦ a_a .6'GY 3e<-.n.� wp.t.cx!-as ..• ,, �,Ja Kilt •v6CEVEIIi'S N1YE' ?:lM 1; `..� 4 .` v..-,,-..... 5¢ :i ]Jgi OF DFAle pt YaIL\ b- T• at- ,^. 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T • -`i 4,:..h ._ aart a. of o©u.+'e.-r �l^ 5$'..,.--..2;,,,;.'•-'4a: < ♦'k4,t't}' td 15'FATHERS NAYEIFaq M ac laY1 9 MOTHERS NINE PROR IO FRST MARWAGE F ..-",..7.;i itfys ♦ !7! °AREt^S Fred DeckaM f ,c i 1♦ z•dt re 1 t4f ume ' "-i ' t▪ ••� t r f&• Nolma.Retltlng/-� , ! °y r 1‘...:14::.y -�•_p \.ri'!`'a, • �. /SS°' Yy,APoR-. :-.- N1eE j j. 2gb REtATpA9n°TODECEDENTY 2Ra.UtL4DADORE55 isyr am::95-sect%-t '$AC I .t a ''`l4.• i �CSY < i Gry {y ne, Jeapnlne Sue;Deckard < N k •4• Wee r 1 p; • '` 3001 u11er Road La.'a eLLe TN 37083 r ° f• ° �'/„p.r11t! k d Y t v T P v�e a": A p_pttipair inpanps ..' v :ZD'ec% I �'i 9 rr4a , 700,- , .OEramt t ORa.ww,sa. 4.• an,Hoy cb1E ?`Y i t 4 ax a 1 ° 4 r "J u "a r 4 A,.3 13r 4t ! J ♦f"1_Sk ♦ .. P34j '$ t er V t� �' r.<•a S Sf f•4 ti 1 f ,y a '• . iSrs' y F.F -iJti'a TyF f]as REO liount Hope CemCeryS• r.sd�. + Daampa ne lamots Ftiv-4 > 1 < 4 - a Qal, •�L.,,a d 4� Pa > °l $1G WTUREOFNNERAtpLECt:R1. 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PART ea ..coed als\\mvi yy b 16••M W tutmacro r tste ry ads we PARTY r Pa WAS AN AUTOPSYPF�IORYEa>:.-... .,. • -Y c Si t Yo-9gtr, <, ) 4£/a '•:••••• C a P9� G F t1 • t.re:-.11);;;;.93,""S",.:•fj F.;',7;:527"-0•4;.,"Q/b ,A ! } • Yi r r V. 1Y• YI}Ot , Ya, s-C e>.;♦j •A.a . Ft . > a• , eo' t -. 4 'x9r-WE l4EC IROF Di AVaubt.TO . r l? .,▪ H• 1 IILL �t0.2 t l Ty.'t 7tvlitik Y No ly9 Y Y f r.} f Vii" ! COYPIFTE ❑ e>Q A.° 4� .sit ouTX a,t3 m aD io9ACCa USE b r. E i� • - 1 +;P rr > ASE. J v3 k 4P4} f >�} CONiFBUTE TO OEATIi , uaFEYAt°�aKn�� ) � , .5t'S O'1b•1•'!w- ' [ Q ,arg c < _ORS a ONOIV•aaaetFrwa..<]amm S f 3 si C l°v>'o F',tr�"Dr< ">s • sl099i5r 13°.rac tun-.sn,. yOr Ovrx,_w!i to ▪QPIFTStro-edet. fh. 'YA i,i=c,.o-m ,•e g4. E cVz:n lD € �< b�4T✓/•e.-a .,,.,....,..,..-m: i� O M zT • u t et�� ,a� y2 Y 3 a ...+� '< } ems{ va.ram No^ w.C34 t 1]Nxv.q�:oRACDa Piste oFDart aury ivaaW cbam t.,r /.° S,t C'.1:0•O Kd •� �a...a WI' •R Or 34.wTEOFLWIii) 3U' nLEcr ].<WNRYA ,,,;n: JNryAeenar.NRY-allw.lagcaglwr[C °a'G ▪ j 4( m9. . L a Raa' lna:tDF iii); dle Dr pti'2/ Ern !a y a E! s f.."`aa r �e „So:° i•,ri S > 44 i° fE�y � Y- Yt . ,; 3▪ `i r . r i! }t4 's £s a..ye try%%s-k°al 'r (, �1- 'let 6• DPU'ecarl br a4.DESCRWE NOW INJURY OCCURRED a De.LOCATION OF INJURY.is mg harder, om SUR) j?"4":• 0 V 4Y141 C° :O0FARESo/-A. 44"• t y 9 &t tr. a-il /+. s .... CO i� -F 5)• a o♦v•'lt1Y A9 C▪ R 4x1 V. a r r 0 A S'3t•a•i• •a 9 s e. e} +•-: A - sv it x((93 f �< � -21? c•'0 P1rt6591R 1fYtD111+♦ r b '^ a t-. c 'l' lES r A f {I,J1+ lte�la.t 4 8; ��h'o,.y<. it t§l !c.>°~<.izt °ts s, < i;.. •i-J F cr 4T; �`9 1 s S 2 VT,Lr • I'62y.wo p Lg 1� O V e,After,acvt 3 S .,: tvC i a iii ! rM .e J S y ll 1 k:...,:.• 6 •^ ,. . pyr ° £ e Yf ey 7 i o � • fi 1 • • .•-a e s..'E+/t v+ °. •y 7-E`c t Ific t,,t ..1 hereby cenrfy the above to pea true and correct representapon ofithe recordAor do., merit on 51e in ch , 4) S,,kic�1 f r tt Las s` '` �'1 a department:TFiis cerLfied copy is valid only when pnntedl on secunty paper showing the red-embossed seal°tiq'yr.tt,'°'pr£4�gr y I 08951633 ibf the Tennessee;Deparbnent of Heafth Alterandhor erasurivo`ids thus cenficahon a Reptoduchon of ibis *'y a.vt. y A• + )' !r!r d''6,tj''v .s �' 1144et$ dcarTiantls- iohiblted'-hr .. r/-s ,-• .W. 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THE ty`'yL,�Qt.4B8•P i.N.iaeti; J va is a i ,::.;:e . . k.t•° v ,} a 3 �• '� '• 8T t F�,l v <s4-e...01.,..,..t.,;;,-.:,.,...-5R !r ai• .L,.C T •-4 9 -AO> a i\` n i a �r ♦a, r01 1 i Qe ti Y. ▪ C �hx\ . + L}�t i �°'�'1 , H..�-�k�-�, a .�& 3• s �� �1 3 3 4 . •l(.{ton I1AFerranti PhD MSN MBA,RN tit„lotlnJ-D ehne i ID PH F EM;• flats Issue 0 < -,..-49(111: �.r.a t FFp.4,1 ;$, .� y a, •n. ..,,, s / ! -�7t Yen st E .l•-'l lac 'v'-i rrenc ���<" `r'�� h,.�',fir i• r. � f G.State(ieyistSar�ASSt CommrssipnerG COMMISSIONER t.1tt yY5�k.�G r y♦ >„i �a+�?'aY4s-,":1:. +r S i, �t ,47--,•,:,-..,7- 11'r.. % i • A, •A. �4;\�Oplir CT 1UI$%a.� ^ + rl • fia�AAttty i'4 T/DIlifili‘•,:".%.,400...s;..4.•.-47.•, 1 _; 41.00j��I,�1e0ea�elee�,�4*44 • i,D nisi q1/�I°°ri a♦'.':.J�i♦ I�Ur '•'' f11/0�0 j�j°I�I�i1'a'1e0����0��1�0• '�re T °' Ya , ♦ ,040*.eo♦ $4i •CERTIFICATION OF VITAL RECORD 10000 ,444,04,6- rz7viE59� •• as . �Y i `. tote,ei:Oee�ee4...* ,vii <q11 f• < ' -r•• n i�: 06.00"...0 a▪` #., 4s'TR,r0.-:.e rrgeeeei41- :iai\INI/' . _ .<•,,.v Na_.--_-..N60g1/►a• _ _:ieVe`fei•� 1.1jyrR- .4