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Form R-323. 2m-2-59-924805 <br /> ate. lard ,�' <br /> ( ' (USE TWO LINES WHERE NECESSARY,ALL NAMES TO BE GIVEN IN FULL.) <br /> ! FULL NAME OF DECEASED Condition AGE DISEASE OR CAUSE OF DEATH <br /> DATE OF Whether sm- <br /> t NUMBER j (If a married or divorced woman or a widow,give also SEX COLOR gZm'arried, (primary and immediate cater.) <br /> DEATH maiden name and name of husband.) wi owed,or Years Months Days <br /> divorced <br /> I <br /> DA <br /> — , jN Do-ell,/� <br /> L / <br /> n at - -�2_ _�_1�1�P/_rf !s .- l�' ff��,1, <br /> I <br /> Rol R e lei aG�l � nlg __ _ _. _ _-- --Ern Pis m_A., Eve t utie _ -- - - _M..- - — -__ <br /> I . ..�pN Nest �F.b &,e / 414uAies 1= W �,'J e '7 _ _ F' ��� <br /> , <br /> 1 � <br /> .. _ .. <br /> _-- _. .--__ _ _ __—___.�_�______�__ —__-. _-- — - –� _ _ U p�u le£ D___v E Nr�I c u,a k 4)n e'u 4 l <br /> �e t�� of <br /> i coeow!al-y , q telq /Se 9j , <br /> f _ <br /> f�•• 3 <br /> �D M61✓�� Cm e n��_Eiv�te v �3eown �/ /��{y��Q.P� 77 I,/ - /J <br /> ._ �-.. _� __ 'Y..--____ CLJ-!.1._- /l__._.-..._ JZP/L-Q�� r ��C.11 <br /> I, <br /> M1F <br /> /e D 'C` L(�a 11l <br /> r � <br /> , <br /> -:4. , <br /> lot iu­ <br /> w 6v.02 <br /> .x <br /> L ' <br /> .r <br /> AkwAl <br /> r <br /> N <br /> 1 O E l4 2 2Q LcJllit �Drh. <br /> F <br /> , <br /> � 3 <br /> 11 t5 <br /> i <br /> x <br /> i1 <br /> '3 <br /> u Y <br /> 1. .(� <br />