Laserfiche WebLink
Form R-328. 2m-2-59-924805 <br /> f <br /> Lhzd_'a'z_' <br /> } <br /> (USE TWO LINES WHERE NECESSARY,ALL NAMES TO BE GIVEN IN FULL.) <br /> FULL '`AME OF DECEASED Condition AGE <br /> DATE OF Whether sin- DISEASE OR CAUSE OF DEATH <br /> NUMBER ATH (If a married or divorced woman or a wido.,sive also SEX COLOR gi married, <br /> maiden nam_and name of husband) rndowed,or Years Months Days (Primary and immediate cense) <br /> 7 ( divorced <br /> 119 <br /> a28, ,�<,�' a� ha�xeLa� tit } w 1 <br /> { <br /> i U <br /> e A <br /> —. _.. _ _ _._.....___._____.—___ _ <br /> M1]� <br /> tj <br /> 1 V <br /> 111\•••�'m„ --_-. __ -_._..___. .___._._. <br /> '.__ .._ _7.__ <br /> �.c.,4 M C l��y►e�J t /t'o�kS /�'1 1�/ /y A- �.��,�ce.� <br /> yti <br /> Z0 6c.(�l8' eoIV /all' <br /> _ ----- Y..-ZLI <br /> - <br /> C) <br /> , <br /> _... _ z a <br /> " _ <br /> Ale <br /> I � _ <br />