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<br /> Fl�E CERTIFICATE OF DEATH oisrnicr�no OOe� 9220
<br /> - N __STATE OF CALIFORNIA-DEPARTMENT OF PUBLIC HEALTH �ERTIFIC�TE NUMBER
<br /> 11.NAME OF DECEASED-FIRST N�ME 1B.MIDDLE NAME �lc.LA5T NAME 2n.DATE OF DEATH-�oNTx.o�Y,rGp 2e.NOUR
<br /> PAULA � WILHF.LMINA i EICKHOFF �fAY 3 1964 �4:15A
<br /> 3.SEX 4.COLOR OR RACE 5.BIRTHPLFCE cou..ren PO6" 6.DATE OF BIRTH 7.AGE�u+*��•�•�••, �'
<br /> IIXDEH 1 YE�R li UNDFII3�Xq1115
<br /> ��nc.�ir YEARS
<br /> .a�atdalLSd.iL.�-.. .lUME AND BIRTHPLACE•OF FIITHER 9.•MRIDEN NAME ANO BIRTHPUCE OF THER 10.ci7IZEN oi WHnT CoUNTRr II.SoCInL SECURITr NUMBER
<br /> PERSONAL F2'1tt EiI15 i Germ n ris 0 s
<br /> DATA �Z uST OCCUPATION 13.li�liu�rcc���Twx 14.N/�ME OF L15T ENPLOYING COMPANY OX FIRM e�.:i'•^O'O 15.KIND OF INDUSTRY OR BUSINESS
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<br /> �6��ow°ui'�i°.w•no�i�o:�mo:sc�ci 17� iw`ooweo.ono.cco "��" ° 18�.NAME OF PRESENT SPOUSE i8e.PRESENTORLASTOCCUPATIONOFSPOUSE
<br /> 19�.PLACE OF DEATM-NMIE or�roSVI7Al. 19e.STREET ADDRES�rsrv[srpen ort nun���ooxcss on�oc�nox.oo Hor u5t r.o.wx Hu�s[m�
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<br /> DEATH �eo.couNn 19E.IENGTH OF ST�Y IN 19i.LEfWTN OF STAY IN
<br />� *� T ♦ COUN7Y OF DEATH CALIFORNU
<br /> LO$ M eles 4�$ f\n ele$ • S yE� �
<br /> USUAL ZOw UST USUAL RESIDENCE-sixe¢i�ooaESS,c,,.,,,.. IOB.li NSIDE CITY Cf W31DE CITY CORPoP�TE LIMITS 21�.NAME OF INFORMANT iir mxErt rx�N�srous[>
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<br /> ur[-��wwsnMiox 20e.CITY OR TOWN 200.COI�NTY •20e.STATE • 21B ADDRESS OF INFORMANT;;
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<br /> 4314 West Slauson Avenue ,� �� �(,
<br /> FUNERAL Z9.��M�?^0'°'� 24�D�TE Ms 25.NAME Oi 6EMETERY OR CREMATORY 2 BAIMER-5 nei e ur eoox cMUU�[m IICENSENUMBER
<br /> DIRANpOR Burial Ma 6 1964 In'lewood Cemeter
<br /> LOCAL NA EOFFUNERALDIRECTOR1O�°`w"!ON"�T'"O 28.r,"oT,;.,"`.��a�°q�o�s,,,,,,, 29. ALREGIS7R 51:fy1TUpE/� �•�.
<br /> REGISTRAR �y�e�Southwest PAortua Ine. NAY_ b � ► ��r► ��K,
<br /> 30.CAUSE Of DEIITH EIfIEp OXLY ONE CAIISE PEX LIME fOR 1.11.IBI.�ND(LI
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<br /> � � PI1RT II:07NER 516NIi1CANT CONDITIONS LON7RIBUTING TO DE�TN BUT NOT REUTED TO THE TERMINRL DISEASE CONDITIOH 61VEN IN PARt 1��)
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<br /> � 31.OPERATON-CMEC1c oN ������ sr r 32.DA7E OF OPERATION 33. OPSY-LHEtI(oNE: *r o �
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