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<br /> W.-H.CO. M.6200 II
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<br /> STAT OF IOWA, COUNTY REGISTRAR
<br /> L32-- ---/21 Vital Statistics
<br /> County of .
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<br /> CERTIFIC 4\ TI (11N
<br /> . OF
<br /> 1 . 1
<br /> I 1 DEATH
<br /> 1
<br /> 1 .
<br /> NAME OF DE SED 4-4,91.2-1z. a:LIZ ea..' ... ..!. Sexc:=7122---77' .
<br /> • Date of Death ..?!.:!.. .21.-R....../6 19 Place of Deathk-41F-e0 .27j-cP---4--x--QX *---•.-- 1,-9-(---i--_ ,..! i
<br /> Date of Birth or Agg of Deceased.... . Z4./.g.9...y..Date Filed 3._.4...,.._.44._„?5,/y__:-- _,,-
<br /> / 1
<br /> Cause of Death. L ey , 01-Le._ ' 1,, -.., ,., •
<br /> 1
<br /> 1
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<br /> I HEREBY CERTIFY that the above information was taken from the Record of Death on file 1
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<br /> in this office in accordance with the law of Iowa requiring filing of vital records. Recorded in 1 -
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<br /> Book._2C
<br /> .,:\■',;...41.15 211.,."-----,, ,i i
<br /> Date.. ....--" "--,r-..?,..4..3.--!-X Lt-- 19 6-6 A - iii ,
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<br /> County Registrar an Cloi of Distr. Court.
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<br /> AL] c: z.- By
<br /> Dem(y Clerk.
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