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<br />STATE/OF WYOMING
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<br />DEtJARTNI!::NT OF HEALTH
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<br />DEATH CERTIFICATE
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<br />200806044
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<br />Decedent:
<br />Name:
<br />Gender:
<br />Date of Birth:
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<br />, State File Number: 2007-003087
<br />$ociaISecurityNumber: 507-60-8960
<br />Age at the Till1e of Oeath:94 years
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<br />Velva Lucille Walter
<br />Female ,
<br />March 17, 1913
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<br />Date and Place of Death:
<br />Date of Death: October 11, 200T
<br />City Of Death: Cheyenne
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<br />Additional Decedent Information: ",,"""'..'
<br />Place of Birth: Pleasanton, Nebr~ska
<br />Residence: - Northglenn, Colorado
<br />Marital Status: Widowed
<br />Nameof Father; Grant S""earingfm.
<br />Maiden Name of Mother; Julia WellS
<br />Informant: Arlan Walter "
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<br />Gountyof Death: Laramie
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<br />Relationship: Son
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<br />Disposition:
<br />Method of Disposition:
<br />Place of Disposition:
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<br />Removal from State> "..
<br />Kearney Cemetery, Kearney, Nebraska
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<br />Cause of Death:
<br />The immediate cause is listed on the first line followed by any underlying causes.
<br />(a~ Inanition \
<br />(b Dementia
<br />(c Urinary Tract Infections
<br />Other Significant Conditions: Not Recorded
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<br />Manner of Death: Natural Death
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<br />Interval:
<br />Months
<br />Years
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<br />time ofpeath: 14:10
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<br />Certifier:
<br />Name:
<br />Address:
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<br />Date Filed:
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<br />Amy LGruber,M.Q.)))\ "
<br />5416 Education Dr,Cheyenne,Wyoming
<br />October 22;20Q7
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<br />356765
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<br />DATE ISSUED:
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<br />October24, 2007
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<br />'B1is is a true certification of the document on f,le in the office of Vital
<br />Records Services. Cheyenne, Wyoming.....
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<br />Gladys K, Bre~den
<br />Deputy Slal.. Registrar
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<br />Thi8 copy i~ 110t valid u!lle!i5:i prcpi'lred on paper with ~I.l engnlv~d, bnrl.lcr.
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