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<br />Oregon
<br />I STATE HEALTH DIVISION
<br />ont 01 Human Resoutees
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<br />CERTIFICATE OF DEATH
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<br />00518b
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<br />83-012031
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<br />DUE fO. OA AS A CONSE0UE79" - -- --, -
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<br />F"AAT OTHER SiGHlFiCN'.-....-C:QNDt1lQNS..-~~ {.'t,)Olltlt;lIl''''O 10 dtotHh boA not .f!t',4tw l(l c...... (;I,Wtn "l PARr I la) I AUTOPSY I~ tW
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<br />Or. . 970ao:
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<br />/lei. of Deeds
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<br />HS-2 (Rw. 1180)
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<br />STATE OF OREGON, COUNTY OF ~~ULTNOM,l\H)>s OllTE ISSUED AUGUST 12 1983
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<br />I HEREBY CERTIFY THAT THE FOREGOIN OPY HAS BEEN ';iI'AREO BY HE ;.lITH THE ORIGINAL DOCUMENT AND
<br />IS A TRUE. FULL AND CORRECT ,:OPY 0 HE OR!GIrl\l ClYTIllcrllE ;\5 THE Su.ME APPEARS ON FILE IN THE
<br />VITAL RECORDS UNIT OF THE O,lEGON S ,\ E I'EI\L,!! lJ!Vl~IUil ,\J'~,Jl~'1i OFFICIAl~CAR CUSTODY,
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<br />'J(';ejll D, Ca,'ney, S gistrar
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