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COUNTY OF GRANGE
<br />HEALTH CARE AGENCY
<br />1200 N. MAIN STREET, SUITE 100-A q O O p O ~ n f~
<br />SANTA ANA, CA 92701 ~r ~7 ~r
<br />CERTIFICATE OF DEATH ~ 2QQ5 30 ~ ~ L} ~ 4 3
<br />STATE DE CAIIFOHxIA
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<br />NAME AF pscEDENT --~ ilgST IAIJm) ._-__.._._.__. _...
<br />2. MIDDLE s. u3T lFemnv)
<br /> Stanley Keith Weiss -
<br />~ AKp. ALSp KNpwN A3 ~-~ Irwfude lull AKA IFISgT, MIppI.E, usT) pnTE pE eISTH mmNe~myy
<br />° I;. AGE Ym~ MoNhe n y floura~S i mule 6. SE%
<br />~ 06/24/1931
<br />Stan -Weiss 73 i M
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<br />y B. EIgTH STATEIEpgErcln LtluNTRY 10. SDCIAL gECVSITV NUMeEA tf. EVfpwu.3. ARMED 60RCES1 1~, MASITU Sigius lel TMxd ANnl i. DATE OF pEATN mm aceyy e.NCUS (s9 NOUraI
<br /> Nebraska 507-30-9300 X^yEg ^"° ^°"" Married 04/06/2005 1745
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<br /> 9233 Poinsettia
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<br />a Fountain Valley Drange 92708 40 California
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<br />__ Merle M. Weiss -Wife _ _,..._ _
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<br />d Merle Mae Boelta
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<br />< Christian Henry Weiss MO
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<br /> .lulia Etta Dugdale NE
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<br />m 04/12/2005 Shelton Cemetery, Shelton, NB 68$76
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<br />~ 91~AATF mm'Mdlory/drr
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<br />~ Dilday Brothers Mortu&ry F
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<br /> 101. PIACE DF PEATH ece 1v ~ -.vrrM. CI u1.I pTNER TMN FW3PITAl, 9FFCIFV pNE
<br />$ ~ Haag Memorial Hospital Presbyterian 0'F ^P'~""^°"'" ^"°~"° ^iw~r1!TC ^°Nm°`°e°°'"° ^O1'°'
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<br />Orange 1 Hoag Drive
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<br />YES X NO
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<br /> MMEAIATE CAUSE (AI I U11
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<br />~"°'°"°°°r ~ Metastatic Cancer of LuTLg .15 Mos.
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<br /> ts. pTHEq sIpNIFICANT CONDITIONg CprvTgIEVnNq io ATN euY Np Nf3gliING IN THE UNDERLYING CAUSE nIVFNI o '
<br /> Coronary Heart Disease
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<br /> tla.wAS ppEgATION PERFORMED FOF ANV CDNp iION Irv TEM TpS tfrsi (x yea NN,ym, d. gpmfgnem doe) F efMAIE. PFEOUaAi lx ln6i v[nnv
<br />V Coronary Artery Bypass --/ --/198'.7. TES ^ ND^uNK
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<br />i,NEHpwp:1~ANDpucesTATEp.ApMTHE~A~Ees,AiEO. o If 8.41A nE "wp nTlE qF CEMIFIES'
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<br />~~~~ ~~~ A33589 04/11/2005
<br /> W mhlduyy IIF) mm/daayy tfN,rvFEAiiENgdpFNVSICMN'sNAMEMAIUNGAppRE33,21PCODE 92663
<br />~~ 01/22/2004 04/06/2005 Khosrow Mahdavi, MD 4000 W. Pacific Coast Hwy. 113--D, Newport Heaeh, CA
<br /> ,. ICEmIEY TxAi IN MY OVIxwx AEATN nccuRRED ATTKE xpux.DATE. AfmVn.ALE SS-iAIED rFDN THE ausea STAreD eo. INeuRED AT wogKT f.Iwugv PATE mmrdwpdyy In. NDUF Ir Naynl
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<br />STATE A B C p E FA%AUTN.N CCNSUS TRACT
<br />REQI9TRAR
<br />APB 1 6 2005
<br />CERTIFIED COPY OP VITAL RECORDS
<br />STATE OF CAI.IF4RNIA l SS PATE ISSUk;l7
<br />CUUNTY OF ORANC~H J \ ,,
<br />This is a true and exact reproduction of the document officially V
<br />registered and placed on file in the office of the VITAL RECC)RDS
<br />SECTION, ORANGE COUNTY HEALTH CARE AGENCY. MARK e. HoRTON. M.o.
<br />' HEA4TH OFFIGEn
<br />ORANGE COUNTY, CALIFORNIA
<br />This copy not valid unless prepared on engraved border displaying seal'and signature of Registrar.
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