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This is to certifY that this is a true copy of the record which is on tIle in the Pennsylvania Division of Vital Records 111 accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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No.
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C~Yc ffQf\0fol
Frank Yeropoli
State R':;f',isrrar
CalviI~ B. Johnson, M.D., M.P.H.
Secretary of Health
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SEP 1 3 2001
Date.
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COMMONWEALTH OF PEHNSYLVAHIA-OEPARTMENTOF HEALTH -VITAL RECORDS
CERTlRCATE OF DEATH
(Coroner)
090219
;01.<<4.....1111
Male
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193-64-2941
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