HomeMy WebLinkAbout02-05-09 FV.19/p8)
"Phis is ro certify chat this is a true copy of the record which is on fife in the Pennsylvania Division of Vital Records in accordance
with Act 66, ['-L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~~ ~~,~~~
Frank Yeropoli
` F State Registrar
s"~--+t.~-> ~ Q
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~, ~ . 6 J 3 FEB 0 21009_
~;-: [: ~ Y(n ~1o. Date
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Nros~la3 flEVruRaus r? W U d ~l COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
iYPEIPfllSIff~IN; ~ ~~~~~~
P&ACNNI R J LL' ~
K~ CERTIFICATE OF DEATH
~'-- o ~~ (See Inshuctione and examples on reverse)
1. tamed DzceAmllFi mn, wmrl STATE FILE NUMBER
2 se, a smm saudrympmber A. one P, ceam pwoAm, Wy, maq
Carole J. Patterson Female 193 - 24 - 0685 12/5/2008
E Apa Vaal Blrmtlap Unmrl yeel PoealMy 6. pale of Bmb (Mwlm tlar year) ?. ElMpaza lCer aMSmlea loreignemnlpl Be. Plew MpeaM lGhakmly one!
_ 77 Haw °e" """^ r"""" 5/16 1931 rropPnar.
v,p. / Harrisburg, PA olbp~
eb eoomY Olpwm aG ary, epr^, rwP Omeam ^mPANpAI [~ENIOq,PaapAl ^poA ^Nanlm Na^p ^Npnaa^a []omer~sPeclry'.
I Qd FeuLry Name 111 rcliazmupon, giresvwrantl mmmep 9. Was pe[ptlenla Hispanip Orlgim Np Yes 10. WreAmasan Indian, Bmck Vmpe, e¢.
rl Cumberland E. Penn born Ybp, Holy Spirit Hospital ulv>aP ~ro ab
7• Me P p^ofl p17 1~ I Wh1tC
11.Deweenl's USUal Ospupabmlhmtl Wwarkibw AUri sol d Ills. Dp nql she re: rpol @Wap Cecetlen, evern me I"s Decetlenrs Educe! on lSpesNonly M1ghesgatle mmpl leej 1q. MariMIS WiM mM, Nevei Ma,rao. lS EU•rrvna5p>we A Vle. gve matlen Hanel
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secretary ,y, n rrl n cpopPa n-aA S.I
e e ^rpp [JNO 12 divorced
• 16 paedenfs Maiplg Address lSrwt arylmwn. stile, zip mbel Owecenfs
1705 Letchworth Rd. Aawl flapWrce na SYaa PA oi~l0.^vaeaam ~ Lower Allen
rpwnsbiPP ,h Yes,Oaetlen,liveOln iwp
Camp Ai11a PA. 17011 nb. cmAH Cnmharland nd^W, pe Mnl maeawlmn
IB. Femer's Nemp Him, miMe, Ian. sutla7 Asluel Llmlkd gryl Pao
Clarence C. Rudy ,3. MaAa'a Wmalmml, mletllp, malm„paAama)
Mary B. Wallace
2tla.lAlormanl's Name Hype/PIinQ
Patricia R. Sheible xw. mmlmmre dabmgAebmw lsfwl, [AVnpwa. plde zAweal
Y 418 Candlewyck Rd. Camp Hill, PA 17011
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(]olbeo sPe<Iry :br uetlmN Enmiwrl Danaen ®vpa^N^ 12/7/2008 ConOLite Cremator
_ w xza. signmure m niw awe la Person amnq ap aupbl xffi mpmse Number Y SCheafferstowna PA 17088
Q - - xxf WAR aM Aetlrppp NFaplllr
~5p . ~~,L Parthemore FuneralHome & Cremattoo^^Sexxvippes I(n]CC
Cmmlela leans c^ nwmgmg 23a.IDmebuld mr6nwredpe. Mam oawleaal mebme, Bare enapape mletl 5lpneNre me blle) NeWCambe Tland YA 17070
physivvn 61mtare I at Yme altlwlAW 23b. License Number xsc. pare $i
aMlry was a Mem. 43etl IMOnIb, tlaY. Ywtl
Ilems 21-x6 mslbawmPbl¢tlbYPenen x4limpol paam x50e,e PmnpuRetl pazE~lh, EeB Y~
wMprwwurcw rca1N 25 Was Caw fleMretlm Mednal EuMnerl Comnerla a fleasgn purer men Crematbn or pgnenpn?
fZ;~ M. /,Z .,j""10(7 ^Yes Na
CAUBE OF DEATH (See lnsmuniona aM vemples) r Appmvimam mlervm. PaA IY. Emerabas~mikm cM+aa rm. -
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