HomeMy WebLinkAbout10-06-06
H105.805 REV 1105
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This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent~ling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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Fee for this certificate, $6.00
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COMMONWEALTH Of PENNSYLVANIA. DEPARTMENT Of HEALTH. VITAL RECORDS
. CERTIFICATE OF DEATH (CORONER)
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10. 2006
Sep. 22. 1925
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5345 Oxford Circle Apt. 64
Mechanicsbur PA 17055
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