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Ryan, William W . , (Jr'. ..*....rW"'!'PIl I .. . L. L k' ~_~., .... ___ _ L ~ --.,,_'~_:_:-.-. ....~. ~ j -~ o,.partmrlll 01 II..."'. and,R.lIJII./lilHlhr s,...'IrN .. 1l!WISIOIII ()~ I 1I-.AI,l " .I~"V_ "rr.u. nATVTd CERTIFICATE OF DEATH FLORIDA STATE f"lLE 1'000. <<OECEASED RFGI6TRARS -'0. DATE OF DE"~-' ..aNlH, 0"". ,(U, N A.M;' ".1' "'IDOl' . lA" /SEX ~1 mate. DATE OF BIRTH '....aN'M. ou, COUNTY Of =<:..-,... ,'i[~~lldl ~ ,'18'1"/ I. PULE-U..al.l 1071 i 1 I J I , ! j ~ RACE WHIU, H"IGIO, """f..eA'" .....01........ I AGE-U.1f U....Oll 1 'f.... U'4DU 1 O"'T ~~='l12h4~~~:'"HD7!i''''' -"0' To;:;' ~ou" 0 CrTY. TOWN, OR lOCATION OF OEATH - INHOI (I'" 1I""1 ~ I ~Pf( I" "s O. ""0 fallg.6 . ''---lL0____,'.4J2:.:g ..7Jh,--4.LJeJ'Ul-tg.,L}I___C.____________ STATE Of .IRTH '" N01'N U.S II., "'......( CITIZEN Of WH.4.' COVNTR~ MA~RIED, N. EVER ""'....RRtED. SURVIVING SPOUSE It' -N"... ~'.! "",..IDIN ~"'Mr I COUI-l1t'f, WIQOWED D'VORCID r "ICf(Y Ie. . . . ~O_WQ~______,.J!.._ u.S~,<i. _, _J'o__;I;Q0-0,~e&_ --l,-,JII~ iC!L0!A4<:':_i'_O;~.~~~_g~e.p.En__, SOCIAL SECURITY NUMUR . IUS.UAlOCCUf'ATlOJ'o,I c'", .'''',00' w"lI.: DON' OUI",C .11III05' O' 11(11'10 Of' 8USIN. ESS OR INDUSTI' , --O..''''''C. 'If, rlfrl'ol" 'fT.tH1' I !.!--1..o..:i:D.l=5~G~-:G_ J~_ . P .ulJllQG'L___~____ -- ~..;~n___J? .u~~l~'~~ RESIOENCf-SrA.TE COUNT" CITY. TOWN. OR LOC.A.TlON ! '''1010' (In 11_'" STREET ANI:. .... ...,aUl~ ! ~"'C"i 'fI!. O. '""0' _ ~ u,~.H_oll.L(ia UbPU1.d.ta1.l l4,fa.'l. 0 114M '" U':2"' rthGue.., n.c. l.S' I MQTHfR_ MAIDEN N4Mf ." Gnn I, llblld 0{ I. ilC!..c.urct: elL 14, \, HOSPITAL OR OTHER fNSIITUTlON-NAMf (II NO' 'N II''"''.. ~,.! 1.'H1 ."'0 NU""If" 1\ fATHEI_NAME 'I.n .11III I DO,,", ,__S.T ,,", .. :'Z)II urtkJwLL'il 6?l QYL I M....IlING AOc,lilESS 1'1J 485 J'ah-euLew O{d.,G 11 INfORMANT - NAME I ~ I I / ~,.~ J,'h..... , li//'_.'~.:,~, '/ ~ _ ,~t". ~ I 11. mlLl.l. P",RI I, .. mall' . 14, C Lenllwat0'l., J.tu. DEATH WAS CAUSED IY. !fNUR ONI r CNf CAUSE RfR IINf 'OR 1010 (bl. AND (ell ......,,:,.I.......H'l'oIl(I\I.l IrT'WU... ON!.!1 ."0 OU.'I1-4 '...-....'D'.." L: -t: /"'~ . --,-t./,L U"7~,_ -G,.--{ ,7{' /J..C--::.~~ r1- f L- (0) /~ CON0I110NS. H A...Y. WHICH C.V( IISf TO 1'.u...(D....U CAVU 101, STATING '"' UHOft. IlIHG ''''USf LAST Ib) j " 1 ~ :1 ~ I 1 ~ i 4 ~j ,. ~ ;J 1 .~ leI PART" OTHER SIGNIfiCANT CCN:>ITIC"NS (0"'0'''0'''10 (C....,'IOJ"...C '0 or..,"-~~~~~:~~' ~~,.. '.... 'Ul I 101 --------r...... - ~5Y IF YES .....,., "NpI...C;) co"'. I, ~~l.:.. "'0' S:D[.fC.... ~fU,,,,,.,rp.lG ,''us, l"a ::J l~~ Df"'''' (Fi";~boblyi"'A(C1DENT:SUl'ciDE- 6R ---rD....-T.r or--'NT0i1lr.- ,-;O::;'''---:-e;;-~,;;j,H6~il - - ---IHO~IN-JLliYO(CUF!REO .1 IHH' ~~; : j .. L'" I"" ....IT I O' ".at, II. "(~ II J HOMICIDE, OR UNDEtERMINED I I I. ~ellyl_~_____~~___u_____JlO' M jlC>J_~_ INJURY AT WORK PLACf Of' 1f".rJUIilY.., '"'0"" ....... ~!.lfl, '.aC'OU. i LOCA.~ION I ~lIflT O' t, 0 NO, CIT., O' TO........ S....~ I '''l'''' ,.,~ 6. NOI 0"'<:;1110(. PO:: S"'("'" I : 100 10f 110<, CERTlFICATlON-'_ ""0"'''1 . "... "ONT" tr.., "A' : ..NO l.I.S' )........ HI.... ~fI "'l'vl ON I DID 'O~:f- _..: ~~Hlt~~~~~~~_~;: _If:.__/;'!__//(L'~~b,!.2-_ .iL_? / _-b2~_;;"__L!i.._l;~:;';;::/-Z CfRTlFI(AlION-MEDtCAl EXAMINH! 01< CORONfR O"-J h~l ..~,) 0' ''Or 1'4(l1l' 0' n.'~ I "'.f LIlfO'NT w.5 ~~.(;o Of.C 1........'N"TlON or ''"'l ..oOY "ND..'O' ,,,' 1"'...IPI'.....IO"', '0..; "'" n..,'~..:.:".. I "0'.''"' 0.... DI"U~ Oc(uurro O~ ~r D"TI t~[I OUf Ie' ''O' ("U\"5' lo''''lr 210, _.___ __ M ._:~t _ _ _ __ _ _ __ __ _ M ~lE:WI~~1~~ o'tC'~~~~~Q.~t-cti J_ ):,.!J(_!_~___1:~~:_~0_:~~~.. _-4<!Z:;):J]::- ... ::;~~ ~:::?%f~D }?: l;'f~~ MAILING ADDRESS~(U'Tf"fll 1 ~~,""",:r- l)l'_'f' '+" '.-, NO f' . ('rC" lO~N 'I" ; _ ~.L.'Tt l :~IjP;-'.rO. 11i 06 ( 1i2/.-L !JJQLJ. J>!,'L-Lue ..l..Qhq:.O 'JL~' ~U a~l..JJ'+ BURIAl. (REMAltQt.J. HfMO~'-Al ~CEM(lERY OR CREMJ.'CJRY -NAME : LOC'" ,ION (IT. -~. -: _., ~..'f I S'IC'" , ',. " 13 :-: _ I -'r,.... r--',J !~~ _~UA~l,(1t__ ,~ "b G.tgCi--1.Wa t~'l.~ Ce11~e.;LC./L..lJ- __ il" l:.u..!Al'}U)C!:'~'_ :.r~~ ,~. ':-L~_a~, r -, . ~?;-, (G DATE - . 'MONTH. ou ....f..r~.. .."~F~!NERAl HOME~.-,..Jt...~( AND AUD,f(~S \UlP .'J' II r. (__' -f~" 01 T?:"'I ~lA.l"..J.,....t~ -~;:erh ...~1~1.-...:.)-S.VJ..,.. -- 14d .lYe-c.. Ib. Illll :'JjoU.c.h.a./Ul.-tc.II1\..L.olA.e..YL .J1.,m.eAa.c 0w.'lk:'A..X) ( \... I_"';-J.a!l<}o HQ. ' fUNERAL ohif- Ii':....s/G TV' ;;;':'---;-- .EG'S'"",." S'G~...riJ>'f I llb 'A ':~~n 11.7'1 . '~/'''''7 ' ,,".,' ./' -', , i 'I' '. :!.t.'H OCCUItREO ,,' ~Oo4f "l.CI, 0.... Tkr - to'" ;l""I, "NO. to J"H[ UU - ,.., t.' /"' ~I ...,- .NOWlHXH. our " "'~ r AA '0 ,.., (AVSfI51 STATIO. '!.. "0",1 ~ " j :L lOb c..... IE . ~ : ,I t oJ 8,- IOC"l Rte. 'sa All! ".'.,... (~: ',/.) ,., I hereb~ certify that this is a true and correct copy of a certificate on fil~'in the Office of the Local Registrar of Vital Statistics of the Pinell~s County Health Department, St. Petersburg, Florida. \. ,~~~a&j'_n1""L7~ ,Depu,ty Loca} RegiS,~~ar J! i-' De'c~hlber\16;.-i971 0.,. ."