Document NEaY5dbomx4dnXw9N135d7Y4y

oTtoo(o>No 0\ 00 T-H I Q I HEREBY CERTIFY THAT the foregoing is a true and correct copy of the death record for the decedent named in item 1 and that this record was estab]ished and filed in my office in accordance with the provisions of the Illinois'Statutes relating to the registration of births, stillbirths and deaths. --, ^ DATE OCT 21 1985 _ SIGNED ' '<-c / '(A* -f At Cook County Department of Public Health Official Title Chief Deputy Registrar 1r'0n.S. Ma'!>i iml I'r i' ,1. Ill inn is AO Ir' 1 DANA-335