Document O1XMY8KwgxVVNmXxmQLBor6pL
fw
,H
Mi:ti*<)i'<^i.sT.\.v l.m: I.vm'h.v.nti, Companv
April 16, 1963
Mr. (Carl Krieg, Employee deletions Manager 1'He Philip Carey Manufacturing Company 320 South Vftyne Avenue " Cincinnati 15, Ohio
Dear Mr. Sriegi
Supplementing our latter of AnriI 6, attached is a listing
received iron the Home Office of death claims that were paid
between 1957 end 1962 due to respire tcry causes.
Vie hope that this information will be of some use to you.
Very truly yours,
,,,X
/:
.>e- .\yu L'-Ct-
w. i. uisca Grout Supervisor
jrl/ds
enclosure
cc: Mr. S. J. resold, Secretary
Torlwod Lr. crcor to use.Tiole data to ccaplj- vitii *.hta poller-holder'a
7S<V-3t. r^e iirntL TL-z lafcr=t.: or. La occMa biov i pirated \rj Cl' Mt!:,
(
V
C
.."dilir, C*o, Acubrld^o, .i-lfrcd ZUia, Fonj'asin Lassard, Va. v- ^ vA.4 Ui m Eatocccxr^, Tufidis sncai, Hvi-7 * StaJLl, -Lrt-x-
_ TICcUmCr,.'7*r
Zaiasjwaiti, V laced 7 lifcitisy, iJo^-7
ilcna: isj, -t-spaaa
of tha 'asalratcrj Staten:
:3
Futtirraa, *.'r. F-aracad, T*vi3 2bcjrzl3, Ciiaa.
/
67 / ** 65 f6 53 77 * 53 56 -
T
62 r ii.-* 63 -r 57 70 eL * 71
i\
j D. No_______ L^Jll li-
i r/cin iff Dm.
i--
DIVISION - OF VITAL STATISTICS
CERTIFICATE OF DEATH
S-i.r ft* -4)56522
*r*.w** k.. __ 'x 1 H 11
I i PLACE OF OEaTm J . COtfHtt
:i3r*.ilT.cn,
k Cllr. *>UAC(. ot ICOMQ*
J. USUAL. RESIDENCE .^V-
____
t
VSmOTM Of SIAT lH (fc 1
>. *taic QlllC .
_ .COv*rwj:?Z,L
c. QTT# viuacC, Ot (OOiIIOm
* "* ---- -
i\i IXSLS.X.YA TJL Of tit m"* * h*tp*i+i *f IiMcOj>, |* rw MiPffl/ 2SSSS<2T /?*rsror*c-
. * rtACE Ot 0**1* <msq< citt iiirn
__j-
34-25 Beets Avenue
*
i Cineannati
| AO0"iS
_____ -,^r^ rp.vi- Ave^ . fs'irtipiMCE iM5oe cm ttMrs*
^
*. IS ttSIOfMCe O-- A *
* j NAME OK OECEASED
I |TTt( Ot rciwij
. 3Cl
* jfiale
Essie
- COLO* Ot *
.
.
J__Colored
j jr au^ttlCO i
i
rts \ZC mq , List
Jacksor..
I 4. OAft
I Ot OCAtN
'___
V
rfs l.'it
?/
mo r"` Yc#
II Cl
0ttCV( MAMEO Q *' OA1* ,ww* * *6* #* w<w ttaM* \ Tm< m a*t* 2
.A
. /r ktthd*9t------- --
P-, ..--
g o>votcto n 10; Gl,_______________________________________________________ "Mlp ' ---
a^~"UiluUAAtl oOLC--CW.--ATIOvW f<:.i# rw et armr* Jen*.rrcn_ CINQ Of awHNtpi IN(VUU- II. tuTHmet
I}. Pfizer* c*
* *<[* 1 iP * v^rTcx
w
._ -
w4i ccujitii^
i
Phixiln# Carry Co.
JtrargMuen, .-.xa- '--
j 13. rATMft'i NioC
vkboricg o* XaauiiTtlbaT'. aoikh auow Nii"
"
| _ _ Cyrus Jgckscr..____
; Amanda ?
i;>. WAS C^CfASfb evu INC. S. A4<0 rotccs?
j I*. Oa; ttCUtsn f*0. \ It, INFORMANT'S SIGNATURE
Tirol
'* Yet. e*. * ai ' fH.y,.t.tjt*.* * **m**,o* ,o**-**a! --i*7nau.AaC; a2`,o^riaOJ:ac_k senT.34^, j_ a-- e^v:; u/ A--v-
,
- CAUSE OF DEATH \ tenet ant* * e**te fit u+e-pet 44l# <Ai. awa tel.J
lAlfMAl ICTWI
** i. OtAT)* Wa* OtfSfO $t; WM*CDUT| CAUS5 t*
_ Lp OP
n_.,
a^
Cnk:
ot*
i
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5
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rt)ri<iii /j nrr ia j A0OW\
w . ilAOll li< AM4V* 4 Orff /m/4 /^r. J oul TO
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^5^J^Sr??T5
0 CC tP AZV-Tjf)ft A Z*
4ru
Mi. ACCI0J~f
-
iuictci
-
cwn*i4 uaftiunaf t otm
ar Kuna ua
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WjAtClDt : Ml. CtSOlIf HQ* (WIUroSSOy^V*.
kuiit cwm /
rial
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9. m
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mpurfc-------------------------------------------------MU2L
:$*. iraiutr OCCUlt&
/Ov. flAC2 Ot IHKItT fr. *.. t r +mt ha***. , 20f CITY. vr(t^66f pOt lOC^MOr^
W"iC AM r- MOT wwict ^ '
1+m-
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\
^
WQ1I;
'--l At won --J
COU*TT.
21. t *itf**rd tie detemted />w.
Dim Aitm--ed e* ,-----
27*. /SIGNATURE .
^
(/^ jC-Xa
. * * /A/
/Oarw *r w/#/
.. /? Z?.
<jii ia ^ eut*
ttee'd em At end tm
Art/ of < 44rl#y|f,
iw rja'Pi itetfd.
i 721. AOOtcss
13c. s*rf Si
CoTt'otlEP .r'AffILTUS ro. Ohio >c-2 7-(
22. IwirAt. CttM-A'^urTfil
!. NAM Ot CMIAUht*
.F. SteE=H
IScT k** ot C(CiffT O* CltMAiOCr
^1" *
IUC. MQ. 5151a
* r*ar*
2*. IumIUI Mi* AMO AOOtfSS
isttcer m>4
** pOT)i ^ w
:era1 Hone 150'
it. Oai( iico iV LQCAl 1(0.
7*. <fcisTA 5 siowAivn f f* A.'jJ L'.i.-X.
!A
rr7 nTf?r^' ____J I
_____
(JFfce for this ccrtiilcat.e. S3.00)
. WARNING: it is illegal to duplicate this copy by photostat or photograph.
j: N0\H 31981
(
\ Date
1
r-;f-:
No.
J
//OaXuCu/Vw
Charlei Harvester 5talc Ki-istrar
II ;-2ci?a--azsrs--s-sa
CE3** pr r p?" *MC>.\'vi.-ACn OF" 'CCiSVlXAfitA
otrAnmcnT or health
eracs or vital statistics
15530
o;a!`f7. .I|62-!i30--
CERTIFICATE OF DEATH
No. S3
I. PLACE Or OEA7H * I. C>vA|y
W City. &arukici'cG** eeF*/rtr^g*Anat^Fy-
j c. Uert^itit W i(7 in lb.
2. USUAL RSIQa<IC (wheti 4(ticaie4 ii*44 (I jniti'vLitAt nugHHi i
for*
a. Sulo
A, Cvvaly
City. Saougn
Norristown
6 Srs~5* u! -.C^ .V*n2---><S7 ,1!
_________Harris tc'->n..
zjd '. 2-
full :a*;e elf MOT .** *ototsL cim i(:mi
d- Street .^4tan or LvcatUa
u Itwonfriott Sacred Heart Hospital
li Fltca at Duth imiflt <ignitlp>Uly limit*?
5r
Y* S
Na Q
'AJ;lF /
HA* OF CECA&0
A,
(Typ* cr print)
tfinl)
Raymond
6.
5. sex
C. COLOR OR RACE 7. MARRieoG NEYK MARRIEDCC
Male ivhite
mofftveon
oivoncEoc
li JO. FULL H*KZ OF S^OUSC
1J- FATHER'S NAME
George Levis
Main & Sarbadogs
it Ww`JnM Usifi MA*eooL>tr Umito? L It Rdifenu at Form
Yet ___________________________ Nt Q
Y Q _____ No O
c. <.U*l|
Lewis
<- DATE (CtoAin) CS , DSJkTM X
(Oty)
23
<Yotf
S. 0*TE CF BIRTH 3. AGc (:n yitfi if UuCct X yzV II aft*r 2^ hr*
July 11,
Ual plrtMtf)
1903 ____ 53
Claniht | Otyt
rlo/ | Mitt.
Ul. $IRTX?UC CA'* cWn UaU or foeaiun J 22. CIT/2CN OF WKA
. . *.
_ J C"WUK?
wnsv&* QQtC Xwp>
Qo*!
14. (.MTjtP'S UASOCH XAME
Sdith Brooks
13. USUAL CCCU'ATISH (M> if reUna)
| If. Cfitiii Ctowrlty No. 27. l?lF0*.MA*r
ShiDnin-ir clerk
1
Kary Thompson
------------------------------------^---------3------------------- - -
aiSdiCAL CWflrJCATiOH
13. CAUSK OF OCAiH (EaUr aaij ow nun par liao tar (x). (b) t (a;j
PAW 1. Duth vi cautU OyS
lT3)3Wh7'*V> S^shiii^^tSpha Ave.
HTWMt CCrCN Oiiset Aoa curx
IMMEDIATE CAUSE <a)
^tja^.ojsi^^en^zalizj^v^JuIsQiiai^.
CM*itta*l. II *
DUE TO <*)-
tua ( <*>* "Pl
(a) Ia(Ja '*ar*T* j
** (art.
j oufT0 (e)
Cor Pulmonale ~
__ ; - -
^nadgnalja.ce.r-J^t3ufigggrrhngg.
-0J//G
PAflT II. OTHU SIGNIFICANT CONOSTiONS (etatritLiiao Is dt(n M not reli< to th Umuiwl 4ia* gi** In Port 1 (&})
r.t&a7. WPaEs^CaHuMtop3sy
ihq
20a ACCIDENT SU-.ClOE XCM!- ZCk. OESCRIBE .ROW INJURT OCCUItBEO.
CIOS
a______ o
2de. Tlmo of
((MT, tfqalh, Ooy. Ys~
m.
E.S.T.
-wi\jw ?<y-(u-r.-)
!ze*. place op wj':3r_ (<_.
rroft O Hoolimow Q | firm*. t*rcn. fxclc^.
ie.
I 5f. CITY. QOnOUCH. TOWNSHIP
COUNTY
STATS
21. / hereby certify (Aat / nttended the d*ceased, /ram
Mnf i Nl( onto the Geceased
alive on 1/23/57
^...... ont that death occurred at 3.+5.Q..A .frro_m the caxizes anti On ffttf d<tfe tfdtc/I abpre.
22. 4lGNAj,UR
y). or
22A AODREsi039 DeKalb St.
22e. OATC SIQNEO
zu. auiA^jJcftA'noN a| REMOVAL Q
Worristcran, PqnTta
1/29/57
21>9c.SN7AMC^SAEEcoOuUciasfe'Ti'nOyvViBSwYKro'rc-Rtey
UR J2JJ* LOCATION (Clf. Rora^ Two. & Cowntyf fSUta]
Methodise}. Honeybroolc. Chostior Coui^Pa
2t. OATS RCC'O fit 25. REGISTRAR'S SIGNATURE "ec- 1-2S-S7 Julia Me Kennedv
` 3c- SICKATURC OF FUNCOAL DlRSCTON
ADORfS^
D* Hae Boyd, IJorristown, Pa*
....... ....................... ................. -
-------- ----- ------ -------division Ot Viral SiaiWi^.
< accordance with Act 66, P.L. 304, approved bv- che General Asscmoly;June 29, J953
(Fee for tr.is csrtiitcatc. S3.00)
WARNING: It is illegal to duplicate this copy by photostat or photograph.
! NOV i 3 1381 Date
II >:t\i A. -. .. No.
Charles Hardciici State f'.cjistrar
.ivs.zaio--stfte--9.53 o!i.V, _.L62-ii3Q__
f'(Vjne''TeT) C';rS't'Tr'tr tT" o5HcNwt&t:r<
oefartment or he.si.th 0I-/:S1CN OF VITAL STATISTICS
CERTIFICATE OF DEATH
Pit tta. 15SSO Rtffltbrtd N.
a Cawntf
------------------------------ Mcwt
Iff* *4rnMin)
*-Sut` Pa.
A. CoatMlf
Morristown
6 Hrs. hS .'-G.r.s.1
4. FVJLL maM ill HOT in.liotg<UI-gt*> >t/wt itfiwl
]_
1 HOSPITAL
*M
,-- .
^ r*sr:ruTio* aacrsa Heart rfosmtax !
. 1* P(e Of Oeotii * MumeipeJilr LimileP "?
^tasc-Lstgan_____________________________ -- ,A Stmt ,Udnu or Lc*tlM v 4 ^ --. _
Main Sc Barbadoes e. it AtiiUAi tottot MAk(Miitr LimiUP f- U Rt*4tMc cm a Far
v,, a
x. a
*
y. name of / OECEa5EO
y
5. SEX
(Fl/U.)
3. { Middle}
Raymond
6. COLOR CR RACE ?, MaARIEOG HEVCR MARRIES^
Male V.Tiite
wioowcsa OivoncEOG
VztZl
Mb O
T- C
N C
C. <LUt^
Lawis
4* OOAFT6 * OCATH X
iO*r)
23
(Tea/
L DATE CF BIRTH I L AGE (< I-n if under 1 year f IT
za e.
1
July 11, 1903
lutb(UuUyl Moncni | D*jra Ho4fe j M.
JO. FULL RARE OF SPOUSE
11. BIRTHPLACE (Also girt elate r fortlgn 12- CITIZEN OF W>
nor.evnrook Tra., Pa
Ca-XXTRY O^A
13. Father s name
14. MOTHER'S MAIDEN NAME
George Lewis
dith Brooks
17. USUAL OCCUPATION (ni if <tU(*4)
IE. Social Sveuftly *(. 17- informant
Shipping clerk
Hary Thomson
x*nli-Xn ^arey riagnesia medical certification
13. CAU$t OF OCA'H (Enter wly one avn Kf lino for {4}. (b> A (ejJ
PART L Dilth vii euiei by:
I3li KaSh35^Si AveTtawnlnsxovn -
r*Tca*w icrvet OSSET AMO CUfh
IMMEDIATE CAUSE (4)
_A&bjesx.o sis.^^&n.eziali^s^_iaiImQnacyL
CMitfJtiwt*. W **T. v*Mh] qU- to fbv.
m rt< U umi <uu|
,c;
(a) lining in* wMtfif* f
lag cant Urt.
Ji OUETO fe)
Cor Pulnibnale ______________________ ' jDucdenal__uicer--Hj.bXJIgjnacEkag
*0 'T/j
PART II. OTHER SIGNIFICANT CONDITIONS (cMiriMU lo datii &ol not related to (te (UMiiui mm rtm U Port t (>]
19T. fWipAeQrS>foArRUemTeQddri;
204. ACClOENT $V1C;0 JIGMI- 20b- DESCRIBE HOW INJURY OCCURRED.
_______ a
ClOE
20c. Ti0m* e
(iavr. n.
es-v.
Oar.
M. *C*JURY OCCURRED
20*. PLACE OF INJURY
201. CITY, 30R0VJGH. TOWNSHIP
COUNTY
IVfhii it
Net vpii#
____ tiA Q atvop>
home. farm, factory, tr<. ete.>
-XtZZfcfr. :tl. I hereby certify tttmt J ctlcrtacd. the deccased, from
jx
/___ , 15....- to .......... I/laf / toll Mw lAe ScCMIftf
STATE
ally, on l/23/o./.
.......... end (Iras death, neevrred <*( j.;.5Q.~p 5-5T. /rom Me catt^l and on the date tt&teA gbqpg
MU, or 0.0. 22l. ado*esq39 DeiCalb St.
22c. DATE StQMCO
25a. BUMAt/rr CREMATION Q; REMOVAL fl_________
oI1F.VrF-Ac4stWr.uiA. ^m.irloorm^tnw1I n23a....
lamia.
LOCATION (C;ir,
~~L.
1/29/57
T-.- 4 CmIj)
(SI.il
1S57 ^cnevoraolc Methodist;, gonevbroolc. Chaator Cour^Pa
1.. date recd by fas- registrar s signature eo. 1-25-57 Julia U. Kanaadv
16. signature QF FUNERAL DIRECTOR
ADDRESS
D. Rae Boyd, Morristown, Pa.
IVh
*. th< ____Lp-
*_ nrv^im.i'n ur nt^Llh division or vital statistics
si*e,r.t*N.
0bU502
Pr<wr* Xr- H-t, S<* .
CERTIFICATE OF DEATH
KNntnr i No
PLACE OF DEATH
. cut. YUiACt. C* iOCa'iOn
Cincinnati
i. USUAL RESIDENCE ' if inr*K-l *** :i
-ii <fme ortffr iJ*iitiufl>
Onla- STA<________________________
ceowrr
mailton
LCHCIK Of DAT IM 111
r. onr. viUACt. ot iocaTiOh
______ 2 days !
Lockland
*HJOMUITCatf Ol r// . terfini -- *****>>* K>*i *44***tt
Nlfirwnoit
_ .a.h..
t . _____________
. IS MACE OP OCAPf*
CUT UM*rjy
i. intfi itouii
500 J^2S5i0g_.Ayflua,.
. is sesiOCnCE nSiO* err
, I. IS ftCSiOCKf OM A fA*
rn wo l
J. NAME OF"
hc
Middle
Tta f]g Lite
no i
l. OATf
UJ
ws
Ui7
DECEASED Ifvrt ot rii^ri
Clarence
Rolette
Q ofaim
-Julj
8
I960
X. SEX
. COlOB Ot *aC
j NAgtifO XI MTrH MAtttCO i_l #` OA%t * ,rrH ; * f51
"'*"*11 Ue*r I Tree . It 4>iw |4 i
| imti
* ------------------------`
---------------
Male
White
10*. USVA4 OCCUPATION *Gf **** t! ***** W/i iOfe- Cl*9 Of BUSINESS OB lN0Wi**r* It. BiftTHriAOE rJVr# * rr*a** ; tj/CITitEN Of
---* -"<. *-- * "w j(Tirin/iT\g^A Ineulation)
; *. couM.fr>
Laborer
I : J lr>ll J
I Prr: li n Tarav Concarry-: Kentucky
14. KOMI'S 44AIOBM KMC
I
JISJL
-Isaac Hulette.
_Luella.Xaab-
I] -4* OCOASCO I^tt 1*1 . S, AMID K)tai
( l. SOCIA1 Ifoam HO. { if. INFORMANT'S SIGNATURE
*<(*
*" *<**'*>. *7/ 7*`. vt* **** *+4***t/ 4tr*K*f
___ %
Crestbrock
ja.
; 270-05-^300
CAUSE OF death 'ct;Tf ;<y ,'u jur <r (>. it),
ABT I, DCAfM Was CAUSCO V*-
fr*
/
irJJTJ Hulatte
^ e
.i t i T - stxr.wftK . Onset a*o opath
(wtOiAtt CAuSC .el
C*****i*+
* 1 Ouf TO t*j ^
!.
k`M/4
e.l la I
AMie*fMC rI'M* <ei. 1>
'`
' '-
----------------
l;#i ***** >a.i. J -
!
H1 II Ovta|te fMetucMl^aeinee* Caetaittf.M . pufa I <* af afuni re hi Aiaiau' imimi cm* > cr* m> #ae w*
1 It WAS AUfOnv
i ZOm. ACCIOCHT
SUICiOf
KQamOOE : 304. OBSOlBB MOW INA/BY C<
______t y\ *q r r
ere u i
73c. 1|*ME CP /if.*A*t. M*m+. Del*. rc^e
p. Al.
- -----
SON. INNIBY OCOltfBO
. 70*. PLACE Of iftJUM >*..** ** Uj(
V
Went AT r<| MOT WMHf , __ t WO*C -- AT 1
f**m. ;a*!9*i. lift**. *fit* IU(.. if.
71. I altP^aaMAa 4f^a.a2 f^el L ~ l 1'/
7^*
O/eff rrt|l*N W
----- fl^V M H # iN ! T,..-' /V ; N l# IN Niftf At >MtWt/rr. r;to ftP
rlSt. 0*T| S*CN
i U. IUII4A. CB*a ' SA. OaTC
f*PN. 'Ntuti*
[
i burialJuly 12,
)4. fAM{ Of (MAU>tt
___ Thoaae
Wat_3on_
J, fWt*N l"li'AW& AOOttU
">L> g
a/Hc. NAmS Of CEnTEt Ot ClCwAraiV w
/ 73rf. LOCATION
iL<n. btii, N .Z^a*Z i VJtr
*f
19 60 Oak Hill Cemetery
j.-- GlendaleAM a
IUC. KS.I
S3. fiMtUl OUECTOI S VON^rMC
___
-5I22A-
* / - / c i,~- <_
r^.._J*225_____________
(SfBECT NO.J
torn
[STATE)
Vorhls FuneraX^ffocea, Inc*
310 Dann St,
*19;5t. c^CGTSTBa* S SICNAfUBE ZI j= - CslJ^
,^
lockland
77. SUB^ICi3TAjB S ScCNATUtC
Ohio
OHIO DEPARTMENT OF HEALTH
-*x.
-
^r^niri Hr. f
DIVISION OF VITAL STATISTICS certificate of oeath
Son- f.l( N* --eS7525
HMiritif t Na
PLACE OF
CCUWrf
riamflton
. I. USUAL RESIDENCE .wk..,
I
Ohio
TeZZ'^^on
err. viiIaGC. o>
Cincinnati
l r. UNCTM 0> STAT in * i C. 071, VIUACE. O* tOCAfl^N
j I Wyoming
c SS<2f ChP rknist9*t**i *Hr ospit(afrplitwsrt WV'Oi/
, trmf admkss
624 Vine Street
# (1 MACK OP MATH (MIIQE C1TT (MUW
*. *s ustocNa msiM cm uiis>
I. IS tfSICf.CT On a
x: -O ~
3 NAME OF
oOrEtEKCCOEEcAANSstCNetpti
Herbert
M.UJ1C
Lewis
n ~! i.o^_________
u Gooch
. 4. OAK
| oowrn
-o*
M*ma
l;it
Aug,15 I960
3. Ml
Male
. cotofr ot act : 7 maiuco vj ncvcb haimip 1.. /Tf J ****** . acb tty
; Colored ! wi0owro*
z 2/28/1397 ""63--
| Tlw u
*0m.
OCCUMA1IOH^f..-*f */* if **V#ri~T0fc. CnO 01 IVSlNClS Qi'iNOOSr**' H. atVTHNACX
LaVSVSK
; x raiM( s nm*(
.[PUJhL.iLl.Jl.iJp.p Cuaairecjyr Cuuo -----------iag IpaxiiAtlon) --
TOFfi'ersville
4. MOtNCrS ma<dm V<Alif
"
Kyi
IJ.
OWTNHIWCOCVf MIIVI
Alex Oooch
Susie fiewe L
; '"`s'ofciisio |VI .u u. 1. ttmo roicff
; u. soo Staiiin NO. 17. INFORMANT'S SIGNATURE/^ '
" Tfeg
~ 'Wyw; O&e- Ji
;270-Q5 -1023 &x^r-=-vL
*. cause Cr death tJHtt pair
| ma 1. ofAt** was CavSCd t,
I tM0:*IC Ouse it
ii # itnt ft
Ii _
Ovtfr
4gr c
;
f 4*i 1 Ou< TO <b| <
r^ip* |# <*# .* I
j"jt+rt tmmtw (pi >
u*/f*f Mrr K*4 f.
Prr<
;
CV
TO
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