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REGISTRY 0F VITAL RECORDS 1' 
 .3th 6 53* 031888

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STEVE E. BETTS MAY 29 .2003

II

BROCKTON BROCKTON HOSPITAL

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9 
URN EPA

30, 2003



1 9 2015

51% 
C. Sousa 
Registrar of Vital Records mid Statistics

I. the above signed, hereby certify that I am $16 Regi?arar of Vital Reconds and 

that as such I have custody of'the records of birth. Wage. and death required by law to

be kept in my o??ice; and I do hereby certify that the above IS a true copy from said mcords