FEAST AND RIDDLE NAMED) ALICE
U51 was Tomca-

cuumvopusm KING

DAVE DFDEATH JUNE 21, 2M1

HOUR or DEATR 11:" 

sax FEMALE AGE 
SOCIAL SECURVW NUWER

HISPANIC ORIGIN N0, Mm 
RACE WRITE

Elm" DATE -1M
BIRVIFUACE CENTRAIJA WA

MARITAL STATUS WIDOWED
stIsE NOTAPPLIOABLE

oocuPArIou 
mummy summon
DEGREE
NO-

wsoamm 

ADDRESS
CAUSE or DEATH 
A. DEGEIIERATION OF THE BRAIN
mam YEARS
E.
INIERVAL




INVEWM -

OTHER CONDITIONS CONTRIDUTING TO DEATH mam NIP mam: Du: 
DLIINT FORCE KEDING.
NEOPLAEIA of m: MOUTH

DATE OF INIDRV JUNE 01. 2011
Now or INJURY atno AM
WORK UNKNOWN
PM a: mum RESIDENCE

or INJURY mu MLITAKV ROAD s.
cm. STATEZIR SEATTLE. MIDI

comm KING
DESCRIBE HWINJURY accuRRED FALL OUT OF RED

IF MW mm NOT APPLICABLE

CERTIFICATE OF DEATH

 

3


PLACE or DEATH HOSPITAL
rAcIIrrv OR HIGHLINE MEDICAL CENTER
cITv STATE, ZIP BURIEN. WASHINGTON 

--
cIrv swam 

INSIDE cm uuns YES comm KNG
RESERVATION NOT APPLICABLE
LENGIHOFYIMEAYRESIDENCE SYEARS

FATHERIPARENT WALTERWAGNBI 


mun UFDISPOSMON 

PLACE or DISPOSITION

cm. STATE LAKEWOOD, 
DISPOSITION DATE JULV 0mm

FUNERAL rAcIuTv EIWIIARDs MEMORIAL CENTER

ADDRESS anus BRIDGEFORT WAV 
an STAIEJP UNIVERSITV PLACE. WASHINGTON mu
FUNERAL DIRECTOR JAIME N. NARTEN

MANNER OF DEATH ACCIDENT

Auropsv Nu 

WERE mums AVAILABLE com

mm or DEATR NOT APPLICABLE

DID usE CONTRIBUTETO DEATH UNKNOWN
PREGNANCV STATUE IT FEMALE no RESPONSE

GEMIFIER NAME VARID, ND
TITLE 

:25 NINTH AVENUE Box saw
an swam SEATTLE, WASHINBTOII Elm 
DATE SIGIED JUNE 10. 2m

nAsE REFERRED To No

FILE NUMBER - 
AWENDNG PHYSICIAN NOT APPLICABLE

REGISTRAR ROBBIE GASKIN 
DATE IULV 01, mm