PROVINCE OF BRITISH COLUMBIA (Conada) DEPARTMENT OF HEALTH Division of Vital Stotistics Deceaseo _ FREDERICK -0.-A.._ BURNABY GENERAL HOSP’ PLAce oF DEATH BURNAB: 2031. EAST 12th AVENUE ReSiDENce = Eee JOCCUP ATION. ee ‘DGEMAN. an ae rrnetace| en angry REGISTRATION OF DEATH a snes Torco aT Bre |TE Wat 80-09-003. eee |___MALE “TAL, sth 2 Eee yes YES_| Bc. andr Bll olen nes oT le ‘qT = an FATHER | ALBERTA eee ae NOT KNOWN Aba Aye MIU AY. boTHeR NOI_KNOWN WIFE _ INFORMANT [nirataetew at Montes tea a 12th AVENUE, VANCOUVER BC FEBRUARY 15, 1980 FEBRUARY _19 1980 pisrostrion /ANCOUVER, DIRECTOR CHAPEL aL MEDICAL “CERTIFICATE OF DEATH (Sone SR Eerste Dare oF DEATH Acute congestive heart failure. Possible viral myocarditis. Use BLUE or DEATH [Fring ni Joma: santicns, 9110 NeMicros & toxics. chk é VOICE ui at Taseae Fotis) Sunoica, in dn af epbalon oPenATiON CATION Gitonding Piolelan,[s7sNeos ot ayia Dianne ¥. Messier, Corener a DO NOT WATE BELOW THIS LINE — OFFICE USE ONLY ceRriel. cation OF REGISTRAR Eigen of Binet Rog