from the Death Certificate of Kathryn J. Brenneman

date of death: July 16, 2003 at Wooster Community Hospital-CCU, Wooster, Wayne Co., Ohio

birth: female, June 17, 1927, Alliance, Ohio

marital status: married, surviving spouse James Brenneman

occupation: customer service, retail

residence: 129 E. Vine St., P. O. Box 662, Wooster, Wayne Co., Ohio 44691

race: white, non Hispanic

education: 12th

father: Alva Manning Stickle; mother, Lydia Alvada (Boston)

informant: James W. Brenneman, [address as above]

disposition: cremation; C.R.W. Cremation Services, Canton, Ohio; date: July 21, 2003

signature: ___________________*

facility: Custer-Glenn Funeral Home, Inc., 2284 Benden Dr., Wooster, Ohio 44691

certifying physician: To the best of my knowledge, death occurred at the time, date, and place, and due to the causes and manner as stated:

time of death: 5: 01 a.m. July 16, 2003

referred to Coroner: no

certifier: Don Molnar, M.D., 546 Winter St. Wooster, Ohio 44691

immediate cause: Sepsis 2nd to C. Dilf* Colitis; duration 4 days

due to: Respiratory Failure; duration 4 days

due to (or as a consequence of): Renal Failure; duration 4 days

*Note: The writing in these places could not be read.

Provided by Betty Latta Kitchen

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