...Not ripped from
today's headlines. Not based on a true story
gentle
readers, but a reality based on a true
fantasy...
SPOOK STORY
STATE OF CALIFORNIA
CERTIFICATION OF VITAL RECORD
COUNTY OF ORANGE
HEALTH CARE AGENCY
1719 W.17TH STREET-SANTA ANA,CALIFORNIA 92706
CERTIFICATE OF DEATH
STATE OF CALIFORNIA
USE BLACK INK ONLY/NO ERASURES, WHITE OUT OR ALTERATIONS
STATE FILE NUMBER_______ LOCAL REGISTRATION NUMBER 3 199730
010015
VS-11 .REV. 11/96.
1.NAME OF
DECEDENT-FIRST(GIVEN)---2.MIDDLE-----------------3.LAST
JOHN------------------------------------C.-----------------
------GREGORY
4.DATE OF BIRTH MM/DD/CCYY-5.AGE YRS. IF UNDER 1 YEAR IF
UNDER
03/06/1911---------------------86
24 HOURS---------6.SEX---------7.DATE OF DEATH
MM/DD/CCYY--------8.HOUR
--------------------MALE-------------08/11/1997------------
----------2153
9. STATE OF BIRTH---------------10.
SS#.-------------------11. MILITARY SERVICE
--VT------------------------------XXX-XX-XXXX--------------
---------YES
12. MARITAL STATUS---------13. EDUCATION-YRS
COMPLETE---------14. RACE
MARRIED---------------------------14-----------------------
-----WHITE
15. HISPANIC-SPECIFY---------16. USUAL EMPLOYER---------17.
OCCUPATION
NO-------------------------U.S.POSTAL
SERVICE-----SUPERVISOR
18. KIND OF BUSINESS-------------------------------19.
YEARS IN OCCUPATION
U.S.MAIL--------------------------------------------------2
0--------
