State File Number 101
DECEASED-NAME Henry H. LAURENCE JR.
DATE OF DEATH-January 26, 1992
COUNTY OF DEATH-Jefferson
CITY-Birmingham 35205
INSIDE CITY LIMITS-YES
PLACE OF DEATH* ST. Vincent's Hospital
AGE-84
DATE OF BIRTH-October 18, 1907
DECEASED'S SOCIAL SECURITY NUMBER- 422-01-6111
EDUCATION-9
MARITAL STATUS-Married
SURVIVING SPOUSE- Rosamond STEINER
ARMED FORCES- NO
STATE OF BIRTH-Alabama
RESIDENCE-STATE- ALABAMA
COUNTY- Jefferson
CITY OF LOCATION AND ZIP CODE- BIRMINGHAM 35213
INSIDE CITY LIMITS- YES
STREET ADDRESS 4389 Mountain Dale Road
INFORMANT-NAME AND ADDRESS- Rosamond LAURENCE 4389 Mountain Dale Rd. Birmingham, Alabama 35213
USUAL OCCUPATION- Accountant
KIND OF BUSINESS OR INDUSTRY-Accounting
FATHER- Henry H. Laurence, Sr
MOTHER- Viola Johnson
DISPOSITION OF BODY- Burial
DATE OF DISPOSITION- Jan. 29, 1992
CEMETERY- Valhalla Cemetery
LOCATION- Bessemer, Alabama
FUNERAL HOME- Johns-Ridout's 2116 University Blvd., Birmingham, Al. 35233
FUNERAL DIRECTOR-Bower
DATE SIGNED BY FUNERAL DIRECTOR JAN. 28, 1992
PHYSICIAN- Dr. David Barnes
DATE SIGNED- 2/3/92
TIME OF DEATH- 11:50 PM
DATE AND TIME PRONUNCED DEAD- 1/24/92 11:50PM
CERTIFIER LICENSE NUMBER- 11427