STATE OF COLORADO
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File No. 8732
Town or City: Mount Massive Preserve
Full Name: Rudolf Gustav Wernicke
Length of residence in city or town where death
occurred: 0 Years, 7 months
How long in U.S., if of foreign birth: 55 years
Color or Race: White
Single, Married, Widowed, or Divorced (write
the word): Single.
Date of Birth: October 20, 1918
Date of Death: February 28, 2009
I hereby certify:
that I attended deceased from June 4, 2003 to
February 28, 2009
that I saw him alive on February 27, 2009, that
death occurred on the date stated above at 4:11
The principal cause of death and related
causes of importance were as follows:
"Heart failure due to advanced age."
THIS IS TO CERTIFY THAT THIS IS A TRUE AND
CORRECT COPY OF THE OFFICIAL RECORD"