STATE OF ARIZONA 

DEPARTMENT OF HEALTH SERVICES - VITAL RECORDS SECTION 

CERTIFICATE OF DEATH

NAME OF DECEASED- Nathan Ford Clark

SEX- male

DATE OF DEATH- July 3, 1978

RACE- white

DATE OF BIRTH- May 31, 1899

PLACE OF DEATH- Maricopa

TOWN OR CITY- Mesa

HOSPITAL OR INSTITUTION- Mesa Lutheran Hospital

AGE- 79

WIDOWED

STATE OF BIRTH- Utah

FATHER'S NAME- Nathan George Clark

MOTHER'S MAIDEN NAME- Esther Ford