Loading...
HomeMy WebLinkAbout0399 t.~1~wf i~~~ ~ ~ tTATI ~o~NO a? M~w~n~ GERTIFICATE OF D~ATH ~r roa~ . ~Uh[AU OI VITAI OTATIfTIQS <7A7t FILt NO.___..----. . rLOatpA l - ord •n ~1 Y N RS RA 'f N. 116 P r~~ 1 K~1ti N KA~M GOO[ NO. 2 MWAt A[Ml~MCI : n?... ~..~,r rw~1 1 r..rw... MI«. wr.w.l e a~~ • d ~~UMT' • SY~Tf ~ COUN7~ St. :~ucie 6'- ~loricla St ci~ e. ~ F- - n. - - _ _ 1¦ f- A C~7~ Tp1Y11 CR LOC~T!'JM t iS ~L~C[ pf p(~IM S. CI(Y T01YN.0~1 IOC~~KHI t ~S Rf~~OEMC[ •N• ~M510f ~T'C liYiT5/ IMS'P[ CIT? LIM~YS! f11• , t. . leT'C~ rES~ vp? ~ ~'t~ nl~'TY~ ~7f~ iqq~ ~ M~M( d---. w~f U1 ~M/Y~t. /Yt KrMf MBM+~ t STR~ET .1pfMESS ~ M6YITAL 01i IMSTI~~JTKM F~t. pie^ce M~rm. Hcspital 314 18th St, ~ ~ - _ - 7 IMIIlI i'YU NiMllr Larf ~ p,tr[ 1d~wN~ De/ Ye~r riLL?K~ Oi =na~ d w~, ~ u,~ ~c.~r~ *~arc, 9 F ...EtiZ...~~ - _ SI1( ; 6 COLO~ OM IIACF ~ YARAI[OV MFV[~ YAM~IEO C~ ~~Tf O• EUTM ~ 9 •4E R~t ~ U~f1~ 1 1'UR «q~/ M 1/4 ~ 1erlli~l'1 NwNr. D+N Nwn Yo. ~ Male ~Jhi te .ew.Ep O pY011'f D Ai~ ? 5 1 P 86 _1 7 8 __L_____ t , , ------1---- - _ -~''~--__--s.._-_-_ _ - Ip~ ~SU~I :XCU?~TqN :l1W !f~! o/rmt `rwt ~Op Rn~ooF WS~nESSO~ ~M[+~'ST11Y 11 s~~r~+~c[ yrur w h~sy~ r~u.f~~ I rn~aw ~ r?w~ wxn., • f t P f: r lr.fiy w~M ol rmAMH !~/t. nrw ..caa~ , • (~ner~(?~rator ~ r~,~rnitur~ ~~tore ''ennanv • ,'r'A el.e snt - -~f~~i_ac.S'i~_ I~ lliNflt S 1111A[ 11 YOTf1(~ S YAIpiM NAME . • •t~•• CTtto ~tly,~3~~uL__ F:~estine 'Vee!:e - ~ IS •fi3 OECfASfD LVY~ ~M ~ 5 ARYfD KMC[S' 16 ~QC~~L SECUIIlT~ Iq 17 MIidO/I1 ~ MrMATY~~y ~~~~r17 ~ i i".+ r s wr1.~.a~ ~ i~ w~ Fr w. r i~~ rw. No 469-01-6~51 ~~r.« r- - ~ ; - . ~ ~ rue. ~i ewvs~ w isArM (Llu.. +idr.w. c.... tcwr p. u}. l~' •.t~ ) ~Krc~r~11. rrTrrtcM ~if• TsI ~~~i1 Of?TMN'ASCAU4ED~Y. OMS[TAMOOFJ~TN . u. ~ t~• ~rrco+~TC cnux ~~1 ~Q2Yk1dI~l . JCC~.US 1Ci1 t~? .r- ttit - • ('owlur~w.~fMr. OVE TO tA~ i F?W ~;''4~~ui?~ rt6! r• s~ik1 y~r rtq to 1 1 • • 1 rnar (~1, f ~Iriy rRr K*/tr- i r ~ j i • ~ tI1M aa~r t~+ ~ Wit TO ~rt - - - - ~ - - ~ _ . . . - - - ~ - - - - - - ~ - - - ~ •t ce ts ~ - - _ _ _ IAitT p'f/~F SIiN61CMT tL~pTlOlq CAIRryR171w1 K' dUM Rl7 1lD~ IKU~~ID fc *Mf ttMflrMt 01fltS[ fANO~'tCM GMtIl~ PIMi ~t~) W~AUfO~'SV \eM~ •C- 1- /[RfO~MED~ t~t 'Ath or p oro '--'._-'~-.v-__.- TLS~.~ MO~ ~ El~ ' ~i t7ESC~tif H~'w -M;v11r oCCUMAE D h`e;rr w~rrr o~ ewJ+~r~ M 1'~•1 1 a Rrf /f f{~A~f tj' Yikl ~ •ny FCCID[~T SLK;OE ?~OwK~p! . e n o P ~ - J ~ - - - - _ . . _ _ _ . _ _ _ _ . _ . _ - - - - ` - _ •~dJ Xk T~rf as Hwr Newtt, fhf Ym ii-': ~ tRJl;11Y C. ~0 _ ~ . ' ~ • 4 : . . ~ ~ I[1/ ~MiURr OCCURAFO T$k /l~[[ Of iNl'~~F+ ~r M a~ s~a~.t Lo~. ~Df ~.-~TY. Y(~N CM ibCA71pN ~~r;- -~`(Z7yMTT ~ S1~T[ ~N~ll ~T +rC~t wN~~E h+w. f~et~•~ M~rM. o~l« hlp . etr ~ ~ YYURK J17 w'Di~ K ~ ~ _ J` _ ^ r 21 / ~ft~ndsG tA~ /~r+~s+d /rom~ry - - - ~c _ - - ~r~d i~~i wr h ~Lt~r~ o~ . D«rth ocourrM ~t ~~~5~...- m on tho d~N ~t~t~d ~bor~. rnd ro tM b«f Otj ~.flpMl~~ I/[Yf71~tIV~,G~Y~ I~Olpd ! 1 ) , t s t • ~ ~ ~ ? 12e M~IMTYK (!Mf'n :~~{t;---------~- 22! xOL~?ESS . ~ ~ a;?~[ S~6wED •t• 0 1• . e•~t ~e. a ~.!'Q. ,:3~~C}l ~ T~*. ''lE'*`C'F? rle~~ }/1 ~ /~S aet~ +.t~. Z30 ~IJIF~~4 CM.Y~Tinn j3y p,ltE ' ZSr N~tlE i>f ~Cr/[`F~'r 01!CRf V~1/1N~ 2'S/ l6CAT[!A ;1'1f/. lw1~M. eY PO~~!!~~ iSPY:tI IIE 4q4 LL; Vpf c r; ~ ~ i Burlal ~ 3!a~~FS ! _Ft. t~' ' ^ * ~ ~ rt. ~'~~~e r'.;~ri ~a .I ~'C CJ~1 f . - . _ ~Z t..`~. .~II~ :.~T 1 _ _ _ i _ _ . _ P.' .'Eli t~ fUMf11Al 6i~~iR SS~~~?7.Rf ?7fN1 S ~25 D~T[ R[C-~ St 10Cf~~ hE~ Zb REGtS~A~R 55~G71~T1:11E ~ ~ 1 ~L ~ ~3;,,; ` r ~r'=.•~ 3...~~ ~ ._~~j'ni ~ ~e, P~6 ~"4~ + ~.'r.6. ilF: L'1P a i / c~ ~i: a'T...~dr~ Z ~ _ . ~ - .r l, hb~qb~'(~rjtiTy_this to tx a true and correct copy af the l.ocaJ t~ f`~ , R~ ~~tra~s• I~r~on fi~e in the St. Lucis County H~sith D~art- , !r~t~it Fort.Ayer~, Florida. ~ (Warning: No¢ val~d uniess ; a;sed ~e31 ~;;f the 3t, lucie p fj~~:Q ~ " , Coi;ri~y ~ Health Departme^t is afr~~ed.} ~~~"E~ ~ B~OK ~ , . . , ' N. D. MIIIER, A1. 0. ~ 4 ~ ~ , 3Z ~ ~ ~ ' County Health Off~cer $ local Registrar ~~5 ~~~Y ' 7 ~ 1 . ~ ~ ~A. '~~M~' ^nC r~F~K i ~ 6~1s De~uty local R istr~r ~i i~t+~, ~ ~ . ~uc~E cauNTY. ' ~LORIDA ~o~~ ~.18 397