HomeMy WebLinkAbout0323 TAIa e.- ~vAY~ /OARD o~ Nrw~rH CERTIFICATE OF DEA~TH -t ~ y~ ~ ; ~.:3 ~ >~il.~fiu,1 ~E..-
eo~s• • DUR~/?U U1r VITAL i7A71f71C~ STAT[ FILt NO.
1ea•3 FLORIDA
ord ¦~e~ BIRTH NO. RCG16T11AR'! NO.
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le peI- A. CiTY. YOWN.011 LOC~T~OM t. IS KAGE OF DEATN t. CITY, TOWN.OII LOCATql1
~ •~A~et tMSIDE TY LIMIT51 IIfS~or~ ITY LIMITS~
riy.. Fo2't PieY'Ce YE5~ «oD FOI't Pier`Ce resE9 ~a?
I. MAYE Oi Mf h ~Mpild, /iN Itlttl dlnN) LEIIGYN OF STIIEE7 ADDIIESS Of1 A FAIIMI
NOS?ITAL 011 Y Id YES ? MO y~
IMSTITUTiON 701 N. 19th. Street ~rs 701 N. 19th. Street
3 MwML r• Firu NWk L~st 1. D~TE ]1iwu~ Dat Y'ca
~~«mr,u> Zack idorris ~T~ lt 6 1960
~ S. SEJI 6 COIOR 011 IIACE 7. M~I1111E0 ~p,{ MEYE11 MARIII(D CATE 6F /IMTN 9. AG[ (I~ yttl! I 1'F,M {IwC[~ I~ MS.
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. i c. :~Iale Negro rnoowcnO avo~ctco 3-1].-1a9~ b~
~ 1 a L e 1~ 10~. uSU~I OCCUI~Tq~ ( a1K ki~1 e/rak I~ne IOD. KInOQi ~USIMLSSOA INOUSTIIY I1. iiRTNhACE (31fft a Jaslfw as~~tr1) 1. CR~Zfla 0~ ~MT OOUKtf~Yf
vit?a }~r- ~trfwl yr~rti t~/t.nrwiJ+etirtlT
.~~.p: ~arm ~aborer Retired Georgia U.S.A.
ll~~k 111k ~3. fATNEII'S NAME 1~. IWTMER'S MAIiIEM IMME
Of
crp...?~.. George Morris Unlmo~rn
ls~ WAb OEC[AlLD EYE11 IM U. S- ARM[D RONt[Sl i6. socuLL sccu~irv Mo. t7. n~ s u~+~?*uru ~~lyn Jenkins Morris
1 Yr. r. ~r wJwwl l!J Aw wr ~r I+4~ ~1 ~..nw7
Xes World War # I 18-~9-1~26 ~~w 701 t. treet
?un~ r~ 1 1~. C~Wi ~I KwYM (bbin MlI au nwr yn !(we 1+~ (o). ~I (r).~ IMTEIIYAL ~ETWEEII
plSET AMO DFATM
ai..~cor •~~Ti• oc~YMw~sc~usco~r: Unkno~in found dead at home
•Y~l fl1• tMM[WAT[ CAUSE ~S
th• ~Iatural Causes
t! f i e~ t• C~~~(pu. i/ p~. ~ p~ TO (D)
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f 1 t A 11~ 71 O ?Al1T 11. OTIEII SIi1YhCAMT CAM01Tqf6 COMiA1~1lf WG TO OG1Tl1 FR MDT RE1.~7ED TO TNE 'RRYNIK OIS~iSE G~1101770N 6Ni11 11~ ?MT 1(~} . ' .W A'} A
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~ 20/. t1UU1lY CoCCURREO IOt. r6ACE OF IMJUf1Y (e. fe~ M~faW ?lMt. YD/. GTY. TOWM. OR LOU110M ~ C04M7'r STA
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WO~K AT MIORK .
r 21. ! attrnd~d t!w / en . to ~fld INf N~ h,~ a1ir~ on ' ~
DsafA ocaurnd 8 • m on fM d~te st~t~d ~60+~: and to tM b+af aJ aw kno+~i~dN. !?oar tM wu~ at~t~A.
111 itor~ WO~~y~ (Q~pnalYk) t2D. ~~0~[53 ?Ic.OATES~iiNEO
ar• t•
~o•vlie• • E.p. DeFriest Peace Justice 221 S. 2nd. Si~. Ft.Pierce :la -$-b0
•0 C Yf L~. M1N~JL. ~TI011. ~ DATE n[. IIAME 0~ CEME7ENY OR GREMIITORY Z3/. LOCATIOM (L~f/~ fM/!. K COYIUI) IEl~1t)
oe~rqo (srK+n~
Buria"~ -10-60 Genesse Memorial Fort Pierce, Fla.
Y. 6l ~ 24. FUMEIIAL D~ 911 ~S S~GMATURL AOORE54 TS. DATE RECD. ~Y lDCA1 IIEG. 2~. REGISTNAII'S SlGMAtURiF
~ Rsr.~oee Curt~s E. Johnson 718 Rve. D 1t-8-60 Anna Lee Denison, d.r.
;
' ~ ~ ' ` ~ r-IL~~
'.I hensby tw7ify fhis b be a trua and cMract cony of the lxn: ~ z..r ~ ~i E C
RspistTar'~ iacord ~ir± ffb in tfie St. Luci• County He,lth Qepart- . l.`~ ~~~i~+~. ~~0~,~~ ~K
rr~i~t at Fbrt Pierad,, Florid~.
• (yyarnUrig:" (+iot valld unless raised x li ~ f the St. lucia
• CauMy Heaith Gepartment is ~ffixed.) J~ ~ y Pf9 2~
.
N. D. MILL~R, M. D. i e~i j ,
~ . , . County Hea(th C?fficar & local Reyistrar ~ ii G ; , . ~ , . .
. ~-~_ciZK
- ' ~J~Ic COU~~;TY,
l 1, ~ t Fs .(y j .c_. ~+e.~ t~ s.~, Q R i D A
py,~ pop+~ty local Reqistnr d•.- .
'~r~ 500~ ~~1 ~I i
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