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HomeMy WebLinkAbout2358 - fTATt a M~TM CERTIFICATE OF DEATH 14432~.~ ~ `O"~ • ~YRt/?U pI YITAL RATIfT1Ce fTA?t /ILt MQ '•~•1 tLOIIIDA ~~a .n.~ si T NO R sr~w N. 2119 p r e p~ r l~ ~~awca wTw coo~ Na 2. wwt ~~c~ t wa... w..r w u....r.~.~.~ s..ar. ~..w:.) ~ • a~ e u t~ d ~A~ STAI[ S. COUNTY •"d St. Iucie 6b-02 Fl~rida St. L~de e. pi.~.e - P~~- A. CITY_ TOrM.OA lOC4i1QN a ruct a a~rn t. CITY. TOMN. OA LOCA~b11 t. IS ~ESID[IICE . i . ~oc cm urrt~ c~rv ~wrts+ r,,.. Ft. : ierce .cs No ~t. ~'ierce ~y~] t. ~~rc a ~ I/ w 1. ~wrr.t. r.r ,rr«t Nbs«~ ~ w~1M o~ ~ STA[(T ADD~t55 OM A fAAYI r~;~;~e~" ~ ~ " N rE:O NoD f t. ierce eT. Hospital ~ 1~'~os 2712 So. 15th. St. 3 IMM[ N - Itnt - NI//t L~N ~ wt[ llwt~ Dq Yt~r (71l~ /rfwq r T ~ :li~J :tA:ZI, SCHn~ . ~?TN JULY 23 1961 :.r:_. S SCl S COIOR OA AACE ~ MAAAIEO LIJ KKRYMR~D a~ ~~~R7N !~GE (h Kd~ t~~~R 1 t(A~ {~~p[~~ 1~S !~1! A 1 y,~~y p~ Rww Yr. r~ale whit~~ ,.,~„Ep ,,,,~o Aprii l5, 1888 • t"~> >o. USUAI 7CCU?ITpN , r.~. u•a.~ ra~ a.. ~ Ru~oos luswicsso~ wousr~r N NATIM~~CE 1 tiI~ M~tyA tM~If?~~ t a?~w as .w~i awa~r.r? , • 1 t A p~ /rrt~/ AoN M eNlqf h/r, ~Kn •j rNVd1 Contractor :~eating oc PlumGi - Nev York City U5A ~ Di~at !nk 1~ i~TM[R S M11Mf I MOTIIER S MAIDEN MAIiE ~ ! or - ~ t~pe•r1t~r .:ar.~ua3 3chaiL 'nelen eCohler : ~ 1S M1?S DECE~SEO E~t11 .N U S ARMEO ~011C[S~ 1~ SOCIAL SECUwIir MO. 1 ~IMMANT ~ Mf~MTY~ J•/~ • Yates ~ i ~ Yr. r. ~.~tvw~ .II w. pw wr ~~Yr~ rrwr~ _ E 'vo 0~0-28-21tti0 'r t Pierce Fla. ~ r v n~ r~ 1 1{ CAIM~ ~I ~i/1TM ~ Bwttr wJf ~wt tswt ~e? ti~e IM lAl. sa/ (r).~- - - - INTE11Y~1 ~C'~M~Q- e~r.<<or ?AIITI oE~~Mw.s~.~,sfo.~ ~erebrovascular Accl(~C:it L4~rST~ . IMMEWATE CAUSC la) ~ ¦ u s t f 1 1 • . _ . . - ~ - - - ~ te. c~r- - - . . . - - ` . °,fl~.e. ~.,etl~....;~..,. ~ To ~s~ Post Jp Status from T;:r Yrostate ~lano . t t n tA• aik~ pre sra~ q - - + o c • I ~Aat ta~n (il. p 1~ 1 r• i~ t r ar d~fi~I Ne r~4r- Di0 ?~11~61 ~ s t `e ! n T3 Z l~iy u~~r fuf Oo[ TO (r~ -p . . - - - . . . _ - - . . O ?U1T H OrnFl1 SK~ai[~u~1? COwwip~6 ODIIIMRMG TO OGOTM ~Ur Np~ ~ELA1p W TM[ RRrur~ pYASE COMO~rpM G1YES ~M 1YIt e(~i r~S AU70KY leuure F ~E11iORME0/ ~ t~r d~atA 3 . ~ ' ' ~ ' Y[S? ~ ~ or C~for• ` r~ t I nt an~ ACC~OENT w~~a MOMKIOf ~ aXRI~[ MOw NUIIwY OCCUR~fO fL~~l~r ~~Irrr o/~~)rr~ iw POf / M/'Vt !1 Utw l~ ) ~ " soesf- W ? ? ? - - - - - n ef V 2t1[ T~YE O~ Hor? Vwf~, D~/_ ?'t~ _ d~. ~j nuu~r - ~ V ~ 2Q/ ~~~u~+nct~s~[o mr ?t+~tt o~ Nuv~r (e. a r~tMr. m/ C~Tr Tors. o~ ~oUtqM CWM7Y St~TE MM0.E ~T (1 hOT NMKE ~ I~?A. /~tt~~t. ~trtd. ~~tf N~/.. lrl.) ~ MOwK V ~T MOIIK 4 7 i 2~ ! ~rund~d ~h~ d~wwA/rom 1'10 1 • to -7~2~~ '1 - _ - ~ad bar a~~ A,~ ~h~~ on # o ~ , ,i D~~tA ocevrr~A ~r __Z_ b• OI1 fM ~f~ ~f~f~d ~00?~. •~d t0 tA~ bMf of ~n) ~no~l~AN. f/O~n fA~ e~uM~ ~f~NI. ~ y ? 1) ! t~~• ~~1~IY~Y11[ (Uq?rr p(Yk1 ~ ADWIESS a[. W1TE SIGIEO ~ t.Pierce Fla. - 1-61 ~ ~ ~~•D1i~• • '+:.S. Turner N.. L. 1122 ~ran; e wve., F , ? 3 g ~ • e e ur.e•. ~rinow ZlD p~rc 2L M~YE O~ CfYETEAI OA CAEM~TOw? 23t ~oe~tqN ~ryr. t.r.. r ers.r~? 3 IItYOYaI lpr~//~ . ; ~ Remova~l ~ul 25 l~bl `~ort'~~ort Kural i.e~:gt~~ 'a. Nortnport,l•on~ Isiand ~i.Y. ` ~ T. 1. /~11 j1 ~tN1E ~011 S SK.w~Til~ ~0011[SS ~ W1E ~[CO ~Y WC4l IIEi ~E6rST~l1R 3 SIi~A~11K • 1'~• Joseph :v. Yates, r t. r ierce, Fla. 8-1-61 Anna Lee Uenison, 3.r. f ~ - - - - ~ ~ ~ . _ ~ ~ _ ~5~ ~ dpqt ~ ~ 3 ~ ~~""~"'`ss~' ~ s ` ` ~ ~s; _ • li +r- xi~~ ~w ~ ' , _ ~ _