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HomeMy WebLinkAbout1090 . • R~e~~s.s ; t 3440 ~ r~~. ~r~n ~o o~ Mw.TM CERTlFICATE OF DEATH 44a9.~`>R s~~~• a N111iA1! OI 111TAL RATN*ICf fTATt ?ILR N0. l.j.l...- TLOitaa .re ~r~~~tl~ 1. KMt N NA1M COOt N0. YQMI ~l~a..1~u..Mwt //wiiwr..: ~rYnwMw.rwW •:~e~t~l ~ a lTA1[ COIINTY •~A •i!1 ~lae~~ 1¦ 1~~- CITY.1'OAM. t. q ~tACt W t. d?11. TOrM. T~DM f. ~f rsroc cm unns~ ws~a cm uwm+ r s i.. vcs ro r~s ?~o (Y ~ .~/~s~t ~~~W ~t.~r.~~ • urcni os t ts::cT aoo~etss n!~DDa 1:0i1~aJ.eaCeJlt sT~r w u res? M~ IMr! N Firrf AfNM , Lrf l OATE ~fwM Dq I'irr . l~ ' ~ tATN . SEx ~ GOIQ! Ow 1l~C[ W1R~IE0 O~Y[R MA~l1[O M?t 0! M~TM /Mt M?~WMI Mwr~ O~w /111~ 1~. ~ r f t • ~pp~p p~y~p ~ ~ 1•! ~ 1~ Mr. ulllAt oavrAl~oM (OYr W/ Nw.t Me la. Krlo o? MrSwESS oR wousTpr 1. rrlnMti~?a (~.h rr ~wys aa~?t 1. tl?ae~ ar wr?r mw1~n . i~. y..- ..~+....s y...w..rr...~. a na?.e, •s~•.t ?~.•r i.t ~ r~n~~s wwc rorwu~s wuocr w?Mc •r t~~~~ris~• w~s oca~co Evc~ u.: iuMto rv~as+ socut scammr ~o. t~ s swMrw~ Qgpielb u.....~......~..~...,r Gladsra R. . w~... r..• r.1 ~a s~Mt ~tN (Ow. a~w ~w a.r Ir? W. t~L s.t lU. urrcevw ~cr~tr~ OUf[T AIO oEATM ~ir•~t~r ~r?ouTM~~sc~scow• ~Ebs ~r~i iil. wM[oW1[ cMbE (~1 _y - t~• tltls~t• • f t~ t~• Oli TO (0) _ Y~- D~L~.C--- 1 • • • ~ ~ Disease 5 Yrs. r.~f.s... •p~•~ 1~• ••+r•. ouc To ce sit\!• '7• - A~r! t- ~A~'T N. Oflfll t1i~ICMIr CO~qn0~6 OuuIrU1M l0 O[t1N ~IR nOR ~OAI[O 10 M 1fbNM~ Olftl~tE C0~01~ GwFA w!Mt 1(~) A t~r l~~t? } n1~WIM[a •r ~~t~r• ~s? ~ ~ a at~~~ 710~. a[statyc wow wn~r ouua~~o (E~k. ~~nve y~.r~ 4 Art I~? Pwt 11 yYs. N.) noaot~t wicrot wr~pot ts~~~•~- ti~~ •t . TN~t 0/ HM~ ~~M. QN. YN? ?ti~• ~ MNYwI ~.f. F ~ II~NI~t OCCYM[O mr RACE OF 1MJU111I (f. ~ M~f M~[. mJ_ M1/.1'O~M. O~ lOGi10M OOYN1r STAT[ w~ ~T ~ wT ~as ~ ~.u.?r.,~.r. Mr. a4•..a.~ ~K ~T ~K tl . / ~tNmN/ IM I~wrr /row . to ~ed !wt w~ A~'~n~ ~li?~ ow ~...~t.~ ~ DwfA ooeareN ~t n+ on fM d~N ~t~f~d ~1wv; ~nd to fM b«t oI a lno~ll~d/~. lroai tM eauw ~bfM. ~ 11 1 t~r• flMl?T~[ •(qM?ee r Nrlr) im AoD1e[SS tte. oATE i1GKo •r• t~ 1• •~~~l~t~ ~ t1~f ~t~. R~~. ~1~• jk NAME O~ CEMETE~~ OR CRCMATOAr (Q~ATDN (G1f/. tlb~. M/Ntf!/I (~/t~ , ~YOrLL l8~fl~~ r. t./ s i s u. ru~ s s~w YAt E='al HOI~E t5. wtc ~cco. w wt~ Rc4. . Rcc~w-s s~+? a...i~ss i .l~~i~,.., ~ ~ ' " , . RIL aLiS~~Y DE~ ;~`~>~~1'~ep~r' certif~r this to be a trus and oomat copy of the Lo~ 9 0 0 K •'~~~gbtr~~~d on fite in the St. luck ~ounty Health Dspa~ ~ : ~~.~~t ment at Ro~•P`+w~a~. Florid~. ~ - ~ ~ 3 PM ~1 : I3 ° (~1(~rnin~ t~to~v~id un!e~s ra:se3 se:t :i the St. Lucie 66 ~Y ~ . ~~„~;.~=e- . ; L~3~act~rent is affixeda . 1449a6 . ~ , ~ i J:)~~~~ ~ ~ ROGER ,~J~TR:~ CLERK ~ - _ N. D. MLI~R, M. 0. $T. ~UCfE COUNTY. +-r .=~;1~ -;Z Caunr~ i:eafih Oif~cer b Loca) Reyishar FLBRIDA ~Hj t'~~;?~• b ~j 0~~ ~~jL,~.. ~i 3 ~....a~t! ~ ~ . peputy local Re~istra? a~ r~ ~ r ~ aoa~ 144 ~88 ~ - ~ ~ , _ ~ ~ - J~~~_ _ - - • - - - - - ~~v - - -