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HomeMy WebLinkAbout2281 tn~. STATt ~on~w or Nu~TM CERTIFICATE OF DEATH ~4 y,~~~ ~c eo~~s a ~YII[AU O~ YITAL RATIlifq fTA7't ~ILR ~.~.l..a- FLOBIDA • ord re~• BI TH NO. R[G •f NO prep~rl~ 1. MAC~ OI ~fATN GODt N0. 2. YfYA< ~{1~fMC[(IM.I~w+dWL 1/irwr~r t~i/wr~+iiriw~ •:~o~t~a ~~n a iTA7~ R OOU~rt1? ..a .~11 St I~ucie D~ ~l~s~~ ~ 1• 1~f ~ CITr. 7~MM.OA 1OC11T1011 t. 6~IAC[ OI 0[ATN i. CITr.10tifN.0w 1ACATION f. If IIESIOCNCE ¦~~~~t 41f10[ Cf~T UYITSt INS10E C(tY IIMItfT fll~. rES MO A ~ b ~ IuYf OF (qfN i~ ~M)fd. Iirr ~Orrt ddql) I. ST~EE7 ADDIIEft x 6 Lakexood Park ` ~s o~ sb.e ~Iw. ~.u 1. a1s at..a~ D.r Y~.? ~ ~ M~ THOMAS J.B. CARROLL ~?TMNovembe=` 14s 1965 ; sa s. ootn~ oR iuct ~m ~~vt~ w~uuco wr[ w w'rM Kc U. rs.~ r~aou ~ rw u~ou ~~ws. 4 tw~q ) r.rr aw r«.. xs.. ~ r i t~ ~I W rnooMrca olvo~tEn DOC• 18 18~~i 7U t y i•i• i> >o.. us~ oaursnoK o~.e d.t N...t+.s. Kaaor ~ae ~ouar~r n. a~Twu?a ts.ir.r/w+Y~ a..bi) a~ a awr aou~n = ~.,.~.~e,?¦«~+u~. ~ ~~ad Balt3more, land USA # ..p..t Hachinist Re . ti~~tc t~t ~«TMU's wrt t. ron~us ruoa ~urc ' sri~~HNr jbMis (~i81'I'Ou u[10~.. r~s occu?scn cvu M u. s. w~co roRCES~ ti_ socu~ sccu~rtr Na 17. ww?*wt g~ pmgg ~r......«..+,..r w....r.....~w..r...cw Yes 1~1W I 705-07-925 P't. erce, or enwc ~r wnr (aa wh w cw« ia thr /r p~. q)...t cc~.~ ~wro~vw ~nwcn~ ; ~ lrs~r~l L~lSE7_ ~g TM . e i r.. s.. ?urc ~ oun~ r~s uuuu sr. oC81'd~8~ Il1f8Y'CtioA :C 170 ~ j uUl[0111Tt CAYlt W ` ~ •~~t tll• . tt• •~r- : _ `E s~r...e. ~,~,,t~,,,,, ~,o u~ Arterioaclerotic Heart Diaease Yesra ~ ; .sc~ c1• ~ l ` ~ 1•••1 ~~s~~~~1 . r~sisNst ~y ~rK l~f. pyE Tp (d ~oar• ~ n a~ ~ci+rcwr oo~ortias dor~w~urwa ~o oum wR ~ mno vo twc ~crrrr~ oaux oo~na iwa w rwr Ky ' •iie• lo roliferative dreme Gout, Hiatal Herafa mp p? o r~~[~ r• ocsat~c Now ruu~r ooaqueta (~....tv~ y1~v~ 1~ Art I a Are lt y 1an ..t,.s ..s ~''i?aaocMr w~aoc Noriao~ ~•~.st- O •t Tw[ C~ Nwr X~N. D+I. Yrr •~A~. wN1111t a. s. ml. RNIRY OOqIM[p mr. ruc[ a~ su~n~r k. I. i. r.1~.t w.r. m/ pr. 7~Or1~ OR LOCATIOM ODYIITY STAT[ , ~K AT O AuDT~~2 a It ~1. wrsd. ~et ItM~ ~.1 21. l.ee.aNr rs. r......I ~eo.~ ~e . ro v~1 r .ws l..e ~ .u.. ee ~ v..rb oewn~+.t 10: ZO A. ,w on r6. s.e..r.r.a.eo..: .ws a eA. ~e ar w 1~,a.r.ep. ~rom eA. o.a..~.ae.s. •il ie•¦• lt.. s+swn~ (~.w..r~nr) tt~. ~oows ~ts. a?~s~enco Ft. Pierce, Florida 11-15-65 a..~i.o. • Ha~ar~ A. Schalk,K.D. .~~vs~. z1.,.,~w~o~~r. a~~~o~noa1 i71. wt[ i~c. ~u?rt or ccrcTU~r oa c.~c~urosr 7lt. ~,outaM (Ctrr. w.R. r a..cf) (ew) KCmOY81 - ~ ~S NeM Ci8~i~1Q~T~ riEtlldt.e2'31 HSZt~mCl'e K81`~1181'~d : r. s.~sis u 's s~au ~ooass is. a?n ~cea ~r ~ocK imo. ~srw^s s~+u? - ~a a...l.s• Kilton w. Baird 11-15-b5 Mna Iae Deaison, d.r. ~ . _ ~ ~ - ~1LE0 ANb RECORDffD ~ ~ _ ' I;t~n~1?' ~fif~' thi3 to bs a true and ooR~ct ooPY of the ~oca: 3~. LUCIE COUNTY. Fl.A. ';~btt~+a re~qr¢~q"tfil~ in tfis St. luci~ Coumy H~.~Iti+ DeW~ RF ORD VERlFIED ~ m•~? ~ . ,(yVarn~~l~1o~-~alid unl~s raised se~l ths St. Lucie ~ 27 f • 1~ ' . ~y~Ys~~th Department is ~ffiXOd.) , . ss ~ ~ ~ sq ; - ~ . - ~ ' ` _ . . ~ ~ ~ - t r` N. NuLL:R. M. D. ROGER POITF~A~84 ~ ~ , - . , Covnty Hsaith Officer ~ Lxal Repktrar ~ _ ' , , ~L.EAK CiRCU1T COURT ~ i;~,g~,,; `b (e . ~ p~ p~puty trocai R,pistnr 41. r, • ~ ~o~~ 146 47~ i _ _ _ ~ _ _ s ~ -