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HomeMy WebLinkAbout0220 . T:, ~ s s.- ~rwn wwRO os Nrw~TM CERT1FlCATE OF DEATH '-4~'-~ ~ ~ co~rs • •YIIRAY OF YITA6 fTATI/TIC~ fiATt ?IL[ N0. ~ . a o~a~:e ~ FLOBIDA eca~srnwR•s No. j•,_ p r o y e r 7) BI NO. COD[ NO. 2. YfYAt w[NMi1Ct l D4w Murd t:wr. Uw~r~: R~wlw« ?d~ ~ f ilCY~~A w?e= ~s ~wTw a s~•rc cou~n 3 •nd ~ill ~ S`t• ~l@ srj ~ • { D• ~1~l~~ ~ 1 n p~t- CITr. T0111M.011 LOC~TION e. a n~cc os oc~tM t. M11. TOrM.01! I+OGl1~OM t. K RCStOENCE j •an~At ~+y MS10E CI~fY UMITSI INS~OE CIT11 L1M11Si tl1~. i b• ~e~ rES~ M~ ~ ~ . I. ~urE or tt/.~ ~ b.~w. w«e .w.,~1 srucr ~oo~css • Ft. Pieroe Msmo~ial Hos i 3. w?M~ M fMat A/1Yt Lwt a?TE ~fwt~ Dq Yer cn" «".`•",.s.,~ J~ FREy~IQ,AND ~*N Jtme 7 1966 . scx s. oocai o~ iua r.u~co ~ rcvc~ w~~co wTC as ~arn s. ~.c r.s. r ~ww ~ nN uroc. r,ws. t.~t MnNa) ~r..u. aw Ka.. ra, • s. Male Whi~e ,noowc, oryoRCCO 31 I883 83 R' p 1 a 1~ 1~ 10~ IRY~I OCQ1~ATqM tOM~ ti~ ~/wrt Mu 10~. KIMOOF WSYtSSOR MtOUSiRl1 11. rN1T11K4C[ (3W M M~~A asKr/) 1 Mn01 O~ ~wi COUMI~n •Itu *~r- bM At~~,/M~dl ~ 1 p..: ~ af ~on~e"~t. City of Philad~l ' a F~ and USA 12~et l+~t 1 MTN[R'S wYE 11_ wOTtl~ll'S W~0[I~ IMrE ~ c„~:rtc~~ JOl~i1 F~c~lkl~ild ~ (lhavdilable) ~ . eocu~ sECwarr ~o. n. s s~ow?twe . Og 261-80-124 Jadc J. Moaac~e Ft. Pieroe Fla. ~ ~ 1~, sAWt K KATN ~I M~ ca~n p M~e M(~1. t~). pf INitIIV~L ~Er~rEp~ `3 ~ ?u n~?~ 1 ?~AT R O[All~ t~S CMp[O ~1/: • • NrD OEATN ~ ~ d i r~ a t~• MYtOMTE CYq[ (d ~tC~$~~C ~Q~1C~ lai~r ~ •u~c ttl• ce• s•e- = .ica~~t?~ ~~~1/~es. oYE 70 t~) ~ Of St~0111dR~'1 5 • ~ 1 e e • 1 ~Airt ~i~w~•~ ; ~ r~6tstr~t ~f~liw/ Mr ra~e?- py[ Tp ~ ! t h 1 • 7! ~ . ~1AS ~YTOK1f . ~ 6 e u r• ~ ?ARt IL Ot~B SR~iRMl1 OOI~Oft10N6 pMf~1111fR 10 OGtM wR N0~ RII?7p 70 M tprla~l OptAfC OOIMi~OM C1YG1 M HRT 1(u KIIiO1lMEOt . . y~ t~r d~~t\ y YES[~ NOpJ o r e~s r• ~ me- ACCW4wT SYICWE n01r~ClEt t0s. orsa~nc Now w~r oeewRCO. ehlre w~e~ve N41~r b Art !a Prr tl ytrsw i~~ ~ . ¦atle ~w~ ` ~fiO~~i- ~ ~ ? ' i t i oe • TwE OI Jlwr a/wM. D~I. Yt~? ~ ted~. ~ NUY711/ a n. ~ ~r ].1. I 7`~ ~ot. wwr xw~aco JDs. KA~[ OP I~NRr (t. i~ ~r ~ll~at M~. m/- CfTt. TOr~1. OA LAtAi1011 OO{IIITY STATE ' i t1011K AT O AT l011K ? N!~•!~?I• ~f?td. ~d M~/.. dt.1 ' 21. f~tt~M~ tM d~cwaed /rou+_ G~l~s ,~0 6'~7~6 •nl/ut Aj~is~ ~li?~ on ~~~fi~i ~ Q!~(1 A_ s~ en tM d~N ~t~t~d ~Aw~: ~nd to tM LNt o! eq lno+hdp. from tl~ auau ~~~t~d• ~ D1atA oeturl~d ~f A11 it~~• ~~~T~ (~~rwk) jjy. App~ ?Is. OJITES~6N[O •r~ t• 1• • Alva D. Ozrr M.D. F`t. Fieroe Fla. 6-9-66 • e t ~r • e•. tb wu..?. awnok Lte wn Zje. ~uMC or arcrc+~r oR e~er~~r z3t. wunoM ~Girr. a.s... a~.rp (&.re) C~ m3~'"Olf~~ 6-9-66 Ft. Piex~Oe ' Ft. Pie]c+oe Flar'ida ; v. s. ieia t~. o~ ~~""~e,ra Fl~2ial HU1C~e ~ ITLC xs. atc ~ca ~r wc~ ~c_ ~cwsriuR~s s~c+u?nu~c ~ a~..,ose Jadc J. ?'booc~ Ft. Pieroe Flo2+ida 6-9-6 r '~f~~,,:,,.,,,,,~~~ ' Y ~i~''• ~ ~1; u C / r K~ - ~ - ~ : • •y: C~~-th4 to be a trus and tornct oopy af ths l,ocal ` ,;~~,tl -on ~le in the St. lucie Gourrty Health Ospsrt ~ N ~ ` • - : ' at ~ , Florida. c~ ~ . ~R~ ~a! ~ . : .yd_ .r.• ~ ~r (yyunir~i'~lot w(id unteu?sised s~at of the St. Lucie r'r~ c ' ' ~._~.n~ ' ,.i ~ ° ~ q . , ; C,o~nfy Health Dlpartmsnt it sff(xed.) 7D = rn G~ ' -.1 • = f:..ct,; _ } A ~'•l.V ~ • N. 0. MILIER, M D. ' ~ ~ ~ v~z " f I ' ~ • . : . : ~ ' ~ Count~, Hsahh Offiosr 3 tocal Rpistra? ~ Q < o ~ r~,\ ~ - _ ~ ~Z~ i~i~ --i - - ~ S _ ~ ~ i ~ ~~w r J~'r ? ~ ~ ~-n T+ ~ ~ ~Q~ ~ ` ~y I+ON~ R~Qis1fN' C~ - ! . C N ~ • • ~ -y ~ ~ ~ ~ i .r ~ i o R. ig ~ 8ooK148 2 ~ ~ ~ p~ ~~r~ ~ ~ - - - - - _ . - . - ~ , ~ ~ _ ~:,~~a : s~~ ~ ~:w~