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HomeMy WebLinkAbout0723 TAi• s._ irrwrc wwiea o~ Hrwt.TM CERTIFICAT~ OF DEATH • ~unrwu o? v~rw~. rrw~mc~ srwTC r~u ,~46421 F~ ~ t•s•t FLOHIDA otd •M~e et TM NO. ACGIfTRAR•f HO. prs~~rl~ et~ert~d KACt O~ KwTN COO[ N0. L tlW~?L 1![t/KMC[(1I4vf,o~r~f~rt ll:~.r.~w.~: R«i~wuw~.~i:ri~a) ; ta1 ~171 a STATE j 1~ ~l~e~~ ~LIC~e ~ 1¦ O~r- C~?Y. TOMN.OII Tqll t. K ~IACC Oi ATN e. an. TpMN, OR LOCATq11 t. K RESIpENtE ~ MISIOE CITt LIMITS/ INSIpE CITY UYITSt fll~. Y[S ND? ~T~ ~ U/•w b b.*.1. Nu .b.d w.aA sT~ ~ooRCSS r[s w # WSTRUT~ON @ ~t. ! ~ ~?w wIYYr Lwf t.OATE X~wal d/ Y«r , cnrv «r+•n RSTINE CHRISTENSFId E"TM ~e 9a ~ 96b ~ . SEX i. COLA11 OR R~CE 7. YAJt~lEO O liE1R~ MARIUfO . DATE 0/ MIRM WE (lu ~ar1 If VmE~ ~ tW t~[tt~ ~f. ~ j (~/t Nf1f4I M~tlu Mw Ywn Xi.. 3 r ~ t s• moorto GD o~voRCCO A ril 14 1876 90 ~ 1~ i"1 ~ 10~ usu+?~ oaw~noM ((Ji.r tt,~ yrrt ~u 1os. K~o oc wswFSS wt r~oinr~r 11. ~urwucc tarre w ~ t? ~~s- Iss6y nw~t yNrtW tik, an yidbs~ JM'ry~ ~w~bp1 ~nrd or rw?r o0~wmn e Own Hame Denmark Nat. USA ?iaet t¦t ~ s~~~-~ ~c i~. YpT1KRY Y41DEJ1 MAIIE ! `,,::•ss•' Elt~~eda Johansen ~ . socu~ sccuMTr Mo. ~7. s s~a~uru~s wNn.. ~ ara Dolk Hawl Rd. (iihit~ City) Ft.Pierce,Fla. ' rY..~.l ~ws~ N wn~ ~a.r....a... n,w re. r~ ~r. ta. t~~...~ a~.) ~Kresv,w scTrrccr ~ i e e•. ?MT L OE~TM ~Af C~YS[O tT: Oi6ET AMO DfATN ` ~r~t r~l• ~y~cp+?~t uust cardial Infarction i , t\• s~r- it •lt\e~t*• ~ t~°y ouc To (N _ K40C~t"d~~ ZIitBPC~ ~ 1• c a 1 ~t t~ra~t~~). r~~l~s?ar h~~ D~E TO f t1tA1~ 1~ ---.Ar'LBl`j.CSClBrnei s (~,P_11 . g 1o~r r- ~ ?MT u. Ot~d M~s+wtr caeort~p6 po~rtMrtris ~o outM ~u? ~em Iltu~ro ro nrt tww1~ 06utt CoMO~tnr Gho b?WtT e(.) . x~s AutorsY i e.~a~ s Generalized Senilit - i- rcesoaMCOi ?.t... fcsO w ~ ~ t0~. ~ Ct3L~'P.1! y~,~ h~ Pat Ir P.rt !J y(rs~ ~tJ ••ti~•+ t ACCWfMT w~cwc ~,a,K~a m°. ocsuuE«orruuRraccu~RCO. t o.r... ~ ai.~.,i- ~ O O p l~d •r ~ mc. Tu~E Os Hwr alNt?. Oq. Ysw IKIYRY O = 20i. NIY~Y OtWMtEO mr. MJ1C[ 0~ w1UR~ (e. i~ ~r ~hNt Mns. 2Q/- C1T?. TOwI.OIt lOG1qM COYItTY ST~TE ~ . 1iYM~4[ ~T ~ w~T MNRL ~ lbA. /~M/. ~hed. ~~te At1~.. tlt.) i MORK AT 1qItK 21./~tt~nd~dfMd~owa~?/rom 6-~Q ~ .to death •nd/otuw~A,~di~~on ~~9~6 i M~fh oceurr~d~t in on tA~ d~t~ ~t~t~d ~8or~: ~n~/ to tM bwt d o~~ kno~l~dN. J100! fI1~ C~YNI 1[~f1fl_ i •11 f t~~s SICMATYR[ (GrMa w tWr) t=6 AOOitESS •t• t• ?It, p+1TE 5~6MED ` b10 N. th. Ft.Pierce Fla. 6-1Q-b6 ' .ee~r~t~. 2~. waru.t~~Tioa 27S OATE ' Zk. MMEOiC[?~ETEUYORC~Ir~T01t~ 27 23/. LOCATION (CV/. Nn~. M pYYp (8t~Mj ' •rrovx ~Sprci/~l N White Cit Cemete Ft. Pierce Florida r. e. ~e~ s z~. sunc+ua c ae s s+c?u?Tw~l N:DOtJ~$. SL. ts. wrc +rreo. ~r wew Rte. ze. ~ear~u•s s~uuTwc `••.1°66 Nilton W. Baird Ft.P~.erce Fla. 6-1k-6b Anna Lee Denison d.r. . , e~b ''u~ctifY this to be a mia and torr~ct copy of the Local s r~ord on file in the St. lucie County Health F~CEO AND i}tt~q'Cslr Depart- gT. RE DED ~ ~QR ~.,~'.-';~.Qrn t a t•f~, P+ e ro e. F{ o r i d a. WCI E COUNTY, FLA. ' : c~• ~ ~ 1~/ . , . = RECORD VERfF1E0 ; . s Not valid unless raised ual of the St. tucie : :s . - • )y Heslth Department 3s affixecL) " ~ N. D. MILtER, M. D. ~SS JUN 2 y A1N 10 : 3 ' % ~ ~ ; - - C,ouMy HeaMh Officer 3 local Rpistru ~ . ~,j ~ ~ \ . ~_f<~ - n~~~,S ~ ~ ,~~~~3 . . . ~ RK ~~r ~ t =,~p • ~,,,~~E CIR~ ~~RT pl~ D~puty Lou1 Regisaar ` C~•r = o Ki49 . ~ ~ a-~ ' ~ - - - - _ ~ ~ .