Loading...
HomeMy WebLinkAbout2142 . • ~ ~ ' ' ~ ALACHUA COUNTY HEALTH DEPARTMENT .L4ii;2~ 816 S.W. 4th Avenue _ _ . - GAINESYILLE, FLORIDA `drb t1 G. Dyrrri, M.D., M.P.H. FRpnklin 2-954) ~;rector P. Q Box ~C~7:•. '.i`~` . i f.:::,Y ~r.~TC eowno oR Huttx CERTIRICATE OF DEATH ~ evRUU oR vnw~ srwr~mcs F L O A I D A ~TATt FfL[ NO. ~1R"' Nt61fTRAR•f lt0. t 1 ~c~'t O~ OC4TM _ COOt MO. 2. VfVAI A[NO[NC[(1?Mn~w.r./N..t l/:..~a.rwv 2~rJ..rM..w.ww) w. P`~: ~'Y STATE I. COUN~Y .S N;<~c~~a !.p S Flurida St. Lucie CtT~, TOwN.Ot IOC~!~1 t, 1S K~tF OI DEA7M t. CITY, TpwN, OR IOCATqN t. K~LSCC~(!h'i ' l1LSfD[ CITY LWITSt iM5'OE C~T~ ~W:iS~ _ i r:eSVi 1 ic res~ NoQ Ft. P iel'ce ,ris;[7~a~__~,_ , ~,j "••f pr ~!J xt ia loapYd. l~st it?~ef aJ4tu} STR(ET ADOR[SS OR Te~ i n 'sfos i ta 1 120G k venue B 3. ++4~r Of `fuat NifCt La~t pATf N~at~ pq Yrss otc( aK0 `~~~t4•~"i'u~ .fO~N FR/1NKLIN POLLARO oi:r~ OCT08ER 30~ 1~G.; S S[IC i. COltlll OR ~laCC 7. yARR~O ~ NCVU M~IUItEO ~~IRTM ~GE (Ix ~ept r 1i~0[tt 1~1~ tF:ita 1~ Hr: _ 1 !~!q) N.HM D~N Rw.~ v.`' r; i te ,nocwr~p a.r,cFO March 26, 1894 , lCtia~ _~':ll OCCWATqN lCis~ tiR~ sJa~Vl tate f06. KwOOi WSwESSOa ~wOClSCRr tl. ttR7MlUlCE (Sf~lt fNtra ~N~!>>) I. pTI2EA 0~ MWIT W:r•-=~r : . : +.~t! N ac: ?is~ t.i.. ue* :J't.. ~^4 e r arada Uniied 5*aLes a S!I~rE It. MpTMERS MIl10Eh NAf1E • . ~ ' ' ~ ° ' Nar Cave~ . 'S M~i ,~'E~SFO CY!!1 ~K f:. A ~1f1wE~ ~ORGES' K. socu~ s[cuRm ra. u. ~/4~1A J KO TY J t ~ r•,.. ..:,a,...~ Cr.~s'S~'~ ~"i.' ~':`~ti _ ~.L u ~ c"t7~ t he~o r~ 5 ''~'1=~r=~ f- n , - ( ~ n A!4 ~ . . ~ ~ a - 'J . + c.~vsa Os c tet N(d~te• rih ~~vr pal/k pr (A!. Mf (c).1 INTCRY4l !£T a~ i y s~\T L(+EATn ~MAS CAL•St0 ~t: D OIKET A~0 ~F'~ ~n IYY[DUTE C~USf ({I _ileSFIJ r:1 Qf~ r7t'C YLi~.~_ ~ 4 c~*s~+.t~~•, j o~cro~u ncho~en'e Carcinora ~ 30 3a~;s _ r~u~ ,art } ~Y9?f i~ll!f~~~• 1 #.YJR* #~(!J~ ~ D{I~C TO ;T :a~>~ n:x Ja~t. PART ~R QaK! SG~a?1Grr t.Owp7~0iK GDMT~y1R~lt TO Of1M ~{f! MDT R[UiEO TD iM TGMUrI OIStASC CO~pT10l1 GIYRI M/Mt 1(~) . iA5 AuTa~SM , ~ KRroRrCO7 ArLeriosc)sratic Cardiovascular disease ~s~ ,ap a i4' :cc~:c~r wK~oc +ar~aac DESd~~IE MOa w~u~tr OCtuRli[0. (LM~a ~~hv~ yhya*t ta RH I~r P~•t y ft~w 1/~ z • i; ~ ? 0 - ~ <Y 7~ME Oi Nei? ~1/IRt~. IIJ~. }'t0 . INJLRr q. . c D. w. ~ ~'rl~:RY QCCZRRfO ~At. tUCt O~ 1%?U~Y (t. I. ~ M r+N/ ~I~1t. ZQ/. CITT. ?OMII. QA IOC~T1011 CO{111TY ST~TE ~ ~ ~~.•`4E ~T O N0~ WNIIE Q I~~A.I~MI.K?lN.~~ttO~~I•.lft.) ' * aa A/ MORK - . l.tt~ndsd Jleea~r~d I~om Octobe r~ 0, ~ 96~] ~o C bE ~nd /uf ur A~~ a/i?~ en C toue r J i_~ ~ Duth o~ rr ~~t on tA~ d~t~ ~t~tM ~bw~: ~nd to tA~ M~t ol o>> Ano~l~dh. /ro+n eA~ uuNa ~r~rM L'.. ft Y\Ty/.~ f et~r f A~~S3 Teae 1 n~ i'~~JSQ 1~a ?Zl. CATE StG1f6 1 ' Gainesvi~te~ F~orida i1-I-~~ i~ r••Ru_.ucr~rn~. pR~ ? E% 7fL'~11[IIE Ai • ~r ~ ~ 27l. T? i , t~aa. tr canxfl) 't 1•1 ~ g•v~cr_ > rufi • t ~ . . ° ~ c L C ~~~C C~n! ~ ~ ~1 .i-ff..ctf r+~c,(/ic /~.~i~t ..{~r 7. ~ '~L ae~•~ S diM~iu ?S MTC [C ~Y LO ~ A[O. . 11(OISTRAl1Y 11~ A U1t ' -r i j ~ _ : ~1 c~ ~'u -~C~ 9 6s . " . . . _ r~I.~V•ty ~'.i N T.~7.L1E Y.a~.U ~./.hCl C~1r1 ~a : 1~~:1: i C~.:.Yl: ~-~.n~: . ~ - - - - _ . " _~~Q ~i ? ~ ~ .J• _ .1Y'-~}':..=. ~.11liNi~..~ ~ . • ~ ~'T ~2~~ ~r: "r ' ' ~ 7 r . _ - *\~T~ . n' ~}•~r i .T .-rT~rT-. : ~ ' ^ ~r . _ CCL. ? i ~1ull~lill Vl 1 ~~I~Y L ~V:.J r-~r~:rV - ; Q:~. ~ / ; t ~ REGIS ~~:::i A~:~ . J i - . rEwO ~ zEAO . mn. . _ y . _ . . . . - ~C:.Pr ' ~ . ~ 3 r . . ~ . _ . _ FtL~O AND RECORDEO - ST. LUCIE COUNTY. FLA. ~ ylCApgIL[ 1(iq i RECORD VERlF1Ep ~ Leiibili~jr bi w~ritin~, t~rpins ~ --.~c~,~,~~~' ; or printin6 aasatisiaator~? in , ~ thi~ docareat ior ~icrotiltins; ~~rrr Zg pM t : Sy _ 14'7266 ~o:~~?-: ? o,~R~s ~ooK151 3~ CLERK CIRCUIT COURT u. - - ~ x.,~~ai~ `~s'``~ ° ~ R~ S'~} ,~i i~ ~ - ?r~ - 1af