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HomeMy WebLinkAbout1541 ~ ~ T le. ~TAT[ oo~~o or Nu~TM • CERTIFICATE OF DEATH 156~02 co~ea • pU11G1! OM YITAL fTATI/TIC~ KATt /ILt N0. ~~A•~ FLOAIDA - ord vA~n 111 TN NO. 11[d1iTQA1~•# NO. prnp~rlr •~~eut~i 1. r?AC~ 0/1[ATN COO[ NO. Y{YAl wtNi~MCtIIMrM~MMM/. //bw~i ~~~/wrW~~MrWt~ 10V"'~ gro~~urd /6-// "T~n Florida R t01Miir Broward n. ~l.eN e. K ~ts+t~cwct ~ n p~ pT11. iOrIM~ 011 IOCA~ION e. M13~0[ Clir IIMiTi1 tlry. TOrll. OII LOCAT1011 N~S~O[ tRY l1M~Yf1 ' fll~w` ~1i~r S40 rtS MD J7a.r,BVe ' 1fq MO I. IUMt Of Mf 1~ ~M/kd~ IMf rbpl MNfM~ s1~[[T A00~[ti ~ ~ 6~l ? South ate Blvd. - 634? South ate IIlvd. ' MAM[ OI i~?~f MNrf LtlI OA1L XMf~ D~~ Y!~ iii„"«p~,o Floronce Li.llian DIXOti o~TM April 6, 1956 s. scx ~ ooios o~ iu?a ~uu~to C~ ~c~ wuaiKe • o~TC or ~1N f. ~cc tt• ~rr~ s u~oc. ~.w ~oc. ~~.s. ~MM~N M.rr n... w.... xr.. w t• Femille Whitg moo«co ono~ao Nov.28 1918 1~.~ p 1~ f w 1~ 10~. YSW?l OCCINAT~OM (Oi1~ Nw/ ~J~N/! /M1t IN. KMIpdF NIfM~tf (M MIOVSTA~ 11. ~MTIM~ACi (~dt M AKM~ ~M~1 pfltiN Oi ~1 COIMI~t~ ' .1 c A y. t- ~arr~/ .~wt y wrthl q~r. ar+ ~J ~/N?M ' H~~a~~wife Oti+n home NeW Jerse USA l1~ek l~t 13. ~ATMEII'i MAM[ MO11KR's MAIOEII M~[ . • er ~r~•••~••~ Hanr Werner Ella Mae Ar~derson . socu?~ scn,R~n? .pr. n. a~ • s~sw~~ ? 6?- ~2_I ~ Q,(,X.,w ~ 7 South ate B1vd.,Mar ate, Florida' n• ~.1 1~. e~u~t N~un~ ~btite? ~ Me awe /o fMrp? (~1. A). w(d.) , 11(T[AVAI ~E'TM([M ONS[T ~o ouTU . d 1 r~ e t~ ~ /AIIT l OEA1N MAs CAYSEO ~'Y~ ; .u~t C11• ~ cn• esr- ~ ' tlt~e~t• C~~[illrw.~/aI. pyErp(~) ~ - .ftn t~• e~&~ ry~t ~ • . ~ (i)~ ~.a~:«.. ~.a.. ouc,o ca FILE~ AND •fthlu 7~ nl~y h~1! ~M1. ~ O /AIIT N. O~la SKiiYR GONORIOIa OOIIIrMRM /0 Oi~1M ~IN 110~ AOA1~ 10 fR 10~111ML ~ . MAS AIfTWSY ~ l+our• Q /(11ipRMEOt c~r a..o. ~ ~ VERIFIEp resp Mo~ ~ o ~ s. r• r• = ta. ~ asuNC eo~r ruu~r oau~~ca (~s ~.tia~ y~r~ t~ Art I~r rw /1 y 1un ~N r aY i w~ ~11~ ~ ~~p(NT SYICIOE NOMICI~ ~c a~.p•~i- v ? ? 0 v7 • ~ c~on TIME Oi Nwr XwN, Dq. Ys~r Ded~. ~~Y ~ o 1 i tot. auu~r oeaiuco ~or. ruec as owsr ~e. ~«.e~w wse. x% em. ro~t {~~O I T R~ S. STATE MIORKAT ~ ~Mp KE ? ~w•I~M/.~f?td.~~ttMf1..l/t.1 ~LERK CIRCUIT `.L, _ /~tt~nd~d flw d~a~wd Itom A et 1 . fe l~at wr ~~/ir~ ee~ 4 f D~~tA eceu~nd ~f 7~~~ A u+ en tA~ d~t~ ~t~t~d ~8w~; ~nd ts fM 6Nt e/ m~ Aea~Ndp. ItOflt fA~ C~uN~ af~/~d. n~i ia~~• i1CNATYII[ . • r• t• ~ar[ M/Yk~ ~L. AOO~ESS ~IC. DATC SIGNCD ~o.a~.~.. Pompano Beach, Florida 4/?/6b a e 2~. ~IMnaL. GK~utqq. 2~. OAT[ 2~t. NAM[ Of C[METER~ 011 CIICMATO~~ I7/. I.OCATION (Ci/. (MR. M tNtwl/I ~S[dt) + Luc3e Co. 3 Rem~~a'~"' 4/8 66 Fort Pierce Cer~etery St. , Florida v.. t~. sw~cR+?~ o~ s sw~+? ~oo~css ts. aTC ~cca ~r ~oca ~ca ~caaT~uu~s s~ u~c a.•.iass ~:~i~~ ' , POmp9Y1o Bea ~t1~"'~i7 ~ ~ ~A _ ' - - t t~_"" _ .1.~ _ ' _ ,-1 . CERTIFITD COPY L'- I hereby eortiYy the above to be a true.and oorreet oopy of the Loaal ~ Registrar'a reaord on file in the Broward Couat~ Health Department at Fort Lauderdale, Floride. ~`~``~~~.~,.~»~t~ ~F~T~'+i~~ : ~ ~~g: ~iQ ~~,v~Q,id unleas rai8ed eeal of the Bro~ard County Health . ~ ~ ' ~ ~ ~ ~ M~ - ~"~Q.;' ~ LQU~•• ~~a# is atlizad.) • ~ . .i:.t' • ' .:'i . _ ' ~ . ..~Rl~ ,,~:.i~~r,;, - ' - ~ r,?1 ;~~f ' ~ - ; ae ~ • _ ~v -E;:to~ ~ t ~a~-e.n } = ; _ ~ ~ : : ::::_.,y~~ aQ~ ~A. ` ^ .r~ ~9..~ L,., Count~ Health Ot aor and Local Reg3strar A y:i C `~~•~~~I~~~~~~~C~ ~ ~~i_:~ '"i . . ~ ~~~i; aoF V~t ~ ' ~ /r1 ~ ~ t S .i'.~~,~!1t1~~t11,?R ~ ':.~~i 1~G~~/~~'/ . . ~;=x;~~~;_~.:;:;;,- : D~pnty d1- 8ogi~fre?r ~ ' ...:e.: . _ ac~ix~~: P~6E~~~_ ~ _ ~ - . - - ~ ` _ ~ ~x,~~