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HomeMy WebLinkAbout0669 " ~ Tei: s._ nwTi ~onreo or Nw.TM CERTIFICATE OF DEATH eo~~s • /YRGY OF VITAL frATlfl7q fTAT[ FIL~ N0.~~~- l~a~l r~e- o~d •A~n 91RTM r+o. FL08IDA p~~~RAR•f NO. ~ p~op~rlp L YfYAI Rp1KNC[(I1w.~rr~/1ir1. I/:..N~r.w: R.:b.~rW...i:r:..; •:~edt~d 1. KI?~TM O~ATN COD[ NO. a. STATE ~OY[1TY •nd •111 ~nt ~.11 ' _ s~ ~l~et~ e. K ~ESIOEtiCE 1• 1. dTY. TWRM.011 tOCATqN t. IS KACE OF OEATN t. GTY. TOMM.O~ LOCATION ~MS~OE CITf UwlT51 •aw~ws ua~oc cmr uw~rn r ~ Fort Pierce .ES CB ~ O o ~ ~ I. wra os cI/..e a bqtat. ~t~e.n«e.~aw) ~ sT~ ~oo~css . MOSMTAL 011 . ~ °'~T~T~TiOM P't Pierce Memorial Hos it 000 1 h~a 1. runt o? itr~ MNOe L4t DATE Xwt? MI YNr c°`~`~+.n JOSEPH LEON SDGRIST ~?TM 3u1 2 t 96? ; s. scx c. oo~oe ae iucc 7. wrwao (~rcvc~ w~w~co wrc os wrM ~cc ch ~e.a ~ u~ou ~ rw ~cc• r~ws. ~ lit O~tVq) M~M4 D~r Nwn Mi+. ~ r ~ ~ s. l~fale kfiite .now.co O avo~cco AuB. 29, 1889 7? " p 1~ i s 1~ ~a. usu.~ occu+.~ ca~.r ~ y...~ r..e IOS_ K WOOi WSIIiE55011 wOUST~Y 11. NiITMR~CE (9~ls a JWe4~ wW/1 12_ anta as ~rwT aou~nT~ .itl~ y~?- t n«tN~tWbk.ar~~/~eN?M1 - ....e~ ~arpenter Construction Long Island, Nerr York United States ~ llaek lat 1 iATIW'S IuME 1~. MOTMEII'S MAIDEN NIWE ~ sn::~~s.~ Joseph L. Segrist Margaret (Unavailable) ~ ~i. socui scamm ¦o. n. a ao+u~ru~c .~~sa ~ ~33-OS-9975 A Agnea Segrist P.O. Box 37g1,Fort Pierce,Florida rae•r.i G?ust ~r ~rwrn (s.wwlr..sa..rtattae/r W. cs~.••~ u).) ~wrciwx~ ~TM fA ai~.~c.r ??~r~oc~rNwascwusco~r: C02'OA81'p T~1TOalb03~3 °~cu~e ¦Y~L t11• WM[OMiE CAYSE ' ' tY~ e~r- . :ii:`~i?. ~ .',<••r. ouc To Coronary Artery Disease I . ` ~ o ~ . i .e.K ~~7•~ r~alstr~~ ~~ti~ l4 r~fer- pyrt Tp (t) .lssaw Ts `rr" fwf' ~ O ?ART 0. ODp S~i~I1Wlf 00110111016 OOKIMU~wC i0 OEtl11 ~1R MDT RL41C0 TO M TFbIN~I 064f[ CpOfi1011 GNEM M f~f 1(~ - M~S AUTOKT Aorr• at- ~ rERfORME0/ o.~ e..c~ s resD ra o r O~ fe r• ~ ~~r oteu~ieco. (E.ra..rvs y Wv~ t~ Art I r Art ~l ytrew tIJ •akf~~ ~~7 ~ ApCWERT SYIGO[ MOMICIOC ~ dl~~~s!- ~ ? ? ? tle• •f p~. Tu~E Oi Ilwr XwM1. Dq. Yar tiN~. ~ ` uuu~r g s. W Z 20/. MJYII~ OCCYIIMO mr. ?LACE OF YtJIlRY (t. I•. iq n~l ~~s. CITY. TO~N. 011 IOCATIOM OOYNTY STATE MNILL AT ~ wT wxat ~ lrw.!«a?r. wur. •~cs eW...u.) , MIOIK AT M6tK ~ 21. !~tf~nd~d t!w I~ewMd~ory- - ~L' 9~-. to ~,Y ~ 967 ~nd lut No A m d:~~ on 5-8- 7 DNtA ooourr~d~f ~ m on tM d~N ~t~t~d ~6w~; ~nd to tM bwt o/ m~ iew~NQN. ~roa~ fA~ uu~s ~t~t~d. ?11 lt~~• jj/. NOMATY~ (D!/IKMlbkl ~b. AODRESS. DATESiGNED ~r• s• 1• ' ~..,~.s~ a H.C. McDermid M.D. Ft.Pierce,Fla. 7-3-67 •eerr~t~. 23~. M~a~t.C~uiIOR iy DATE 2]r. NAMEOFCEMETERtORCaEr~T011Y 23L IACATqM(GSt/.twrs.raa~t/) (St~t) 11[rova~ (S 1 Buria~ 7 Ft.Pierce Cemetery Fort Pierce,Florida v. s. teiz 2~. NMERAL pRE o~ ~s s~c~u?1wc Ft:AS~Ce~ Florida a. wrc.cco. ~r wcw iecc_ ~c. ac~sr~•s s+uu?nMc ..,.~~se Jack J. l~ore Yates Ftuieral Home 7-b-6? i Anna Lee ~enison, d.r. '~~N~r,,;.,,, ! , ,~i~~Ji. ' ~ . _ ~•.~11t ~p ~ i 1tNe ~I~ CORed COp~/ Of t~le L~OCi~ ; . ~.~k«~ onfiie.in tt~s St. ~uc~e Coi,n~y ~isahh oepart- ST ~~D q~y0 ~,t'~~dt~~ ~~d+• , ~ C~ R~ `~"~?~W'a~nirps Notiisiid~th+less alsed seel of the St. lucis ~ n~~? CpVNTy pF0 . ~,,,;y, . o.p,~,,,~M ~ ,ff~a , n IF jF~ Cq, . , ...:3,~=~. • ~ . sJ ~ ~j ~ _~,.:-,1-.«: - a . ~y p ~ -'~'j 1. ~.(j ~ ~ , ' ~ 1~I. M1LLER~ /111. D. ~ ~ ; ~~1` • r ~ . • Coix+lr Hesith Officer ~ t~ocal Reqbtrar ' 8/ki ~ -j - , ~ , : • y9 ~ . . ~ , C~ r, : F - S ~ • ~7 -~~`-(0~7 ~ . . ~ - _f ~ 1 ~ , s ~ RK C jR~ 'Ui; f a~. ~o~.~ r~unw ~~T ~o~ j . . Rt ; { ~ ; , ; 5~~~~7 ~~E ~~7 _ _ _ , # ~ - . _ . _ . . ; . - ,