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HomeMy WebLinkAbout0017 ~ ~ . r ~ 1 iAis ~rtwTt ewut~ or Nsn~~ CERTIF~CATE OF DEATH ; eo¦~s • ~YR[AY Ol~ ~IITIIL RATI/liC~ iTATt Fil.[ Nn 1~~~~ r~~- FL081DA ~rep~rl~ s1RTN NO. RSQIiTRAI!•~ NO• ea•ert•e 1. MwC[ N~tAfN cOOS !10. L YsWtL wtNKMC[c~a.rw....,: 7:w1ar: s.o/..~~Ia.~wr:c~I •wA ¦11~ ~Y a STATt NwTI 1• ~lac~~ t l~ dil/. T0~1M.OII IDG1TlOM t. ~S KACE Of OfA1N s. C~Tt.7011M.OR tACATOw. t. K RES~OEMCE ~~N~t tlIS10E ~ITr LIMITSf . 1M510b CITY lWIT31 . t! 1~. 'I~i Pf B B rE3 MO KS MO f. MWE Oi (fJfN! i MqiON. ~it ~trNf NbrM1 1. ST~[ET ~OORESf fqShTtl OR '"n'mR'°" Pi B @ M s. .wrs w r~?« ~r+wk r..r a?rc ~w.u na r.« . • FBA?YK P. ~ ~iAKIIt °EATMSe tember 2 1 6 . S[X LOIOR OA Ytt 7. ~yRRiEO ~'I ME1KR YARttO OA7E Of MIITM ~ 1~~1) Mw.rr Diw Mww Y • ~ 1 t• 1'[ p ~ ~D ~l1YORQ0 ~Ta..'1 • ~ ~ 1 S O ' ~ 1~~~1 ~ 10~. 115~M~ aotlir~TD~ /Oiw tW y~nrt Iw 1M_ KMOOS NIS~MESS 011 u~ol~snlr 11. NRiwaKE (~b ~r MN/~ p~aEr/) pt~ ar ~rrar cotArRrr •lt~ aMty~N?4hf~.~y~'eA ~cher l~sic British West Indies Nat. USA ?1••t s.t 13. s~rnu-s wwt ~s. uonrt~Y ruo~ w~rc •r s„~~rsa~e I{enry ~8a1Cis $aker At1r18 A. PY'overbs ' soa~ sccwm ¦a n. . san+?niw~ w+a.« . _ 033-16-4804 Mary E. Baker 2108 S. 3rd. St. Ft.P'ierce lrw~r sl w. tnw~ N w~n~ (s~w...Ar ~ce aw ~e. tt.r /r fs~. p). pI cd.) nrttav~a ~[t~r[Ew : ""T` °u1t0"~`"'~`°"'` Cerebral vaacular accident ~ da ~ tzt• ~cw?rt cw~t W j aN s~r- - _ _ _ - ~~rs••~• c~.s+r....~iw, o„E,~p~ Arteri.osclerotic heart disease 10 Yrs. .~e. e~. r?~ 1 • a • i ~ t~war (i~ r.s~.s~.~ s.~w u. .d..- wc,o c~~ 10 Yrs. .is?!s 7a h~ c~~ar trt. a•+• t- o ?MT w a.a scass~ wa~~as oor~~s .o oum rn w0r ww~u ~dC~ o~ o' ^~r' K'~ .~~s~ . ~••s` S - Acute py~lonephritis .csp eo~Cl •r [~r• ~ ~SqyE ~w~1, nAMr o0[vuEa IBda s~twi yfyw~ 6 Prri f R Ar111 Ntr~.1u •sl1~~ AOC~O[lIT SWCIOE NGMI[IO"c tlf~~af- Q ~ ~ mc. T~ os lfwr Xw1?. Oq. YMr + S s~.- ~ s 2Ct_ ~w~r ootu~eEO iDs. ru[E os ~uuer u. i.. h r~rwt i~.r. ~f• tm?. 7o~r~. at t,otwTpw oou~mr sT~TE 1n~w.E ~T ~ ~PT rMtt Q M~• /~I. aVed. ~a NM., ~de_1 rIORK ~T 10~K tt. l~tNnd~I tL~ O~ewwr /rr.a~ . ro ~ ~ard /ut wr ~m eli?~ ee ~ ' DwtA eae~risA~1 ~ ~ 5 Px m on tM d~t~ ~t~t«I ~bw~; ~nd to t!N bwt pf aq Ann~IMN. from tM uuNa ~bt~d_ •lI lt~~• ?L. NCIIATYw[ (Or/rKMN?!f) ?L ADO~ESS . 71!_ MTES~GMEO •I• N N • H.B. Goodxin,Jr.,M.D. Ft.Pierce,F2a. 9-6-67 •ee~ra 23.. ~u.n. anunoa ri o~rt Zlr. Nart os arcrc~r oa euwroRr t3t wui+o~ (Cir~. twrs. r ewy) (sw) Ft.Pierce, Florida ri~"`'~' 9-k-67 Hillcrest 1~".em. Gdns. r.:.~eia tcsu~w w~ssw~.np~c ts.o~TCUCawwc.~.cc. Zi..cc~w~ss+wru~c . . ,~...,~ss l~ilton W. Baird Ft.Pierce,Fla. 9?-67 Mna Lee Denison, d.r. , i ~,}~e~, this to b~ . nrue ,n~ correct oopy af the locst FILED AND RECORDED I•,~tc~p~r~tNqori~.on•fits in ths ~t. luci~ Coirnty H~ahh Ospart- ST. l.UCIE CQUNTY, FLA. ~ , ~ n~it at ~Pieroe. Flaid~. s3~^t!R~ ~l~-.RIF?~p ~ : ~nr~ ~ w~i~a ~i~ ~.~a ~i ~ ~ s~. u,~ 161530 - . . e~,nRr. ~iht+ o.p.rm,enr n .tfixea.~ _ - - . - '67 Npy 7 9 : 2 p . . , , ~Q~µ~. ~ . ~ r , . , , ~ co~?ey ~ ~~er a c«~a~ R~o~.~ ~ . FtU:~~~ N r•i1f i S ~ ~ C~ CLERK CIRCUlT COURT ~ ! .2~ --L'7 ~ . ~n, _ l ~ Tr~ ~ h n ~ s _5~.'M- - Datr Deput~? Lo:+i R~istru c~ - s~K169 1? - _ - _ ~ - _ ~ ~ ~ - ~ 1 ~ _