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HomeMy WebLinkAbout2047 TAts De- YTATt .o,?~o w Mu6r+ CERTIF[CATE OF DEATH ~~(~Q C~!~ eo~es • 'UR[AU OF VITAL tTATt~TIC~ lTAT[ /IL[ N0. -L_~i~Oi ~I(1 l~`.~ FL08IDA otd ¦U!p BIRTH NO. Rt61`TRAR'S NO. 49 P~op~el~ ~uei or ouTM GOOE NO. 2. YfYAt w[1I0[MC<l~M~~rrM1~w/ I!we~.r.w: R~JwrW.~~i.ww) ea~tuted a. ~Nn a ST~TE C01ihTf . •nd •111 Florida St.• Id1C~C e~ ~i~t~d . t. K RES~LEntE lw Pee- S. C~TII. TOMM.OR IOC~TOM t_ ~5 ?l4CE O~ OE~Tn t. GTt. TOIMlI.OR IOCAT~ON ¦~a~~t u4WE dTt tw~T51 urT~DE ~TY tW~rS1 YES NOQ FE P1CZ'CE lfES NO t. NAYf O~ (//Yf iq ~M~ifd. Ire Ihat W/W) I. ST~EET AOOwE55 ~ IqSMT~L 011 . ' u~STITUTqN ~ 28 j'C$$ AVC. 7 MnYt 0/ FirM AfiiQt Lyt WTE ~IW~ Oq 1id Ott[AftO c~s~«r~•n B~SIE K1Y LUD'~.'IG ou*" January 27, 19b? S. SE7[ ~ COC011 Oi IN[E WIIR~EO ~EKR MARRRO • DATE Oi NATN ~6E (h /t~r1 ~~W u~~[i H w~eS. ~ !Yl ~i?tW~) Xw~Y~ O~s~ Nwn Nu.. r i s. FCmBIe Csu. xioowEO D o~oRCCC 8.2' - jl<lely 1~- Vw~~wAT10Nl iMkid~/iMl~Mt I~.KtNOO~N75Y1ESSORMO~ISTAr 11. 11RiMR~CEISi~ftw~Mt1/~paW/) IZ QTROIOinMSODtJ.\i~'ff . •~t~ P~r- fariywtyr~r~iybJe.nrt~/retrM ; ¦~w~at ~(OLlSCM1fC Qidil ~{OQtC t.212111 ~ 11~Ct lwk 13. iATM[R'S w~wE Il rOTNEII'S ~uWU ~urE ' er ' ' Solomon Carr roline 1~. SOtul SEd:R~T11 M0. 1). INIO • NOMATYR[ difHN . ' Herman C. Iudr+i 1928 C ress Ave. Ft.Pierce Fla PYA~?~1 ewuu or ourN (s..u...tr..rcn.~ r~?r~.r~r.. cU. te~...e cc~_~ iKrc.r.~ scTrcc~ ~ air•es•r ~*Nw•swacow: °`~?s~T"'a°c~T" ,~„Ea..c uwsc ~a Respirato Arrest rii. e~. e.~- e~r~~.s. c~,,w;M,.;~.,,.. Advanced Ca. - Com.=on Bile IIuct •lte t1• r~id /srr ? b i u~ 1 e c • 1 ~ ~ ~I r~atstr~r qiE TO (t) I •lt\!O 72 l~iy (~rK l~af. O N111T K OI,EII S~G~i7WT CO~O~iO6 COMI~RJ~MG TO 0[aiw ~IR I~W 11[UI[O i0 iN[ TitYwY 06[?S[ COlitli~Ow iMEll M~Mi 1(y . MJIS AUTOKY ~ \our• af- ~ K1tFORNEDr I tet d~~te ~ ~5? p~ •r tel~r• c pEwtyE ea~ wutrottuRa[o. (6~tn a~?v~ y~yv~ ia P~rt /r P~rt yiun ~~J a~kloa ~a~ ~ ~~~T 5{!K~OE NOwK10E . •~ost- v D O ? ' 00 J 20t 7WE Of IIKr 1lwf?. Or/. )?r lOd]. V uuuR1l a a. ~ ~ 1. A. ' Z 20/ Iwll:lY OCW~IIEO m[. ~IACE Oi YUUIIY a~- ia ~r ~af Mst. 7D/. MY. TCIf11. O~ IOCA~IW~ OOYNTY STATE YrtiKE AT ~ I~DT ~lE ~ NdMI. ~trtd. Ma ay.. Ht_) - . M1011K AT OO~R 21 1~tt~nd~ tA~ d~cwNd /roin ~'C.. ~ 9~iS ' . to Jz.^ -~-~37 •nd lut a~~ Ai'~m~ d:~~ on ~ r DNtA occur~d ~t m on ~hi daN ~f~t~d ~bo?~: ~nd ro tM bsst o! mr ino?I~dN. Irom th~ uusu s~~t~d. ~l~ 1t~~• ?2~ fICM~TVR[ (LrMnMftrlr) ' 2Z6 AGaRESS T2t. OATESiGwEO •re te 1• ~••viie• • N M U ^t Pier e a ~1 ~ 7 •eerr ~t~. 23~ ~wau. tau?rq~. 270 wtt T7t ~YE OP CEMEi[Ilt 011 CREw~TOllr 23f. WC~T~ow (Cr~. t~w. ~r ca:~y) (3rn Nc.a.~ ( Syrn/~l - Ce::ete Ann Ar'~or k.ichi 2-? r. iei2 zs w.cc~o. S~,w? Ylashtienon - o.TC ~~o... wc.~ Rcc. ~~c~~sTw~~s sww?swc . ~'"906 s'.°°~~h. St. a...1965 Ro er L. Ft.Pierce Fla. 2-6-67 Anna Lee Benison d.r. . - - i hereb~( c~ti~ji- ffiTs1to/ be a true ana correct topy of the Locai S~~~EO AN~ Registrars re~erd on file~ in the St. Lucie C~unty Health Oepart- r,~VCIE C V ~ORp fD merit~at F~ier~¢,,Flocida. • . ^ NTY F : - - ~:tFt~ p~A :(Warning: Not va{id voless raised seal of the St. Lucie : County Hea l t h - 9 epa r t m e n t i s a f f i x e d.) ' 6 T OEC 1 2 8 52 " . ' ' • - Z~ A~ . ) t; j, N. Y i. MIILER. M. D. I 2 • ~ • • . ~ounty Health Officet d~ local Registrar , , ~ ~ ~ , eL~r;'~ c;n~U~T, • 1 ~ = ;~t-~(b^1 ~ ~ - - ~ . . 1_~,3,,,~_ . CDURT at. ~m? ~i R~~Sn~ ~ - ~ . BWK~~y ~A~~~(13U