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HomeMy WebLinkAbout2771 ta~. ~wTS ~owRO o~ Nu~TM CERTIFICATE OF DEATH LE~i3~ r.,~~.? ~o..: r ~ueuu o~ v~~ ~rrwn*nc~ rrwn ~u Na ~~a•l FL08IDA er~ •A~s BIRTM NO_ " R~GItTRAR•f NO. ~L pr~P~~Ir COOt NO. t YfYI?L w[f1KMCt(Ia..I.rdr..t Uwrwew t.:4..~I...~....:..) ea•e~e•~ 1. KA~TM KI?TN a ST~TE 001N~TT 1 SL. Iucie 25 Florida St Iucie ~l~e~~ t. K RESroE~CE 1¦ /~f- dTt.10r1M. WI IACATDU t. K K1~CE O~ OEA711 e. CITII. T01I40~ IOCATIOM •~N~t IIIS~OE TY LIYITSI 116~OE dTY 11Y1TS1 _ r, i.. ~erce ,res~ No O Ft. Pierce .cs ~o I. NaY( Oi (If Mt M MqWI. MN Mrat M4wI ST~EET ~oollEtt Saster Manor Convaleacent 407 South 18th. Street wurt ~I ArM 11fi1~ Lrt 1. wTE Xwd DA Ye~? rna~« i•an SIU~ . DIII~IIEL URCGI,IS ~?TM Ju11e 7~ 196T ~ S scx ~ caw o~ ~u?cc r..~~co ¦cra wuKO ~ w~c os a~ .cc, ~cr.a s u.oc. ~ rw u~oca H~ r r t c. j`( ~nooirco O p~w.~ Pril 6, 1888 ~`1 ~ w..w o... r.~. r:. ~ l~ f~ 1~ 10~. YS11i11 OCCY~ATIDN (OiM !W .~J r M\ /Mt 1~. KYW Oi WSIMESS OR YIOYSTAr 11. MwTMRACE I~rh M~/~1/~ paiWll tQIZfl10f ~Ni ~OUM1~t1 HtA ~.r- fsriy~wdywrW/b/r.ar••~?Nwep M.erchant Kens Clothin Thomaon Geor a U.S.A. ?l~~t ~Ak 1~. fAiNE11'S IU~Y[ 1~. rOT~KrtS MNOEN lu?ME e~.:... K.T. Mi a ~ma Vir a Daniels K. socu~ sccu~un ~o. q. s s~ar?Twi[ wqr.« _ b3-2b-0936 Lillie N. Wi s 407 So. 18th. St. Ft.Pierce,Fla. ~ /~~~t~l 1~. i~YK N~TN (i1M?whww~ar/afZwM W.(?).a~ls).) IMTt1~r~l~EMO~ u..e s.. •""T ~ °E"TM `"""O w: Cerebral Vaacular ACCideAL ~ ~•~TM wrcontt avlc (~1 ~ ¦••a f11• t~• e~r- :ie:~~i~. ~ ouc To c~~ Arterio Sclerosis 1 • e • 1 ~ r~ststr~r ~~I W aMn- puE Tp (c) •fe~i~ » l/"y eywr t~M' . w~snuTOrsr ~~•r t- ~ ?u~ w ar~ swrs~wr oo~aro~s aonaw~wc ~o oum wir ~ w?~w ~o M aarw? o~atc aaonnw ir~w ~?rR q.~ rcvoR•uo4 a.r a..c. 3 res0 w[~ •r t~f~r• ~ ~ ~ pESC~~yE~~JY~roCCUR~ta (6~tn~dvr~/1yv~t~~lrtlrArt/lytN~lt~ •~klws ~~7 ~ ~OCWE~T SIIIpOt NiDY1C10E l~~l~~t- ? ? 1~~~. ~f ~ 7ar. T~~O~ H~sr X~~N. DiA. YN? py i IO/. MJIMY OOW~IIEO mr. RACE Oi w1Y~11 (t. b M~IM~I Mr. 7DI- CR1.10~M.0~ LOC~TIOU _ OOYIRY STATt ~ac ~T ~ noT ~wat ~ 1~•. f~r..orar. N~u ety., ac.1 MORK 11T ~OIIK ~ 21. f~tNnd~ tJH I~oN~J /ro~n . ro ~nd l~at w~ A~'~s~ ~/ih on DM~A oocurnd ~f ~ 02 15 A• H~ ~ pn tlw d~t~ st~ted ~bo~~: .,~a ro re. s..r a..y r.~.~.+~.. /rom tA~ sauws ~t~Nd. 1 1 t~~• MaMATYAt (Ae/ra M tY/tl ?26 AOO~Eif ~ ?lt. OATE S:GUEO •r• N a H.F. i~fatldns,K.D., Ft. Pierre, F1a. ba?a~- ? ~ee~r~t~. ~ M~K_~W*~ ~ jk.yyE~~Y[~[AYOACREYATOwY Z~.LOCATqII(LY/.f1~M.M~1 ~SWd Remov~l°"~'' J~e 8 1 67 Mrens Cemete ~ Mrens(Jefferson Co. ) C~s. •.a.teis su~w era~~ssrc~un~c1 34$~. St. ts. wrcaea~r~ne~~eca. ~earmuss~ew~ruu a...,.se ~ er L. Ft.Pierce,Fla. 6-21-67 ~ Anna Lea ~anison, d.r. ~ RECORDED F1LED AND ` ~ ~ ~ ~ gT. LUCIE COUNTY. F~A t~ ' ' - R;.COR~3 VERIriFO 'y .}~~y p~Mr thi~ w t» . rn,. .~d corr«~r copy o~ the t,oal 3~sZ .m. =-~O~C+~'s:~'~4td on fi1~ tn fhs St. Lucit Coimty H~sfth D~parF ~ is }~r~ a~+ P~.ro.. ~w.. ~'6~ JAN 5 AH 1 I: 08 - ~ l1NwnLq, Not y~1ia]n~l~ss nlsed seal af the St. luw G~uewy I~IMhh C~p~tmaM k affix+d.) • , . . - . - ; =J';~~5 T ~ ' CU CO~R ~ ~ ~ ; , ~ . ' N. D~ IlAtttER. M. D. ~ CLERK CIR IT ' Cow~tr Health Ofi~cer i Loul R~pisttar - ~ - ~ -Co7 ~t~~ r• _ )~~.5.~'u- _ u,t. apury? ~oc.~ a~p~s~ar d, r; . . t00X~~ PAGE~7~