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HomeMy WebLinkAbout0997 , tA~. 1~- ~TAT[ ~OARD OR NGLTM CERTIFICATE OF DEATH -l.64~i~`~i j'` eo~~s • ~U11[AU OI VITA{. RATIfTIC~ RATt Fllt NQ i '•a•''•°- FLOSIbA •rd rh~~ at TN NO. lt~01lTRAR•• ND. P~OP~rI~ 1. ~LAC~ ~I ~[A~M COD< NO. Z. MW~I ~fIKNC[I~M~I~N1i.~ Ilw~.tie.~• R~.M~W~M.w:w1 etleYt~4 ~T~ ~ Si~T CpyMTY ~ St. Luc~e b-0,~.5 ~'lor~da St,Lucie ~~T- CITt. TO~II.OR lOtAtqN t. K~IRC[ pi pEATN t. CITt. TO~II.p11 lpC~ilpM t. K RES~OE~I[E IMSIOE CITr LIYItS/ ~ii.we Ft. Pierce aa'oc uTr ur~TSr Nop Ft. Pierce ,,,Q ` f. MAVt Of (/JAM h iNyil~f. /it M~tt[ Mlftp) I. STIIEE7 A00~[SS Ft. Pierae Memorial Hoap. 803 Cory-Campbell Eoad 7 NAM[ 0/ f1rM ~lHYt LW ~ pATE alwt~ a/ Yea Kir`~« ~i.n CLA~iDY COLUMBUS TEOUTMAN oi+`~TM J61nu 2 1 68 3. 9 . Stlt i COtOU 011 RACE ~ MA1111E0~ IIEYEII MARRI[D • DA?[ Oi N11TN ! ACE fh /eM1 r~~ t iUl! ~~~K ~ M Cau. Jan.10 "'w"' . . ~ . . ,~~o ~EO .1892 ~I~/e1~ 10~. USIIALOCCIN~Tq~ICrtti~/~/rMtla~ 1~ K~MOOFWSMESSORINOfIST~Y il. ~MTN/UIC((S?~ffp~?t~p~y~11 plRdpwMtQOIIMA?~ .ft~ ~~.~,y.«tyw.~i.~hk.ne~i/~A4Nl - Production Tire Com Nelson Co Kentuc _ U S A ~~~6t lOk 17. fATN[II~3 11~ME 1~. YOT11E~'S M~IpEM IMYE C. C. Troutman Unobtainable li SOCY? S~CUIIIT~ Ip. 17 IN OMiIA ~{ItNA?Y Aµy~ ~ . a9o-lo-o6a ' ~ o~ .s ' • ~ I~w~r~l H. tAYK N K~TN (Bw?a ~~ae twn (i~t/rv ~I !1, u~f (ci.j . lirrp At ~[j~RE~ ~ ~fr,ee•r r~~T? 0(ATMw~SC~VlfD?r• ~D~~qi,~,~p~O(An, IYY[OIAT[ C4YS[ •+~t tl1• a~~ e~r- ~ ~ ~ tftle~t• C~~~ityu.iln/. py[ Tp •1t~ tM• r~k~ ~re ?fs~ N _ 1 • e • 1 ~D~r< <wae (i~ ~~sf~tr~~ +~~I Mt ~~Itr- - ~J~t~ h~~I nwr twt. ouE To (d ' ~ _p2u`~~ ~itsfw 7~ _ A~r~ f- O ~11wT 11. O?rp M CO~q~fOK OGtf1t ~V? iRN R[URC 10/IR 1~lIR 04G! Cd~1f10M iM11 M/MI 1(~j . tiAS A Y ~ K t t~f I~at~ •r Nt~r• ~ t~E 1qQ •~tl~S 4CCID[NT SYKIO[ IqMICMC ~ 0[SCANE ~r accu~sco. lEwo ¦.rr.. ye~..~ h Hrt l~r Art lJ y1r~. r~.) ~t~~..t ~ ? ? ? s~.. •t ~ IOt Tu~E O~ 1lwr ~l~w(\. /HI. YMr nuu~r S Y 11~J1MY OCCUtR(O ~ ItAC[ Of IMNRr (t. 1A M~Nf ~1~f. 20l rnr. o~ ioui~w COIIIITr Si~T[ ~w[ ~ MOT rM4E ~ f~?~. Nri~r~. ~h~d. ~,~tr !d~/.. Nt.) wORR 4T ~lOlt7[ ~~e n~d fM d~c wOliom _ 1 9 68 . to •nd b~t N~ ~li~~ on 8 W h eur~~d e _.y~ n~ on fh~ d~t~ ~t~fM ~6w~: ~nd to tA~ 8«t o/ m~ ~ne~t~dp. /?om eM uuws ~t~trd. ~ll ft~~s ~a u. . J . .s- . « - ~ .ow~ss . ree 721. W1Tf S~G~EO ' ~ia° o ko s M D Fort Pierce, Fla. 1/25/68 •eerr~t~. Zl~ RI~Or1l.ClEwtpq. L~ OATC YCO~C(YE1[~yORC11EMAT0~1 t31. ioc~tiow~GY~.rws.rns~) (8~fr1 OpWr4 (Spnnl -2 - 8 ~ Pierce Crematori Ft. Pierce, 3t. Lucie,Fla. a. ~e» ~c~ i o~ $p~~o~L`h 3t. ts an ~ecco. ~r wca ~co. ~ccariu~~s n~c , . Pierae Funeral Hom i - ~ 6 - 6 F' . - ~ . ` ~ ~ ~ " . ~ ~;~y ~,~,~~'b;-, ~ ~a~~ ~,y ~ ~ FILED AND RECORDED - RegAY~rs~eFa?dn~q+ f~le~ ths St. luci~ County H~alth ~spsrt- ST. LUCIE COUN7Y. FLQ. a+e~f at fat Pieroe. Fipric~., ~ Fi E_ C O R~~PV/Gr~r ~:(VUarninQ: Not valid unr s ralsed xal of the St. lucle CotiMy Htalth ~partment is affixed.) ~68 I PM Z• 3 ~ ~ _ . ; f FEB ~ '~i( ~ y~~ ,•ly. D., MIIIER, M. O. cs[.le~G,l~ . , CouMy Mealth Officer d~ Loca! Rphha? ;i~lTr~% S ~ . ~ ~ • CLERK.CIRCUIT COURT I - . ` O~M~ Drpu~y l.vcal 1Epishar d. r. 8~K170 ~~E 994 ~ . r -