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HomeMy WebLinkAbout1148 t,,~, n~T~ ~oMO a Ms~?~TM CERTIFICATE OF DEATH 164115 : • •u~uu OR VITAL RATIfT1W rrwTS r~« rw. s-~ i.,~.i ` _ orA ~A~n SI TM No. FLOSIDA w~~RRA11•f MO. ~ 3 prop~rl~ ~ eseeut~~ 1~l4tt K KAfM GODt f10. t YW~I A[N~tNCtI~M.~M'rdMi f/:Miur.w: R~fMrNw+Ywri~a •nd °0°"'r St. Lucie ~_p~y ~ STA~lorida `~t~t. Lucie ; e. ~1•e•• 1 n 1. CIT~. TO~11.0~ IOC~TDN e. ~s rua o? a~rn dT1. 10R11.0~ LOCAT101~ K IIESIpENtt ' S ..e..~ Ft. Pierce ~ ~ `~"IIr = r,,.. Ft. Pierce „op ,~s .o ~ I. MAME G~ I~INf I~ ~M1ifd. ~it MfMf NdlM) t. ST~[ET ~ODIIESS ? ~ ~ 1~~ Ft. Pierce Mem. Hosp. DOA 518 S. 6th St. ~ ~ N~r[ M FiN ~fMlt L~N WTE alwM D~/ YtM ~Ky, ROBERT C. ROLBECR a°i„T„JBnuary 2 3, 1 9 6 8 - SEI[ ~ COIOR OA wKE 1 r~4o ~ r[vc~ rwe~[o WTE Oi NATM 1 ACE IM~ • IFOEw 1 tW INOEA N MS. ~ !Mt WN/ql MwM~ Ww l~wn Yh. j s s. M Cau. .~oo~coD orvo~c~o March 7,1911 56 r to.. usuu occw~r~ ~oi.e ~r.~y.«~ a.. q~. Rwoos ~ssa~ wousnr n. ~Tw~~c ~srr. w E..ey~ o..wr? ~ vnru ar ww~r m~rRn ? .ien ~•r- ~a.Lf N~e~?thI+~ ert~f/.efYep U.S.~Ia t~fet.) Government Wilkes Barre, PA. USA ?1llk !~L 1_ iA?N[11S NA11E I~. MOTMCII'S MA~EN N?~t[ . ~ Ulrick Kolbeck Henrietta Smallcomb ~ . ~ . °1 61-14-4603 . Ft. Pierce, Fla. o . U/un~r~l 1~.lAW[K~~TN~6wIn~~t/w~tc~M i~t/rI~1.{q.~(t). -~~C i IRT[I1~ ` ~ etr.ee~r r~~Ti oc~n~~wsc~ow~ . ; . .u~t ttl• n~r[oYa t~ult f~l _ ~ - - j U t~• e~~- 2 y ~ t1f1eN• ~~w~.~/p.. ~ ~ ~,1 1 ~ ~ ° .1 t ~ t 1~• eliA Ire ~y~ b l + ' x t• e a 1 ~t twat (i). j , s , r~al~tt~t f~nuf~ f ouE ro - F •ItAI¦ 7f ~ ~ ~d ~ ~A11T N or~ siwsan aaa~oa oomrwwwt ~o oum wrr ~er ~cu~u ro n~ aarwu oeus[ caano. cw~a~ w nrr Ku . w~s ~u~o~sr ~ 0 *ear• •f- rE1KpIMto~ ~ - t+t ~~~t\ a~ TES? MO~ ` e r!~ f~r• I0r ~ ~ asu~c ~ww wn~r occweuo. 1a~.• ¦r... yiy..~ vw ~r r+.r n yr.. N-1 ~ i 3 •~Y~~~ ~w~ ~ KCIDENT SYKIOE NOMKIQ ~ ~f~/~~1- ~1 : i ? ~ ? t 1~~ •t ~ 7~rE Or Nwr Mwf~. d/. YNr ; ?~~1• ~ uuu~i s. ' _ p I- # = m/ MlUll~ OCYURIIEO mt. ~IAC( Of MN11~ Iw ~r ~M/ w~t. ml dT1l. TOiMM. 011 LOCAi~pl ObU11TI St~TE , ' wNiLE AT ~ ~oT wMr.c ~ M•. I.ra~r. r.r.r..Ike MN-. wc.) M011R AT ~OwK ~ ~ 21 ~ I ~fNnd~d fM d~tMNI /ro~ . fo _ ~ ~nll~~t ~i~ ~li~~ on = O~ t~oecutnd ~t ~ - in en tM d~N ~NfM ~60~~: ~n o tM 6~~t o/ m~ 4no~NdN. /roin th~ uuw~ ~t~tM A 1 1 1 t~~• ~ N ~l ?lD [SS aTE ee~~l~t~•~ ~L ~ _ .ee~r~t~. il~ w~wK.c~craroit t]s a?ic 23r w~w OF[LYEiEll~011CREM~T r i3~ ~oaT~l ~.asn.rnsrp . ls~rd _ Relf~Z4'~~~' 1-25-68 Delra Crematorium Delra Be Florida s./si~ ~c~ s 9~1n N. 7t St 2S. WTE R[CO. ~t LOC4l REC. IIE6KTM11'S SKNATWIE . c~.h - ~••.uea 1 ~ Ft.Pierce,Fla 1-- q - ~ b ' . , ~ ' ~ . ~~Y ~;fy ~ii ~"b~ , tru, ,na co?recr coPy of ~+,e Locs~ FILEO AND RECORDED` R~gfstrar'3, ~r~ o~+ fi~e, i~ ths St• ~uc'~ C°unty Heelth Depart- ST. LUCIE COUNTY, FLA. : rri~nt st Fwt Pte~Es. Fb[ida. P. ~ C 0 Z t~ ~J = R I F 1 E p ~ - (Warrling: Nottialid unless ralsed seal of the St. l~rcts . 1s411a~ ' Cc~unty H~altb, Department is effixed.) '68 f E6 6 AM 10 : Oa ; - ~ ; ~ . . . , . ~ ~ N. D. MILIER, AA. D. i ~ , r ~ " - County Health Officer ~ loul Rpbtnr ~ . ? ~ i; ~ . ~:o,~ : o,Ta.,s , ~ ' • " ~ ~ • CLERK CIRCUIT COURT " l - ~Sc7.=(vF ~Y~ O~t~ O~pA1? Lou~ t~pistrar c~ . ~r= a~K1"!0 PAGE1~44 ~ _ ~ _ ~ - x~=~~ ~ ; _ ~ . -