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Home My WebLink About2279 FIl.EO AND RECORQED~ ST. Ll.'C1~. ,r,i)ll.•;TY. FL,A. RE.coHn ~r~ RfFtED ~~e r~~,R 4~~~ 9: ~ y ~ ~vt',-r,:~ ~ c~c~~. CfRCl:1T COURT TAIs D~- sYAT[ Qowno o~ Nsw~.TM CERTIFICATE OF DEATH eo~~a • ~URtAY OF YITAL RAT7lf7C1 f1'ATi FIL[ N0. 1•~•' FL08IDA ord ¦D~e BtRT NO. REGI6TRAR'f NO. 7S7 p ~ o p~ ~ 1 r 1. 1lAC[ 0/ OtATN COO! N0. Z. YfYAL R[t10[IIC[ ( II?n r.wr ~i«/. lf:.wwr.w: lr~r M/i+w.:«:w) ' et~tut~d ` ~N~ STATE OpUNTY ."a ."1 Saint Lucie 6G-025 r o'da T ~ r s• Pi•e•s ~ s4 y•.- a em.lowM. o~ wu1aM a ruee os oun~ a aTr. T01YN. OA tOCAT10N e. a ecs~oc~ce a•qsnt uiS10E uTf lu~~TSf INS~DE dT1? l~r~T51 ril•. F'Ot^t PiP.T~C@ res~ ~a? r _ rES uc I. MAME OF U/M! h JM1il~. NM W~ NI?f~) I. STREET AOORESS NOSMTAL OII ~sY~T~au R`t. Pierce "temorial ~1os ital 44 1 v 3. Nw~e oI I7rM A/li~lt Iwrt wTE Afwt~ Dq Yea i`~ «i•+.~~ MI1.RY AT.~E:LAIIIE i~IA"~~'~1S ~TM June I9 396 7 S. SC% i. OOLOR OII IU1CE 7. NA11111ED ~ NEYER MMRIEO WTL OF ~tlITM A6E {h /~1 li II~OU1 ~ YW WEA 2~ Mi ~ wW~1~ Xw~M Ww Xwn Xi., i s. Fertlle :Jhite rrioowco aw„cco Dee. Z3 2892 74 ~1~fwl~ i0~. USU~IOtCUrATqN(Obeti~IywrtMt {~.KWOOi~1I51NESSORWOYST~T 11. uIITM!?ACE(ST~feO/~rtl/~qr~ry) . C~I~IIwOf~W1TCOiMtll~t ~1tA p~r- 1 ~I~tN khlhk.snfJr~tirM •~A~OL i`~ouse:.n'~e Aennsylvania tfiited States 11~ek !sk ~j, rATtER'S NiWE 1~. MOTNERY MA~DEN MAME or ~,,..~,s.~ *lichael J. Conrov t'tarv (Unavail.ahle) IS. WAS OECEASEO EYEII M Y_ S MYfO PoACESf K. socuLL ucua~Tr ~o. n. u~ro • wsw?TUw~ thcY~ael J. '•~t?~et,?S r. ~r rntwd 11/ M~. M w~ ~r i~Y~ ? 4~~r1 262-20-5 1.T 1 wa..,, 78 Kinp Aoa e.ane .~vt ttecan IYA~T~1 ~rA{I~ N KA~ Mh Mf ~NN /V l~t~ (S). af~ (t).~ pP.7~.S lV~l IIfT(~VAL ~E~WCEN a i*. e ee r r•~T ~ oun~ rss uuseo w~ y o~ uw oc~TM w,,~n ~ (',ereb~al 'I'~ra~bosis 2 wee~:s fY~t t~l• t~• e~r- tifie~t• CAlv~.t/atf. pyE rp ~it~ tl~ s1in~ /rs r' 4 I o e • 1 ~Eat tnat~~1• r~alstrar at~4y t4 rs4'• q~E ~o (d •ltDla 71 4ia/ prat !W. •oa~ t- O fMT Il OT~i713KAf1Wlt OONOITIOl6 OOMIpql~tiG 70 OE~TI ~IR MOR RU?~tO 10 M iERrwY OKUSE OOIphON CMD M?MT 1(y . 1MA5 AUTOKr t ~ERiORMEDT s~r d~~tM s s.ror. YcsO wofl = 7Aa- ~ 7DS. DESCrt1~E NOMr NYUItr OCCURRE0. (A~ter *Yws y1R/v~ 4 Hrt I N f4K 1l Ifrs !tJ ¦~klni ~ ACdOEwT AIKWE IIOMKIOE y poal- Y ? ? ? • ~ 10d •f TWE Of tlM/ XAf~. Qq. Yp? ~ uuuRY o. S t- Y = 20/. IIU411~ OCCifMEO mf_ M.A~tE OF INJURY (e. I.. in M~M1IY! w~t. 7DI• ~m.10*M. OR LOCATION OOUNiY STATE 1~KF AT ~ MOT IMMILE ~ ~~1.1 ~dtd. ~tt OlI/.. lft.) . MORK AT MI'OIIK 21. J~tbnd~dtJwdwMMdfrom ~~2~~7 . to ~-~.~~fi7 ~nd/wtaa~ A,~ ~/i~~on fi-1 ~-i~7 ONtA occurnd ~t 4= 2n a m on th~ d~t~ ~t~t~d ~bo?~; ~nd to tM bwt d m7 x++o~'1~dt~. /iom tA~ uuws ~t~tM. •11 lt~as ~ t0 1• ~~aMlYk~ 7tA. ADDRESS ?It. W?tES~GMEO ~.,p~.o. • F. `~?a~cins 1'I.n. rt. ~ierce Fla. 7-5-67 •CeY/~t~. Z~t. Mn1?l. CREl1~i~011 Z~. Di?TE 23[. MAYE OF CEMETE1l1l OR CREMATORY Z3/. LOCATION (GSf/. IM~A. M cNifl) (~ALft) ~i~' Liolv Se lc:ir~ Ce~ete~~v P'niladeln?~ia Fenn. Ret^ova.. s.~ a iU~RAI DIRE Y s~c~urwe .oopcss T't . Fleree ,~I~L~ aco. ~r ww. Rcc. xc. ¦cc~sr,us~s sw~ru~c , R••. ~oss ~Ta~: J. I~~oore Yates Funeral :io,. 7-i0-67 F I. Si~:~cns s ' ,i~t~i~~.~,,,.. r, . - ; her~bji.,cehify, ~?~'io ~e s true ana correct copy of the Loca( Reg~tl~a?'a•_cetord on' file ,in the St. lucie County Health Depar? me~At-at _fQrt`l~te~. -Flo~'ida: `"-~NValrning:, Not valid unl~#s raised seal of the St. lucie • - . ~ Counly Heaith _~partment is affixed.) ~ . r ~ l: . _ ~ N,~ D. MIILER, M. D. ' ! - l>~Co~in'Ty Health Officer 3 Loca1 Regi:trar ~-Y~ ~ . ~ -L- - ~ - ~ Q i -s„~?u- i ~ pm ' Usputy local Raflistrot c1 i + ; : i : Retum To: CARL.ISLE, ZEIHER & BYRp ~ ~ t~n 2240 f. Sunrise Blvd. ~06K.C V PACE~~ FORT LAUDERDALE, F(.ORIDA - ~ ~ ~ ` ~ - ~'a,~sU~~,~§~~.~~ ~ ~ .