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HomeMy WebLinkAbout2847 ~ Tn~s Dc- BTATE eowRU cf H~?~tH CERTIFICATE OF' DEATH 165`-'~i ~~~rs • ¦uR~?~, OF VITAL ~rw,r~~nc. FLORIDA °7AT` F~`c "o. leg.l _ec- / otd rAeo BiRTN NO. REGISTRAR•8 NO. I!~ properlr ~ ezeeuted ?LAC[ Oi o[ATM GODE NO. 2. UitIAL R[t10[NCt(IIa,..~.~..th..r. l!;~,c,aa,.; Rrd..wW~.~t.,..•w) •~d ¦ 111 ~~MTM ~'t . Lucie SiATE S. COt;MTY es p~.«a (~b--OZ.S Florida , St. Lucie ln p~~- D. GITII. TOWN.OR LOCATION t. IS K~CE Oi DEATM t. CITV, TO1IIfN.Op LOGTIpM t, l5 Rf51GfhCE •~qtat INSlDf ~TY UMITSf IMi~DE QTY U TSl r,l.. Ft. Pierce YE~j ?~o? Ft. Pierce ,.ES? ,;o~ f. NAME Oi ~/J~ j~ ~Dyr, ~ tMtN tdfrtu) l. STREET AOORESS NOSDI7AL OR IMSTIT~TIOM Ft.Pierce Mem. Hos . 5211 S. Indian River Drive 3 NAME OF flnl Vi6d(t L~l DATE MMt~ D~~ Yta? ~~a M~~-~~ JAMES JOHN BARNES o~THMarch 11, 196 8 S SEX 6 CO:OR O~ BJItE M~Nq1ED ~ hEYEN MARN~CD wTE OF BUITM 9. ~6E (h Kua ~~p ~ rW uwpEa 2~ wK. M Cau . ra~ usn~ ,r.~,. w,. x.... .ra. r" c• ~ rnocwco~ avoAtco OCt. 4i1886 ti~ pl~2al~ 10~. USU~tOCCUfATqMlCiuti~(o/sN!leRt IQD.KIApOF~tiSWFSSOR/MDUS?AY 11. t~RTItKACE137~[[wfi/synqr~t?~) 12 GT~ZGOirrW1TOG1~iqTT • 3 t A ye r- tari~) a~wt y~oor~i,~~ l~/r. ~u~ iJ r«irri) ••~•~c Marine Desz ner Arm En ineers Navesink, N.J. USA ~f Dl~Ck lOk ~j, ~ATMEII~S ?U~ME 11. MOTXEN'S MAIpEN NAYE or a ~ t~p~~~it~r Walter J. Barnes Unobt. ~ 16 SQCiAt SECURITII NO. 1~. IN~OAM • St4NATYRt/' ~ A(Irtp ~ + ~ .c.t ~r lr_ /`,-!tccc-~ Parkwood ~Drive, Brunswick, Ga. ~ Fun~r~l i/ CAYf[OIOLATM(~tpp11/~ftttu b+Itfv(~).(.~ a~/lt.J ~ IM7ERVAl~CTNC[h Ol+~cto• ~~RT L 0[ATM WASCAUS[OtY~ ~1 ~ • Ol15ET ANp p(ATM ~ ¦uat !11• IMYEOIATE CAUSE (~I ~ ~ •ri tpt C~~- ~ A ~ ~ ~ tsflc~e• Candi(qu.i/~q. pyE70(41_ KYiV7 ¦fta tA• r4it4 ~Kt na~ t~ ~ • - 1 o e• 1 var c~ru (i). realstrwr +t~++N t~t re/ti- ' •ithln T2 z l~iR/ c~nx fwf. ~E TO (t) _ 0 ?AAT OinE/1 SIW~KKaqT COwqilOwS CO~i~I ~ T p(aTN 01JJ MpT F[ D TO TN[ TF1tMW~ pYASE CqlfpilpN (.1Y[N W fYT 1(~) . MI?S x1.TCKY 3„~ Rours •f- r ~ ~ 0(~~s~•/Og /EA+ ~ te~ de~tp ~ ` ~ ' , YES},J Ii0? or befor• ~ ~ ~~~•pv) ~ating •n~ r- 20D. DESCRt~E NpW tnJUAY CuRRFD (~Af111~~l4~L ~JtA)Y~~ jR PY( I M PYI IJ OJv[~ ll~~~? ACtICfMT SUiC1OC IqY1C10E di~posl- W ~ ~ ? tion ot ~ ~ led~. ~ 20c TiwE oi /fwr M~nt~. /HI. Yro V IIUUNt p. o D- W ~ IOd. MuuilY OtCURR[O ?~A~( QF IMJURY (t. t~ 6+ i~+pMf AOaK, Z(1) C17Y. TOWN, pil LOCATIpN COUMTT STATE wNllt AT a NOT IlE ~ la~~. /otfal. ~frt[t. c~f[t U~I.. dt) wO~tK AT K Zi J~tt~nd~ a.~..,.d~, m 6-1-59 .,0 3-11-68 ~nd/~sta~r A~m ~fir~on 3-11-68 OutA oteu e•t 0 m on th~ d~b at~tsd ~bor~; ~nd fo tA~ b~it ol mr kswwhd/~. lrom tM uusea sbt~d. •l~ 1Nts j~ tIGWTY s~e to Dt ( L~Y' 22! AG~RESS 80'Z N. 7th Street ~TE S~GnED eo~p)at• , wsk M D. - Fort Pierce, Fla. 3-12-68 •Ceyl~t~. ~ 81iALl.CAEYA~IQN. ~(j G~TE T3[ A i/E fC[?tE7tAYORCREw~TORY 23j- LOCA71pNICN~.IN~A.ortpYi1J/1 (J7at! Buria3`~"f'' -13-68 Th Palms Cemetery Ankona (Ft.Pierce) Fla. Y• 3.! 612 "21 ~ CT A~ (~tpORES~ . 7 th S t• js DATE PECO. BY i~ REG. 26. REG157NAR'S SKd1l~i~RE ~ r lJ 1 R`•.1°6S t ~ Ft.Pierce,Fla. ! - 13 _~6 a : ~ , ~ FlLED ~GND ~ nereby Ser~fy t~is fo kier"s true and correct copy ot the locat ~7', ~U~~;. RECORD~p Re~istnirs ret~r~on file~ii~Me St. Lucie County Health Depar~- :~~;~V_+TY, FLµ meqt ~et Fott'.Rierc~.:f{q~tdb;. ' .3 ~y - , • - `~(al'Jarn?ng: Not valid vnte~s raised seal of tF.e St, lucie ~~~tj~Ji : Couaty Health:6epartment is affixed.) '66 `S Pt~ . ` r . : ~ ~ • L / ' ' ~ { ~ • N: D. MIIIER, M. D. ~~~~7~-~'G"~-Cc.L~ ~ ' ° ~ Cou~ry Health Officer ~ laal Registrar ~ ~ ~ - ~ ~ , i : - : y . . c~~~~; c~rcu~r covRr 3 - "t- ~l'-~~ ~ t ~ ~ ~~-v~-- + • . Dats Oeputy lotal Registrar Q.. , BooK~~70 F~c~~~34 ~ _ ~a .`~~~3 ~F ~ _ `