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HomeMy WebLinkAbout0168 . t~~. !e- ~TAT[ wwRO oR wsw~rn CERTIFICATE OF DEATH ~655()a~ ~ i' Fj i:s i:.e- ~u~uu OF YITAL RATlfitq F L 08I D A *rwn n~s Na ~ erd •Aen SIRT Nb. R[OIRIIAII•~ NO. prep~~l> > ei~eYt~~ 1. KAC[ K~[ATN GOO[ NO. L YWAI IItN~[NC[IIM~M~d 'W,. R~iM~W.+~.ru.) ' 3 ei'~~~ ~ 001M~"St. Lucie ..0~~, ~lox~;da t. Luc~;e j i. ~~r- cm. Toww.o~ wut~ r. a n~?cc as oun~ e. cm. mrw.a~ wuraN t. K 1tESr0[+~CE ~ •.¦•¦t r~oc cm worn na~ac cm ~ rn i rs~.. Ft. Pierce .op Ft. Pierce ~ t. w~wc or u~..e r. ~ ~"0 NOSMTl1l OR ~~~I. N~t M7td c!1?fM) I. STIIEET AOOII~f ~*r*~*~ Ft. Pierce Mem. Hos . 211 Riomar Drive ~ MnM[ N FNM ~fi/4r Lrt WTf ~(wA D~1 Yer in;•` «~w~ FRED TAYLOR ouTM January30, 1968 ~ . S. s[x i. oo~o~ o~ iucE riwrto I~ ~[v[~ +uwKO - a?r[ as wn~ ~cc (I~ trwa r una ~ rw u~u ~s. ~ r ~ t t. M CaU M~o ~~o March 8,1890 ~j~~ °ji xi'' ~ ? t•~• ~ i to~. usu~~ ottw~no~ to~r tt,~ yws r... Kwo of Mar~cna~ nousr~r 11. ~rwu?cc (aw a ~ r i e r- fa?io/ .~t y vrthM hk. st~ Ij retMM /MrM~ awn?I) t. ortuu as ~wT mwnn Warehouseman Ballantine B Newark, N.J. USA llaat l~k 1]. iATME~'3 ~E 1~. MpTrt~~S N~p~N ~yrE ~ •r ~s.•••;~•• John T. Taylor Nancy Swithenby ? ~ socu~ sccuRm w. n. ~ a s~wu H _ - ? Ft. Pierce Fla. ~ i~. ~.ws «.r~~ F ~aw~r~l I~?MbMta+wrlv ' IwW (~)J ~wrt~vK~t'nrta ~s~~ec~r r~~ri ouTM~nscwscow: ' oascrw~ourw .~.t t~i• wrcoaTC csusc W ~ t~• e~r- , • ~ tltle~t• p~/ityN.ilat. py~ Tp rttA ta• y,~/~ ~ 1• e • 1 ~8wr c~i~ar t~). ~ . r~si~trar M~ti~/ Ne tNrr• py[ Tp (e) ~ •1t11i~ 7f ~ r~. ~ 11er~• •t- ~MT M. 011E11 S~ililLMf OOIpfI1010 OCMAM~RM 10 OttlN QR IO~ ~[1A7[~ 101ME 7WIiM OQfAf[ GOM~IUOM i1Y~1 rl NR~ 1(y . MAS AlIT0~S1 /EbGRMEOo t~e ~~atY S er ~~f~t• 1R3? p? ut1~s AOC?OEMT w~noc wr~uo[ ocsu~c Mor ruu~r oau~~to. (E1~a ~~tve N4/at h rwt I r A~M 1~ y trsn ~I~ ' a~.~..~- O O ' ~i., •r ~ aoe. Y~rc os H... x..et, ~n. r•.. ~•~s. wuer a. S s. , w = 20/- IMJYAI OCCYRwED ~t. /IACE O~ 11llYRr (f. I•. b~r ~IIMt MAt. mJ• pTr. IOtM. Ow lOGT10M OOYIITr STAiE i 1MM~I.t AT ~ wr ~ac ~ lp•.l•w?r. x.eee. Mc* My., .k.l M~~R AT ~OIIK I 2~. ~.eanlw rA.I.e~...d~.om / -9- ~i .~r . eo _ 3!._ (o A.. /-.3 D - [ r/ ~ ~nd /ut Mv Aiaf Dtitb oae~rnd ~t m oe fM d~t~ st~t~d ~~w~; ~nr te tM 6Mt ol w~ inorl~lp, /roe~ eM uuwa ~bad. ~ll it~~s ~ ~~T~ •r• s• 1• K M tM ~b ~OOREU t7~. wTE S~GMEO e~~~l~t• ? _/Q (~O ~Ct~~~t~. j~ ~UMY.G[1MHOi4. WTE . II~MEOFCEMET[IItO~C11EMAT0111 ~.IOGT .NIA.Mps~t/l ~&~(d r"`~ia~'"`h~ 2- 68 Hillcrest Mem. Gdr?s. Ft.Pierce Florida r.s.tsia x~ ~ ~ - ~N. 7th St ts. a?TC~cca~rwc~~ca. ~cc~+uu~ss~u .r~ ....,.as / t.Pxe~ce k'la eL-1 ~ ' - _ . _ _ -r - . - - - j _ ' ' . i~ ~ . , . ~ Lt~~ f,..~'._ • 1~bsreb~? cettify'this ro~~ •:twe and correct oopy o# fhs t~oul FIlEO Ar1D RECORDED ii~iiitrA~`f~o~ird~ qn f Nb }A the St. luci~ County Hee lth Depart. S T. c U.'; T Y, F! d. - ?~it ~at 'Fort P~e~cb~'~Ip~ic~s-. - ~ _ : . . ~ - - ~ ~ ~ . : ~-~(Warninqa Not va~"Ki.uiil~ss rafsed!seal of the St. tucie 165503 ~ ` - ~ co~~? ~+..~rn-.e~~~t;~ ~tix.d.~ ~ V ~ ; ~ r.~ ~ . _ '68 2 5 ~i ' ~ : -~17 ; ~ l' ~ f 3 ~ =J' •Tl: D.~~MIItER, M. D. ~ ' ...r~ ; ~~,~6ounty Hsalth Officer 3 Lou! Re~istrar • . , ~ ' ~ . C~c:RK C~r~CUIrT COURT ~ ~ ~ r~._~g ~ . . . . . . - aa o.~ny t~«.i ra~tm~ d. ; . 800K~ PACE ~ ; - - ~ w-. ~ "i. L' s^31i~'A+3_ _