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Home My WebLink About2481 i w~ _ _ ~ • • _ $ • ON10 DEPARTMENT OF HEALTH ~Q ~ . / 16`7QE7S _ 1~s. Ode. ~t. _ DIVIiION O~ YITAL fTATISTICS h~"~ CERTIlrICATE OR DEATN t~t.- g~:~~ - i. PLACE E N , • " • - i~MrrtiM: - ~ •r•. a~tY sl E ~ ~ef~ee ~Mwi»I ' w ~ ~`~Ti~ tfAi! ~ QO{N11r R pit. 11 ~Ipq s. 1p~01M O~ ftAY IN t. Clff, 111~1AGE~ O! lOGT10N Y _ C~Gt._~~' • - ' - I ' i. wwE o. ~~1..+.. «:.,r.r.a.., p.. ,....r ,.i STlEEi AOO~Efi u+sunrt~a+ ~ . ~ ' a w~~~?'s 3y~o ~~e-u*G-~~'c ' - a n~ a oEwm ~oE an uM~m ~s ~ou.ce iw~ot an ~uun~ I a~s~~NCe oN w rnw~ . ~ .[s I7 ~+o rts No - - ' ~ NAME O i~nt k W?tE ~s Y~ ~p ~ DECEASED • m~e o...~.~ ~EL ~ Z~ 1$G 17~ t /eU r F ~?TM GT ~ - ~ I- ~ u. - aao. w.na s. ru?enco ~.ueaEO a?re or a.ni ~ n, a~~ t.« n~.+w H ~w.. . - ~L ~ h~ ~l ~~A L ppwEO O WvOK~EO AbNiil Dvp HNa I Mra. - - - M~. YiWN 00[11rA110M f~`s~ ' ~l Mr ~p 1. KINO O~ MIf111[ff Ot IMOYSTtY 1. N~ It• )M~INAi /0~0{IM~~YT ~rM M~rNy I11~ wM 11 nNrd/ 17. I~~~~ 11. MOTIIEC YAIOEN NAME K S/~f - /~L [1Q C1~ ~~i4 S~" ~ f~ E~'N~4.? / - - i~. w~~[CtAfEO ErEt N~ Y. s. AwEO q~CEtt t~. foCU?t itNt~t1? MO. ls. RM T S AM~- A~teu Ira. ~ ~ It! ~n. i~ ~r? «l~a../.wriry a 7G~~ - / ~ v w ao - US A an • ~~e ~~x ?et iN wr . . INtEfl/Al ~l1wEEN ~~r otwni wws uuisn at. ia,n ~ri~ ' I oNSEt w+s ourn w~ua~r[ uust w - • a-~ - . ~~Ii~r1 ~ m~ M OIIE t0 fN - ~ I ~we h1. i ~sr r/rf. OIIE 10 Id . ~ p bti M. ~f~ MNntMT C~MtN~~ CM*MM*N~ t~ M~f~ ~~f M MYtf~ N fN TfNNY N~Y~~ lMNf1~ MM/ O M~t I~~I N. WA3 AYTOKT ~ S ' fEHOWEOI _ i E tEi ~ MO ? _ ~ fY1CNE IIOMICIOE 10l. OE3CM~E 110'MI INAIR OOG!lREO. Il~~ wt~n ~f n~ry i~ I~f ~r ~rf 11 • iN~ If./ ~ ! ~ ~ ? ? ~ !R. nrE p N~w AIMr . D~. ~~r ~ ~ ; N~,., a ~ , ~ - i~w_ xuuer oaoua~ ~o.. n~ or ~wun i. i. «.r.u ~a_ arr, vnu?ae. o~ tocwiia+ oouMn. ~tE ~ O~ At ~ NOT w1111E l«~l• N~wI. ~~rr IIl~.. Mr./ - ~ AT 1MOS ? , y - . ~ ~ t~. / rw~fd tM /~rtrre/ /n~ t~ ~ lot iwr ~ diri ~ . ~ Der~ krwni/ o ~ • N~ l~~ irrd n 1: a/ I~ r1e Mu b~ddp. Jn~ ~M ryi~r if~rd. ~ - _ ~ SIGNATtJRE ~ (D~rp.. w rw1r~ n~. ~wu~[ss m. a?r[ s~cMEo ~ > >ldt ' ~ . ,l, ~ S nl ? . ( ~ 5E b l, t n•a~cc ~ J~~ I a 6 ~ 7~' M~MAI. C~t~M- t7r. OJ?fE J~s. N/WE Oi CEYEiEtT O CtEMATOR ~7I. tOCAT1pN lGf?. b~w, o~ cew~t~l ( ~t1 s ~ ,;~.,T I cL ~ t, o,Z c~~ ~ ~ ~ ~ wirE a u~wnc~ . ~ue. ~o.~ t ruNEai a •s s~ u~e ~ ,.~e. .w.~ ' f ` ; ~v ( . ~sV~ i ~ L_~~l c f~. L'i oie~ _ ~ k~ pM ~ ~E~ (lTtEET NO.~ (dt11) (t1ATp ; = I_ r M n~?!.-~~-~A o 3 r~ 4~ L v D a~ ~ f~ s. t v~ e r. o w t t ~ e c~ o a s j s ~ ^ / - ~ i ~ ~ ~1,~ ~ '~'~iT S/~ / ' CX' / i~ - ~ - ~ ; , ~ r c. ; Y 7~ aT -H~ ae~vE ;s ; - . - _ - FILEO E~ - ! ~ ; r` ~ . =rr, ,~1k~C1-! i~ Gt~ C ST: LUC E C UN TY, FIA. ' s~ ~ ~-',r , . .-~T ~..E~~~;N._C~E'~J~~.~+~~. ~ f~~..nrr^~ . .,r~,~,r ~ . , -y?•r?~~`D~~.~q~~Al RS~O~AI ~r ..lUIW~ ~ ~ (J?~ . ~ ~ STf.T ~'~~r. I,.. . ~ ~ ~ ~ ~ ~ . • ` • '69 t~A I 3 • Z s ~ . ~ . ~ ---t~~~ ~ MAY 10 1960 _ - , ~;.r::,~. _ ~ - ~ '~-r" '~V' i IZ«$ , ' Q RK CIRCUtT COURT ~ _ ~ ^-c, e . .;sa fr-snw -'~+M r n-„~,.,- ~ ;:i ~ ~ ~w• S - ~ - 0' ~ ~i71 ~~476 ~ - _ _ - ~ .