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rai: rrwTS w7taa o' Hrwt.~ CERTIFICATE OF DEATH -
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prop~rl~ CR STIt~UI•• NO.
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c~ «s?an I Bell Williams ~?*N Febru 13 1962
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a e. Female Ne ro .noo.EOp wno,eccu A ril 23 1899 2
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¦•p•~~ ~omesticti s At Home South Carolina U.S.A.
llaet f~t FATIIER"S NAME ~ YpiNER'S yA1pEN NANE
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~n••«s.. Tom Paterick Jaimaie Goodroan
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Dnrlh oee~apd ~t ' s~ an tM d~t~ at~t~d ~bo~~: ~nd to tM l~at oI aq tnorNdp. Iwm tA~ c~uw ~t~t~d.
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ar• t• 1• ~~'M?p N tYk) ?Ib. AODIIESS . . Z?t. OATE S~GNEO
~..,1.~. a 1~iartin G. Gould ~I.D. Fort Pierce Fla. 7.l~ Feb.62
• e! ~ N. 23~. ~urn. C~[~unOK t~. OA?L 23r. IU?KE OF CEMETEIIt' OR CRfMATOrtT 23i. 40C4TqM (~l't/. b~rs. M ew~lp (sW)
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r a~ Feb 18 1 Pine rove Ft. Pierce Fla.
v. s. ~sia rw~c~u oR s siuun~ ZS. WTE 11E[D. ~Y lOG1l REG ~c. eccarw~-s s~u
a.•.loss Per S Peek 2-1s-62 Anna Lee Denison d.r.
1 hireby ceriif y this to bs a tn?e snd correct eopy of the ~oca1
ttegiurar's record on fik ~n ths St, luci~ Couny Hsalth Depa~t- y
' mer?f at Fon. Pie:ca. Fbrida.
(Waming: iVot vel~d unliss nised seai of the St. lucis
- Counry Health pepartm~?t is affixed.)
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" ~ ~ ; • • N. IVIIIIER. M. D.
~ ~ . Counry Heatth Officet ~ Loca1 Reqistrar
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» D~puty LOaI Rpistrar
~OOK PA6E 6~7t7
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