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Home My WebLink About0743 1~'781~3 S7, LUCIE r(!U!:TY. FL~. ~ - , . . , r- t. lb'7~31~ 'uB 1 PM I: 4 7 . . i F: S i-~~RK C{FiCU~? CQURT ~ ~~~~Nf~tt~,yo { ORANGE COUNTY NEA~~~TH DEPAATMENT- ~ VO ~ ~fd - ~ • - . ~,~II , f ~ . _ ~i! N eri Ct*ln1 Ant~tN ' . x .,~».~s~ , ~s P. 0. Mx ~1~7 F <~v"~.!'~.~.t Ctle?ry? 1d711 . ' `y0 ~ , ORLAtitW. 1~LOAfOA • , ~ . ' ~ ~ ~RlARO~ ~ . ' . _ . • . . . . • . . ~ Stste Board of Healtb C~'~"~ '~'`~~A'~'~ Q~? D~~I ' Stste File Na Z~ 3 Bumau of Vital Ststistics . , ~ R-279 ~ FLORIDA Res~atrar's Na . : ' . - . ' t. 1•L111'~ UF pH/1TH; i' L USUAL RESID$NCE OT DEG6AS6D: , i co„nv Oran~e n~ xo. 35-O1 . ~ - ~~b~ r~+,« rna.a xo. ~ a> se~. ~lorida c~.~,_ Orarige ! ~N rit• ¦.m• noe ¦Ya.n.r) • • Drl nndn 35-511 Orlando ~ . • Yo~?* ib.+a xa (e) cits ~r to~+~ (It wL~ dqr ar fara m b. ~e ' a..K o, ~,o.r~~.~ ~:~.~tn~-I~I~''fTandebi t- ~a~ xa 101 V~ndebilt Dr. ~ tl[ ~ot in bosniW e~ i~tiWtiaq ~rite~tre~t ~mxber et {oe~tio~) . - ' i~~ Lenr~l ot ,t•s: in losriat or imeieation (I[ r~n6 sh~e tia~) . Ii ihi. cwwraawit7 12 .9 ~ . ISVKih r•hetAer mts. mnatlr oe d+v~1 Il IoreiFa Dora. Aaw bat ia lf. & A.T ~ra J. FCi.:. `AlIE OF DRClGSED z iq~ lt~ea.nw. • ~(1) SoeI~lBeeoritr HEDICAL CBiltiPlCA?10:1 • _ nwn~e ~~r NO Na _ None :9. Date e[ Dstb: xaevldar~h j~y 15 . ; Y~ 1941 ,o.r x;A~ ~Female co,~ o~ ~,a W~i te i{ i' !1. 1 Aecebp eertlff tiat i~t:cnd:d lbe dec~~ced f aw . hiatie, ntarricd. vaidowei oe di+mecd _~31`Y`~ ~ - IYt~l ,r~ ~[SY`C 14 • - o t~~ 1( m~rried. ~id.nrd or di~orcN, Ausbasd ot (ar) .;r~ or Amos , Ro e r ~ K. s~.~.~ ~~.IS ~ . ' aai tiae destl~ oeearnd oa tb~ date .ad i~onz sutad .bre. D~rathw - 6(ur A6Y 4I ~WIL~Od or wUe, i[ alive _ FiS ~A ~ n~ ~ ~ or ~ Feb. ?3 1863 G~erebral ~`emorr a e ' ~ . . _ ~~•a•w ca.,?~ cs«~~ . ~M~. Y~.w u~..w.....a., n.~ arteriosc~erosis Ren vera ; ~ 78 - 22 9 ± ~ ' r.. n.. m ' ~ . ~ o. r~rt~evt.~ ]t 1458 ' : ~ tcia. to.. er eonov) es~.t~.r:.rais. eo~.a~) oeav eo.aiqoe. ~ - Hou ewife (1i~•~4••~•~~i.s.w.a..r.~.c~? • • :0. ti.ual oceqytiw ~ 1;. l+~d~rtrp ~r bnsines ~1~1~3@ 1lwjor 6~i~ps , - . ` s:. Charl es 0. erkin u'"'~''"' ' ! = w e. ` ~~ki~ MN~ i ~ :s. itirth~•tate NAt: kT1AW ']l i (Giqialeo[opee~tio~l •h~~ti ~e , ~ _ J . ~ ~ NO ~[310tiY11 °t a~tw+s elurte~ sl~- ; . to. :1~iiee nan.e _ 1 ~~tr• : T t:. ui~iDni.ce Not knowm ; A A ope r - i-' ~~~t` KM d~! ~O !Ztl~~il pOM, QII IA LL! IOIIO~rj.~: t~;--Inl~nn~s:. Siru~trre • • ~(al Ateiiest. ~oieMe. l~o~aicide t~Pedis) _ w~s.~.. lp.l_ VA n d~•H 1 t Dr ~ Qrl an~n ~ F1 g. I (bl Dste d ocarrreaee 1t~rN:. c~.~na~i~~i or taaiw~~iT ~reen~veed ~Cl ~I~!(t di~ isjW~r Opeo~t . 3 17 41 Orl8rid0 F18.~ ~~°w"" 1T ~•i URte . . _ I_,_~___1' !bl 1'1~0~ • Nl DY iwi~rf oee~r ia o~ ~bo~t Yose. oa t~rw~. iw l~d~rVitl p4ee. iw . • }'qAeT~{ (hh~ ~n~ a ; i~twtare ~P ~~y~~~/~~ ( Yn1Ue DLet! - '~""ib ~ l.3veei[Y yrpa of p{ace) w~d+... _~.'?'Q_E.~._s~lllr ~~,Q? . ~ .r.u..t t K~.w -ot ~.3.r, . ~ t,:..~ ~h . ~ a _ ~ w:--z-~,~, _~,~t~ fi f,~ ~ lwe~l Il.t~.sr+~r A+ae... .ta e sj.i' ~ - -CE~RTIFIED CUYY , . . , ~J~ ` • ' ~ ~ ~~c. ereby cer Gify the abov~e to be a true and ooi'rect ~ copy ,ofl• t`he ~.'~•ocal :~;~istrar's record on file ia the Orange Count~ Health _~epartm~it%~t W .:ri;,n~do, Florida. ~ - ~ ~ . . ~ . :;;~:ItJ :~tot v~lid unless raised seal ot Orange~'Couaty Hsalth:~pertmeat ~ ~ is affixed. ~ s~ = ?f ~s~ . . - ~ ~ ° - ~.4~~~ ' ~ County Heiilth OFficer & Local Registrar i ' _-l - ; - ~ . fG ~ ~ ~ - ~--~-~-t._¢_ Dste Issued Da Ly Local Re~istrar • so~K 172 PA~E .741 O'LAl10NL.IN ANO O'{..A~JO?t?-1N. ATTOI+PIRYS AT 4/?W. /OAT l~IRACt. ~~1DA ti %'9^ . ~'.w~•-._ w . . . . . ~.'N.:. .~':i' ~ .:3'~i~ ~~d'- 6 ~ I '?h: ! n Y'. .