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No 11-09-79 1 Ft. Pierce Florida
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111 i lt~~• ~ja. NOMATWI[ (De/?aMNNs) ?21. A0011ES ?lt. DI1TE SKIEO ;
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~o.?~.s. ~ John D. Bro~rning,M.D. Ft. Pierce, Fla. 10-17-~ ; _
CY?at~. I3~. MJltl~l. CIIElu1iW~4 Z'I~. OATE DC. NIIME OF CEMETEII~ OII CREMATOII~ ZY_ LOCJITION (Cif/. lMr~. M tw~fll ~~Pdd
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R[rOr~t (Syeti//1 {
Burial 10-1 -60 H~1lcrest Mem. Gdns. Ft. Pierce (St.Lucie Fla. ~
V. S.+A 19 2~. iY11E1tAl D1RE OII'S 51G11ATYIIE pOl A~ 1 ti11 • Sti • 2S. DATE REC0. ~T LDCAL ROG• REGKTIIAII^S SIGIIATYRE
~ ~••.~oss .~.ilton W. Baird~ Ft. Pierce Fla. 10-20-60 Anna Lee Denison d.r. ~ ;
~ ,
I hereby ceNifY t#?is to be a true and correct oopy of the Local
~ Registrors record'on file in the St. lucie Counry Health Oepa~t• ~
~ ment at Foct:~Pierce~ Floride. • ~
~ (yy~~,Al~qt~valid unless raised seal of the St. lucie , ~
FII.ED AND RECORDED' ~
~ `1,,; 1~~`~y~ `~,alth Department is affixed.) ST.. LUCIE COUNTY, FLA. : ~
~ ,,~~'~~1 D. MIIIER. M. D. 1~~3Ci`4~~Fa .
,
~ . ~ . , ~ ' ~'~~~1nry. Health Officer b Lotal Registrar ~C~ ,
- U JUL 2 y I~M .
~ :-:~i~:: : . _ 10. 47
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~ • ' ' : peputy Lotal Regis r
~ '•i 3 ~ j, :c.~:: : U;;f3 $
1 Cl.ERK CIRCUIT COURT
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