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~{Q,~~x~ DEATH CERTIFICATE OF STANLEY J. EVERETT ~
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~ a m`" Re: The South 77 feet of Lot 15 and the South 77 feet of
~@ ~ ~ Lot 16, all in Block 14, SILVER LAKE PARK ADDITION,
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~ 3° as per plat thereof recorded in Plat Book 10, page 8,
of the public records of St. Lucie County, Florida.
?n?, De- iTAT[ BOARD OI~ HtJ1LTH CERTIFICATE OF DEATH
ouacwu o~ vrrw~ srwr~anw fTATt Flii lt0.
'~R•''•~- FLORIDA
ord asen BtRTH NO. RtG1iTRAR•Q NO.
p r o p~ r 1~ t. Kwt[ 0/ oIATlt ~ GOD 6 NQ uw~~ i~M~ Mwr w~. l/:.r:ae.w~ 1tn:i.w W.n ~.ir~
c~eeut~d
•nd •11 °0~ St. Lucie (~..p2~ 4 STA~lorida O0°"'~t. Lucie
Oe pl~e~d
1 n p~i- -6. ~ITY. TOMM.OR IAtAT10N t. K RACE Of OEATI e. QTr. TONM.OR IOC~i10N t. K RE510ENCE
Ft. Pierce '~0~~ ~p Ft. Pierce ~ `~~,q
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I. NAME Oi (~I Mt ~II ~M~ifd, /iM WM! NbtM) I. STAEET ADOItESS' .
Np5?~TAI OR .
~*~T~*p« Ft. Pierce Mem. Hosp. 3143 Naylor Drive .
3. wtKC or i1b.t Atitrri L.w 1. ara 1~l.,n Dw Ye..
ocecwscs
STANLEY J. EVERETT Jul 10 ~ 1968
S. SO[ 6 OO1011 OR 114CE ~ MARIItEO SI NEYER MAA111E0 OATE OF W7N 9. ~cc il~ frva i YtiDC~ ~ YW 1M~oEi 2s NRS. .
lYf ~irf?~1~ MwW D~w IJwn Mi~.
w~ 1:. M C8L1 rnoowco D ava~ao Apri 1 13 ,18 9 8 ~ p
p 1~1~1~ 10~. tiSV~l OtCU?AT10M (Oiu 4i~[ ~J~cMt I~t 106. K1MOOi WS:MCSSO~I WONSiRr 11. iC11TWlACE [S7~Lt~r~i?dA pua!//) I tlT1tEM OF ~IIMi 001Mi~t1
'U .ltb y~~- AriM ~(natt+Hlyk.aewl/retuM
Mac~iinest Sho Nawticoke, Penna. • USA
~ ?l~ek l~k 17. iATME~'! MAiIE IL MOTNER3 MMCFA ~11ME . •
o ~
~ •~p••~~~•. Walter Everett Mary Baldwin
t6. SpCML S[CURIT1f NO- V. R • Iq11ATY A~y~. ~ . . .
x 80-03-1590 - : ~ act,u ' • /40s~F
• Pua~~~l 1~. iAYf[ N Op?TN I~Wt~!~f/qtt'~wt~t?ti~t/~?(~l.(A).ul~d.~ 1 NYAl~ET1KE[M
t"'j 4 i f~ e ti • ~ART L OEATN tif~S ~MIS[D ~Y: ~ ~ n OMSET AMD DEA .
~ost tl1• IMYEDY?T[ CAYSE (a~ l/`h ~t/j (~~/yj,/ `~Q L
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A t e e a t N Calitte~e. il u?. pyE TO _~LL! .G~~~- l
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WE TO
h o ~ T• •[a O ?MT il. Ot~E71 SrG~itJ«T CO~O~T ~wG ~t/f 7Ep tp M~AyyyLL pKGx M?MT 1(Q - MrAS AUTOPSY
ter daatA ~ l ~ RFORMED7 ~
or bet~t• ~ ~ rES 1W ? ~
WE ~101Y YtJiiAV OGCWIlE0.
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~ ZOt Y17U11Y OCGVIlMO mt. tIACE Of i1UURY ra ~r ~A1al ysr. 2D/- CtTI. TOtI11. Oll lOG1T10M ~ OOYNTY ST11TE
MMKE AT ~ woT rreut ~ /d•.I~u+i. a.ser. •ia etN•. euJ ~ :
MOItK AT II~OItK
I ~tand~d tb~ d~pd /ro , fo ~ ' ~nd /~~t ws r~ lir~ on ~ ~ ~ .
OwtA occ~tr~d ~t on lb~ d~l~ ~t~td ~bw~: ~nd to tAi b~st d m rl~d/~. /roin th~ uua~s at~t~d. +
All It~~a N4~~~
•es to i• (~tr tYk) Ztb A0011[SS . pATESt6NE
~ ca~pl~t• ~
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\ ~T_~ L~A DATE 23[. MAM[OfCEYETE~YpRiREMATpRY j~/ ?Q~A7bM(LSf~.[MlIt.N4/tOfj1 ($l~ft) i
-r a~ 7-13-68 Ft.Pierce Cemetery Ft.Pierce Florida f
v. s. ~ e i a rure c o+~ s_ uRC ~ ssN . 7 th S t•~ RECO. ~OCAL REG. GKT11A~'S SKNA?YII[ ;
R°•.1°66 li~~uC . .c~ .Pierce Fla. . July 12, 19b8
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1 hereby cett~fY th?s ro be a true and wrrect copy of the tocai F~LEO aND RECORO~ELD. ;
Registrars record on file in the St. Lucie Caunty Health Depert- $T. LUCIE COUNTY.
: men'~at,~pft.~ie:ce. Fioride. f-.-.~c~ :
`t~~1~ `~~~q; ~tot valid unless raised seal of the St, tucie p 43 `
Co~iM ~iealth Department is affixed.) 8 P~ 3' 3 9 ~
• • ~~1- rt-'- t •
•~~~n~j = 68 AI~G ~
~4s~ _.~_fT t'" ~L D. MILLER, M. D.
:s • ' ~ s~`;'' ~oirnty Heahh Officer & local Registrar _ ~ S ;
_ :.::.~.._~t ~~iJlist.. E
~ ' ~ ~ ~ ' - CLERK CIRCUIT COURT :
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. ~ 3,~,,: peputy local ra~
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