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~ T~~. e.- ' KAT[ ~OMD O' MiAL11i CERTIFICATE OF DEATH ~ ~
• ~ ~ ' ~u~~?u OF YRAL fTATIfHO~ RAT[ EILR N0. #
~ ~.s.~ • FLOSIDA
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y r o P e r i~ coo~ NO. L uww~ wn~w~e[ l rr. ~..~.a wa r~:..w...: e.w.r. rr...r.:..:~.)
e¦~ e u t~ d 1. ~ MA~/1 a STATE C~01N~Tlf .
.?11 St. Lucie 66-?OOC Florida St. Lucie
p• Ol~e~~ . t. K RES~OEIICE
t n p~t- - C1Tr. T0111N.OI1 LOCA?ION e. IS rLACE Oi OEATM ' t. C1Tr. TOMM.OR 1AC~T1011 INSrOE CIT1/ UMITSI
•aa~nt . - M~S~OE CtTt UYITS/
r~l.. Ft. Pierce ~sp ~ Ft. Pie e ~ ~ ~
1. MAME OF ty.~ a b.~.t. ~t...a«e dt.w) t sranr eooecss ~
1904 S. 35th St. ~ 1904 S. 35th St. ' ~
MAMt M flpt MifAe L~M 1. OaTE XNN 1~/ Ye~r .
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~ SAMiJ$L ~ R. FISAER ~TMNovember 29 1968 " .
. acx s. eot~ o~ ~ut[ 7. w~~EO M[ve~ r~ue~rto . wt[ or ~n~ nGC U. ~r+r s uoa ~ rw woca ~ ~ws.
June 24 1879 ~89~~ ~
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~ ~,r::~,~.~ Williara J. Fisher Lida ~
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' 48-16-323 ~ Ft. Pierce Fla. _
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A11 lt~~• jj~. NOMA 1 (Q~y~KM WtI ?IA. AOORESS ?Z[. DATE516NED
" 706 North 7 St. Fort Pierce Fl /Z-G~~o~
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a t e ur a t~. 27~. FJIW. CIIGNnOM. Lb OATE 2~t. N11YE OF CEMETEII IIEM~?011r I3/. LOCATI011 (GYI. twD. M~M1/I) (8dtt1
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