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HomeMy WebLinkAbout0732 ~ ra~. s•- rrwTS ~o~o or Nsw~n~ CERTIFICATE OF DEATH . . eo~~s + ~YR[AI! OR 1/1TAL fTA17fT1p lTATt PIL~ NQ ~ ~ '•s•' FLOBIDA . ord •b~• SI T H. R[d iT11AA•S NO. prop~tl~ 1. KAti K KAf11 COOt H0. t YfYAI 11[NKNC[/1Iar~Mwr~wL l/inrarr~. ~.:4.~h1~•M~:w:w~) .:.e~e•a •ed •111 ~TM S`t • LuCi@ ~p ~ dJ ~ ~A~lorida' - k ~r ~J't. Lucie ' b• ~l~e~~ i 1• 1~~- C~1/.TOvILO~IOCATION t. 13 ~LACE Of OEATII s. Mr.10wN.0~ I~OCAT1011 ` a as+aNCC . i Ft Pierce '~s'°E aT' ~ iii~ ` • ~p . Ft. Pierce ~ ~ ~ wu~c os (11 ~t 1~ ~w~tht. ~ir ~arat.rl~rar) 1. sT~Et7 ~oo~[~ Ft. Pierce Mem. Hosp. 2015 North Old Dixie ~ f ' i'tnt /1lWk l,rt oATE • X~M D~I Yar ' ««s~ BRIICS COLLINS ~~?TMMarCh 2, 1968 ' . sca t. cacR o~ m?a ~u~o (8 Mcva w~~co o+?TC oF wn~ f. Kc th r~.~. s um ~.w woca u~ws. r r z e a M Cau 6,'++K+~n) x..r. a.. r.... ri.. ~nooxE, a,ro~ ept . 4,19 0 g y t~ i w 1 i 10~. YSYAI OOG1?~T~dl (Of~t NN y~w! Mt la. KMOOI MKw~E'SS 01t r10YSTRY ( I. tutTw'tAK (~At wM~ aa~bf) tmLp or wwf OOwlltrr e~ ~a?~V w yur.N.r Wfr. wr. y ryMrN) Owner-0 rator ~ Groce Store Sa~annah Geo ia USA ~~aek !~k 1~ iA7l~[!'i ~MME 1 Mp1N~~~ ~p~ ~ ~f . Unobt . IInobt . ~ ~ ~ - soa~ sccu~m ~a n. • u.w~ .w.» 261-O1-080 • ~ ~ Ft. Pierce, Florida • L', I~a~?~~ 1~. i~~Mt N NATN (~Mr wl/ Mr tMN ~Ir tl~e (d. u/ (c).) • IIITE1tvAt ~ETIEt11 o az..~e.r r~~oc~n~~nsa?uscow, ~Y A ~ ~ nNOOu .~.a rii. ~rcor?TC wac ca .~~/L` ~l`' '~W1o R E~ ~ o er• e•e- . ` ~~~t~e.~. u~ e~ Pf1 Qt~" /it ~ro~E•~t ; U ,i a..w.... ~i~.r... . 1 . e . 1 .e~ a ` ~ y„~ r~jl~t~~r ~~~I ~ OUE TO (t) 1 •ltwl~ T1 '~C ~ a~ r~. ~ \~n~ s• f- s ?ART IL O~IB 9f1IK~Nf OO~OIT1016 COMAiMRMG R Oft1M QR IO? ~OAIO 10 M TFrIwII OqFA![ ~IiM11011 CIR7i1 M Mf?1(V . MAS A c.r ~•,si ~ . ?E~[m or ~~hr• Np~] ~ ocsc.~nE ~e ru~Mr oavR~ca ca~w. s.?ws ¦•t~~s ~ uttac~rt w~t~oc ~ic~ N W~r 1~ Prt l r Pw 1! y~en ~tJ ~i.~..i_ O ~ ~i.¦ .r le~~. ~ IOe. Tu~E of Ilwi xwN. Dq. Yar rw~r ~ f~ n. - ~ 20t. ~NN~r ooqnulEO mr. rutE as wiu~r ~s. I•. 4 n~?..t M~r. Crrr. tiDrrc O~ aau?TqM tov~Tr ST~Tc MMRt AT 0 wr rrNac ~ l~?•.l•w?r. oaat. Ma wN» sc.) ~K AT ~IOIIK 2t- ! ~tt~nM1 eM ~NI !ro ~to ~M /Mt ~ ~ ~l;h oa - --°L%~~ ` DwtA ooe~rnd ~t ~ ' on tM d~N af~f W~io~~: .wd ro rn. s..r o/ a.~ ~no.l.dN. /?om tA~ nuap ~t~tM. ~ ~i1 ia•¦s tts. a?~swNCo ~re s• ~ (Dr1?awfYk) 21i A0011[SS e~~~l~ti ~ ~ f •eerrst~. .~'r' c' ~ C'f < v`/~/CA Z3~. ~uw~t. GI[rrnOR WTE Zk. M~ME OF CEMETE111I OQ CII[M~TOR~ f71. LOCATIpI (Qry. IM. M ew~q1 (Bdt) ria`1'"y'' 3-5-68 Ft.Pierce Cemetery Ft.Pierce Florida r.s.~sis ~~~T 7th„~t ts. a~rc~ccanwc~Rt,o. ~cus~s s.,._e~= ~ .P~.erce,~~ a - N-GF ~ ~ 3 i _ s-~--- . _ _ - - - ~ . . : . _,ti;. ,~s,:. ~ ~ .r, y J''l' • ~ ~I' N~ - ~1Qfd~j/ ~ 1W! 1b bO „a 11NA alW C~OffeCf OD~? O~ tF10 ~OCO~ i~l . i~e9istrar's~ie~oa!rld,on fila fn th~ St. luci~ County H~alth Ospart ~o Z s~nr~ ;_ment at Fort Pietce. Flor!!{ar:- A m o n O (Wuning~ Not yal'~ynless ralsed seal of the St. lucls - t~ ~m2 ~ . CAUnt~? H~aitij DspHtmant is effixed.) ~ c~ v : r : ..r. ~ - r ' ~ -=+-=i ~ Zm ;'~~;`y•~~ °N:'G: AAIILER, M D. n1~ - . .i. ; ~Courit~? H~slth Officer 6 Loal Re~btru oN ~ ~p. , C f~ ' . ~ ~ ~ tr , ~ ~ ~A~ ~A t~ 'J ~ ~Q. ~ ~ ~ i i~, ~ 1 1 1 m~.~~, ~ ~ ~ ~ ~ ^ . s p~ ~ D~wfy. Lotal iEpistrar r ; . , . ~ . ~ ~ «~175 ~ .~3U . ~ .~:~~-4.-~ _ _ _ _ .,~V