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HomeMy WebLinkAbout2399 - - 1`x4~:i:~~ - ~TATt ~owRO o? M~n~ CERTIFICATE OF DEATH eo~~s • ~Y11[AY OR VRA{. fTATIfT1C~ fTAT[ FILt NO. l.s.l.~Q-• • FLOHIDA ' .ra .e.. si 7 NO. ~ R[GI~TNAR'f No. , o••P•r~s ?u?ea or w?~ coo~• tw. 2. Y~11A1 R~ilOiNC[IIMn/nrrMM~/. ria.~~..: ~.w«w...r....:..) O011t+~?rtin ~53-oa `1~T~rida o0U"TMMartin .aa .~ii • ~~~e~~ iw ~•r- atv. Toww. o~ wu?TaN a ~s ~ucc os ou~n~ t. dTl. TOMM.011 LOCATION IS RtS~O[MCE INSIOE CITY UMITSi Port St . LQC~@ '"s'°E cm ur~n~ $tL18I't res l~ No ? res uo 'tit•. IU1YE Of N! iR ~M~WI. /~M MreN dlreN) j. STIIEET AOOIICSS ~ ~ . ~T~~ Martin Mem. Hospital 2$12 Morningside Blvd. Mwr~ OI Fir~t NiNte LW 1. WTE XMt? MI Yeu c~~MM~y) MARY LORETTA BENOIT Jan. 22 1969 . SE1[ COtOw O~ RAC~ II~RAi[0 ~ N[1Kw MAMICD ~ OAT( 0/ MRTN . ACE 1 t~fr1 • Y~OEII l tW U~Ot~t N Mi t~ ~I) X~r4 Mw Nww M:.. r. i e. Female Wh1t@ Mnoowco avoRCCU A ril 1$ ~ ~ 1~1 wl r . usu~l OCCU~~Tw~ (GMe t~t ywrt e . Kwoor wsw~sso~ ~ousr~r n. a~TM?ua ~~r.e• r I?n+n ow.en) ama or wwr oawrnr~ e~~~~ Housew~fe~~`~~y~~ Own Home ~ Thom sonville Conn. USA 11~Ck l~k 1~. /A7N(R'S tl~YE • I. MOTNCR'S MJUOEw MAME ' ~~.~~~s~•~ John 0'Sha~ ness Ma Smith ~ u~~R~TM ~ ~ • 2 12 Morningside Blvd. ~ 29-20- 25 :2.~ -x Po S L' e Florida ' ( INTEII rua.r.l CnVS~ ee esn~11 (blue?Mh wa.~,~n fi~e t.). c~). s1 lt).1. j~ a n si..e~or r•eT~ ourM~nsuusco~r: ~ j C~ .L' ~l ~~~Q..~C~cACL.~(~~ ~L~C- 6~1/~ T ¦u~t fll• IMMEOMTE CAYSE (~1 . t~• e~r. . i ~ ~Q ~ ~ ~ ~ ~ C`~ a tffie~t• /~I. ~ ~ . •1t0 tA• r~ ~ ~y~ y ~ , . 1• e• 1 tl~et csra (il. ' ~ r~aistr~r K~~I tk ralrr• p~,~ TO (d ~ •ltala 7! 11~M nras lpl. i O rMT IL OTNQ SIf.Mi1W~ OOMOIi10~6 OOMAIMJ~~IG TO OU7N ~1R NOT 11[U1RD 10 iN[ 1E~MYMI OlfG3[ 001~OIT10N GMilf M?YT 1(U . W~S AUTOKY ~ Yorrs •f- ~ IE~FOilM[DT N~ d~at4 s ' ' TES~ p0 er D~foe• t~~ pESUyE ~ow yyusr ottu~eEO. (E11n w~tve Ni~(r?~ b Pwt !a Art 11 yitr~ I~J ~ ¦ak~~~ •w7 ~ ~tpIMT SUICIDE MOYICIQ . a1~~os1- u ? ? t 1~~ • f T~rE Oi Hwr XwN. Oq. Yt~r ~ea~. ~ . uuu~r : ~ o F ~ • ~ ml. MUWY OCCURlIEO mt. ItACE Oi M1U111/ (t. i~ a rwt b~r. 20% qTY. T0111N. OR lOGiION OOYMTr STATE Mn~RE AT ~ wT wMiit ~ 1~•. hw~~. ar?~d, Nks elM-. ar.) i - . WORK AT MOIIK ~ - 21. 1~tt~nd~d tir d~ewa~d / . to ~ ~ ~nd lut a~~ w~ di~~ on ~ D~~tA oceurnd~t ~ ~ on tA~ d~b at~ad~bw~: ~nd to tM 6~at of m~lno~NdN. /tom tMuuws ~t~t~d. ~ •11 ss•.. Tuwc .(un?K.. u~ ~~cs uc. wTCS~cMCo •r. te 1. / ~ ~ ~..p~.~.. ~ - ~ ~ iCt-( ~ 1 2z 69 •Ctut~ t~. .~~Tp~. j3~ pAi~ ! 27r. ruME OF CE ET[1111 OIl CR[r~TO11Y 2;#/. LOC11TqM (GSl1. fMrw. ~r ertulf/) (St~ft) Remos~"'' 1/23/69 St. Michaels Cemete Springfield; t~iass. S. j012 2~. N E S S~GNAIYIIE A001~E55 ~ ZS. DATE ItECO. ~V WG?L REG_ Zi. RE66TRAllY SICMA ,TY~[_•..-..~t\ ~ 7'Y-- R~~.IY66 ~ sa~ 3~ lp ~ s7~isL~ - . - . - ~-~s.~~~ t htreby ta?~ifY ihis b be a tnre and correct'ooPY of th~ loeal ..e• ' . . ' ~1 Regi~trors record on file in the Martin Counry Health Dspait-:- ~ - • ~ ° '~s~ ' ~ ~i ` ~y ~ ~ msM M Stuart. Florida. - - ~ `Y•' ~ _ , . - ~-y g. . Q~,~- . ; 'j (Wernirx~: Not valid unless raised seal of the Martl~ ; : _ ` ~,:.a+PG~1 = ~ f i County Heatth Depanment is affixed.) , . ~ ; r' ' • - ~ • Y.,it t~~ • i i _ ' ~.s~~~: _ , ~ ' . ~ =~:~l~~~~ : ~ N. D. MILLEP„'!Ik-B:--_ ~ ° ° : : ••.....-r'- County Health Officer & local R~gittraf • - • , . a ~_G9 Da» DeputY Locat ReS++tru ' . ~ ~ . f i [ FILEO t~ND RECORDED S'. LUCIE COUNTY. FLS'. ~ .<~~e~R ~,~~~i~-r~-~ ~ ~7~~~~ '69 FEB 1? AM 10 : 4 ~ i~~ rt0~~: •OITR:,S CL.ERK CUIT COURT< ~ ~ , _ ~ ~ ~ . . ~