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: ~ t 3 De- ~'TAT[ ww~w or Nw.rN CERTIFICATE OF DEATH ` t
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'`6•' FL08IDA ~
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propt~lr Bt TH NO. IItYiI~Ti~Alt•1 NO. '7
e:ecut~d t. nwcs as wrw GOD[ NO. 2. YWAI KMO~MCR(~1wrMwMliL~1. ll~rtiwrw~ R~iMrWwWirirl
•nd ~111 OOtINTY S'd111t WC•lla a STATE 1. OOtIMTP '
p,.~.a _ Florida Saint Lucie
i n y~?- 0. GT1I. TOIIM. Wl LOG?T~011 t. K~IACE Oi OEATN t. C1TY. TOKM.OII IACAT1011 s. K 11ES10EMCE
i~A~AI IMS10E CITY UMIT51 MK10E pTr IWITSI '
r,~.. Fort Pierce „ESeg „o? Fort Pierce - River Park
a. ~uME oF (q..e iw ~..~r.t. we,dar daa.) ~ m~cc~r aao~ss '
M06?~TAL OII
'"~T~rv*~'Ft. Pierce Memoria2 Hos ita 294 W. Arbor Avenue
+WWt or s~.~ AtWk Iwrt 1_ wTC Xwr~ D~q Yea
JOHN LEWIS IEESHOCIC February 3, 1969
S. scx t. oo~oR oR iucc .uw~co$1 Mcrc~ w~uu~co o.TC os a~rM ~r.c ~(h
y~e..~.• s u~o. ~.w u~oca ~~.es
Y r 1 i• 10~22~1878 ~s~jS--~~ M~Y• Ow~ N~w Mia, '
p,.ipl, Male White rinoo~oD onoRCCO
.3 c n ~o.. uwu oc~w~noM ~oi.r N.~ M~e..t a.e toe. Kua os ws+MCSS o~ wousr~r 1 t. aerwu?cF (sr.ur.. ~?nys a.an?) t am~ os ~,wr mwnrn
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~~A~p~ Owner - erator Food Processin Pennsylvania United States -
llaet i~4 1 sATNEII's MAYE 1~. ypTMERY MAIp~N ~y1K
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~~a•-~~~.r Jose h L siak Helen Wojtun
~n'"'TM N0~ p1 ~ N°N"~ 294 West Arbur Avenue
. _-1860 A Pauline D. Leeshock • a ~
F un ~ r~ 1 1~. CAYK O/ KATN [bltn w1/ Mt ostM Ia n~e /r ot (c).) . UdERYAI ~E7ftEfU
d i r~ t t~ ~ ~MT l OEi??M 111A5 CAYSEO ~lf: ~~1Q iN
¦u~t !~1• IMMEOMTE CAYSE Carcinoma of the lun9 ~AO~ ~
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t'rl°.~. a..~r~,,,r~„,, o„E,o Metastasis to liver ~
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1 o e• 1 ~Gre taut .
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•S tAfe 7! 2 ti~ t~M• ~ TO n eas
A o u • i- ~ ?ART 11, OT~l19GAi1tM~ fAiO~i~d6 COM17~{rtwG T'O WiM ~tff MDT 11M1t0 TO i~R TGMwMi RfGSE COOi1T01~ fi1KA Q 1YT 1(y . M~S AUTOKY
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ACCIOEIIT SU~GOE MOM~pOE DESCRqE NOM uUU111/OCCYRllEO. 6a/a fdwt
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~ 20~. auu~r ottuuco a0r. ?ucc oF uuu~r (s. i-, t~ w.n~.r ~ns. ~0% tmr. ror~. o~ touTaie OOU1t7Y STATE
MN~LE AT ~ MOT NM1lf ~ lp•.lK+.~r. a~na. •/k~ etq.. ac.) .
~ MOIIK A1 MOI1K
ti_ l~~bnd~dtMd~,~,y~ /~om 1969 , to ~ ~ ~nd/vla~~ 6irn ~lition +
D~tAqoeurnd ~e a~OVt d• a~ fA~ d~a ae~e~d ~bw~: ~nd ~o tA~ bat d m) lew~/sdN. Iroa~ tA~ e~uws ~t~eN.
, i i p ~ ~ ~ ~,,,,.,t~ ~ ~oo~ss g06 De laware Avenu • a?TE ~o ~
.e. to 1. /
eoa l~t• t ; p' Florid 2 4 69
• t C u f a f 1. ~~T~ jk. ~yM[ Oi CEMETCIlY OR CREYATORIr j3f_ {Q[ATipll ((xf/. (NA, M OM~N/) (B~ft) •
~`~ia~' 2/5/69 illcrest Mem. Gard~ns Saint Lucie County~ Florida~
v. s. f a,a ~s yat~guneral Ho 6• arc ~cca w~orx wis swiu
Aer. iPbb • y'yjsaty Ft. Pierce Fla. Feb. 4 1969 ~
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~ ~ herobY cerfifY thls to b~ • true and aorrect oopy of th~ Local ~
Registrds recotd on fils in ths St. Lucie Couny H~alth Depart ~~7 ~ r' :
msnt ~t foA Pierce. Fbttd~. , . . , ` ~':v ~ p ~ c cr.~.~ `
(Waming: t~1ot valid unlets roised ieal of ths St. tucis 1~~ g';, l; c' rr: v~
Coumy Fk~hh D~psrtrt~t is affi~csd.) , ~v~' Q:
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. :~.,J~•_~ , . ('~'n V! GO~~
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N. D. MIILER, M. Q , i:~ • ~ ~ , ~ _,C ~ ~oz~'~
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County HsaFfh Officer 3 Local Resktrar ~ - 3,,, T,--+°~
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Dat~ Deptrty t+ocal • R~ep' ar . - c? , N g-- y~
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