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HomeMy WebLinkAbout2900 r ~ ~ . J-~3~ FtLED AND RECOROEO' F ST.~ECOR[: VUR rYEDLA, : i 1'7'73~ , '69 APR 22 PM 3: 20 ` . - T,,,. .T~T~ .~o a, CERTiFICATE OF DEA7H ` ~ ; ~ eo.~• • ~YI~tAY OI YITAL fTAT1/M~ ~ i•s•t FLOAIDA ~0~ C= 03 ~ ~~e .e.. s~ N . pr~p~rl~ CODt NO. LYfYAi I~rw.bcl~irMlr+yrrW e:~ e ~ N~ 1. KACt N wTM a fTAli[ " R COIIMiT and S in Lu ie 66-025 Florida Saint LuCie Pe ~l.s.~ " e. rf ~OtnCt ! e ~ll. R C1T11. tO~f140R {OCAT1011 e. ls ~IACE 0~ OEA?M G~.10MR011 IACAT~011 Fort Pierce `m .o~ Fort Pierce ~ `mb ru.. . r. w.u a cq.r i. w.sw. ~r.r.r.~lr«.) t sT~ccr ~oo.css . ~t~? o~ .~*~Ft. Pierce Memorial Hos ita - 4861 South Indian River Drive . . a, wu.c frr ~/Yir L..r l atc 1b.M D.s Yer ~~`a1i••:`i~•w~ pr~Tp MOI.MARK ANDERSEN ~*M A~ril 1~ 2969 ssx a. oa~ o~ Ma 1. wwKe ww~[o wrc or aain~ . K[ t w.n ~ wu ~.u. u~,, ~r~.y1 r.+. W. www ra. • ? _ • ~ • = Male White .~oo.ce arro~cco 11/16/1893 ~l5 ~ y!.l.l s ~ IM. Yf Wl OOQM~I7~OA f04t N~ ~lwr~ IN. R~OI MRKl~ WI r~011l~r 11. M~1Twa~tf t~h Ur A~P ~MM/) ~0~10/ waT ~orAn .ic~ ~•r_ - : ~..dy..r~/w?avMR.•~+~1/nM~N? • Com troller Hos ital Nebraska USA 11. e r i•t r~n~1'~ w~t . 1 ronK~'i ra+o[s wit Frederiakke Molmark ~ • ~ ~""*Y"' "~+~4861 ut n an ver rlvo ~ 43-07-157 Mrs. Otto M. Andersen F p Florida . rr n~ r.! Il i~wt N~TN [itikr ~4 ~~ar N~r /r (y. N). a~N c~)a ' . . IMTtllr~l ~ETwtp a? r. e~. r r~rs ~ oum r~a wac~ a~scr oun . ~ ti wrcaut ewft W , u. . tifia~t• ~yy„1/aI. MRIp(~) ~ •it? tl• ~~~~~q~~ ~ . 1•~ a l aMe twre t r~6i~trir ~ br/f IMf. OIK10(e) , 6 o r sr f' O ?YT a O~~o is1~Wr OeMrnas CoI1~MY~rs 1~ OufN IOr lo n[ farrM~ Oruf[ OO~Mtp qiY~ r~ ~J .~r~ . t F ..r- a~r ~ut~ a~ ttf MO O . r r~' ~i0[q[IIT fY1C~Ot MO~MK~Ot MOw ~UIMI~ OCC1M~[a (111r • b M l ~ M I) yM~r N.1 ' ~ ¦•tf¦ N ~ St~D~~~~ O ' ~ ~ . ~ os tlwr ~IwM. DN. Y«r ' , ~ 4 ~ tOt. w~wt aoNras wAtE ar w~wr k. I-. 4 r~Mrr M~r. ~I/ cfn, larr. a1 ~oa?Ta~ aDU~rt sT~TE ~wc n wT wwa~ /~n.l~err~. ~e.e~. N~a M4» ~te.) • ro~K ~T no~t Q ~ 21. l~fNwl~IfMNewMI/r~w ~ . fe ~ ~nrIN~N~ ~.df.~M ~ ~ • OMfh ~cewe~l ~f ~ ew f M I~b d~fM/ ~10?~; ~nJ N fJw iNf ~I JNp, frew JI~ ur f~f~I. Ali lt~~1 ~ . . •r• t• lw ( M~ ~ tls. n3~G~[O eo~yHN • ~ / •~V • e a rr ~ t~. 2~i. t~o~ t~ R t~t. ww[ 0~ ttr 0~ tu~u - 27f. tOt~T~ (LTtI. b~n. o twMp (A~Mi , . Buria`1`'"~' 4/4/69 illcrest Men..Gardens Saint Lucie County, Fla. : ; v.i./sis 2 rwrc ss~w Ydt~°F'uri67Cd1 HO ~ a~~aa~rux+~~ta. i Aer.ioss ~~~~2t-.Ft. P7'l6 Ce F 7 1969 , • : ; I hsnhy cKtify thk to b~ a trw and carec~ c~opy of th~ Loul Repistt~s noord on fik in ths LutN County H~a{th D~patt- , mart d f~at Pi~a. Florid~. . ~ . ~ - . ; (Wamkq, No1 valtd unless nissd t~al af 1M St. ttnM t.. .t~;, i., i ; County H~alth O~putn»nt is affix~d.) ~,,`',.:i~*i . ' `~.k~y-~J~~-~~•I•. . N. D. MIttER, M. Q ~J ~ . Coo?nty H~ahh Offku 3 l~tal Rpbtrar. ~ ' = i: . J; : ; ~ ~ ~ . ~ ~Y~~D " ~ , ~ . , , . - . . ~ r, . ` ~ 600K~76 ~2897 ; ~ . ~ r . . _ ; ~ _ _ . ~ ~~~:_~.~~~~?c_. _ _ ' ~ ~