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~n~:'ss~- t..wT~ eo~ao oF H~?~~n+ CERTIFIC74TE OF DEATH
~uwcwv OF VITAL ~'TATI6TIC6 F L O R I D A ~T~T~ FILE NO.
i~j.i r«-
ord sh~n O~RTM NO. ~ REGISTRAR•3 NO.
properly ?
eitcutld ~~ACC OF OLATN COOE NO. 2. YSUAI R[SIOLNC[(IfaweJ~swu~lt:wl I~\V1~fJ~M: ~r~wMWI~N~Y1iN~ ,
~ OOI:NTy STATE A. COUMTO +
p: Di:~
a Broward ~6~~ f I or i da 6roNard
D~~~ a. C~T1/, TOWN.OR IOC~TqN t. ~S K~LE 0~ OEATM t. CITt. TOWN, OR LOCATqN t_ K RES~OEhtE ;
¦anent • INS~Oi CITY LIMITS/ ~NS~OE C~TII l~y~TSt
PI antat ion , .ESp9 „00 Tamarac Lakes ,~s~ ~
rii.. ~
IU?ME OF (//w~l i~ ~~pil~f, /itt ~lrut attrt~i) STIIEET ADORESS
1qSt~TAL OR
~T~T~Tw?~ p I antat i on 6eneral Hosp i tal 4556 N. W. 16th Ter~ace
3. MwM! OF F6~f . Afi/Ilt L~t! 1. OATE )foa[~ D~I ~
citi,~«
D•~~~ Rodney 6 i I bert Spence o
1N October 4 1968
S. SEI[ i t0:0~ OI1 ~ACE MARRIEO ~y MEYER YAQ~i(O ~~TE OF ~111TM AGE U~ /tu1 ~~R ~ r~ w0[A t~ wtt. ~
d~, s. Ma I e Wh i te ,,,,,oowEOp o~c~o J an . S I 9~0 6~u~~~ x..w a~ X~. x~_
p 1~! a 1~ 10~_ USU~I OCCU?~Tb~ (Giu ti~1 o/~rat lo~e~ 105. KtND OF ~USINESSOR YIOUSTRY 11. ~IIIiM?~ACE ($f~ft ~??ti~~ csr+W~1 12. CmtEM Os rW?t GOUnt~rr
•ftA p~r- 1 rie~woNe/ror4ul/+fe.K~wi/rdird) •
••n•p~ US 'T~easury De t. Customs Colorado- USA
Dl~ek int ~j_ ~ATHER'S NAME 1~. MOTMER'S MAIpEn NAwE
t~D~~~iter Thomas Spence ~ Em i I y Wa 1 ker ~
16. SOCIAL SECYRITY MO 17. IXFORMANT ~ siGllAtUR[ A~~~~~~q~56 N• • ' th Terrace ~
~ SI-22-672 61rs. Elizabeth S enc z/ Tam~rac Lakes Florida
r~,,•,.l le CAUti 0/ OEATH [6wftr en!/ Ow~ tauit pt?lint fnt (~1. ce~..~~ ~v.~ i~c~v,?~ ~erwccM
C 1 r~ t t o f ~~RT l DEAT~ W,?S CAUSEO ~Y~ 0 OEATM
w.,E,,,,~cu„~c~~ Renal Cell Carcinoma of Kidney ~~os.
.u~~ tii~
eee e.r-
~~r1~=~• c..,u;..,.;~.~,, o„E To ca~ w i th Met4stas i s to bra i n and ~1 ung
•StA tAe YAK~ /tlt iut b ~
1 e e~ 1 ~Do~e taau (e). '
resistrar +~~I t?r r~Qer. ~ TO e) 2
II~~I nwr laat. ~
• 1 t A 1 n TZ ~ ~~qT 11. OiM[ie SrG~tiK+~+~T COr~GiqtiS COet7RiM/tu~ Tp pGtN M NDT REiATiO t0 TwE iLtMUCJII WSGSf COMdT~O~ GIrL+~ W~xRi 1(~) _ N11?S AUTO?SY :
Sours ~t- F, ~ ~(RfpRMEO? }
t~r d~~tA v ;
rES ? MO ~
or pefor• lReaaD 1 my. pEx~~~E NOw tnJ~:~IY OCCURaEO (Eater aotnri yiajer~ is Pot (v P~-t Il ~J4~w 1!J ~
•atins ~n~ h ACGpENT SUK~OE MOMICIDE
I~ dl~posi- u ? ? ? , - s
~ Dodn ef T~ME os Noa. Montl, Dq. Yso ;
4UURr w. ;
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o D•
~ 20t. UUU~IY OCCUARED 20r. KACE INJUII~ !t. iw V rNrl ~owt. 2% C1TY, TOM1N. OR LOCATION OOUNTY ST~TE S
WMtIE AT ~ rwT wM~iE ~ k~ ~ lo~~, it~[d, ~D[tt 4fQ/., tft.) ~
~ M011K AT W }
21. J~tbnd d • eeus~ ~o e_ t• to ~Ct • •nd lut s~~ h~~ ~li?~ on C • • v
De~tA ur ed ~t ~ on th~ d~t~ st~t~d ~Do.e; ~nd to th~ b~~t o! mr Jcoorl~dj~. lrom th~ e~uses st~eed.
111 ie~~s f~
•tt t0 D• ~ s~G f J~ Nfb TZD AODlIESS~'OO SO.Hospital DI~• ~'~TESIGNEO
~°•p'•:• k Plan 'on Florida 10/6/68
a e e us a t e. 2~a. ~Wa4i. r~. 2JB~ TE 2k N~rE OF CENETERY OR CAEN~TOqIf 23/. LpCATqN (CY/. qrs. M t~unf/) (S[e~ti
/W
R[rOYAI ( ~ptn//1 .
3 emat~on Oct.7 1968 Ro al Palm Cremator Pom ano Beach Florida
Y. 3. 2 j~. ~UNERAI WtiECT011 S S~CiN~TU~E~ Or y~p~ES~ h OIII t7S F H ~,~QATE C0. !11 IOC~L REG ~6- GKTR R'S S~G TYR
~'•.1°"s ~ _ Ft.Lauderdal e F I a ~~9~j~~
CERTIFIED COPY
3
I hereby certify the above to be a true and correct copy of the I,ocal ~
Registrar's record on file in the Broxard County Health Department at ~
Fort Lauderdale~ Florida. ~ ~
.
- ~
(Warning: -Not valid unless raised seal of the Broward County He~th }
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~ ~ _ • • - ~Qpartment ia affized. ) - ~ ~ _ ~
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~ i : a~ ~ p ,r : ~ C~ ~ ~
' ~ ~ c ; ^ County Healt fficer and Local gist.~r ~o~
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Dep y Local Regis ar ~ A~
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