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181243
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CERTIFICATE OF DEATH +
ttRATlt irlL[ N0.
F L O 8I D A ptEdItRRAR•• No. 193
SIRTM NO.
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66-025
•' 0DiJ"'7 .. STATE
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Saint Lucie
Florida
Saint Lucie
TOIMN. OR tOCATKIN r. K rU-CE Or DEATH
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t. pTY. TOtrN. OR tACATKIN INSIDE EITY UNITSI
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Fort Pierce YE No
~, NAME Of tJJ rr Ir ~s+r• t» ~~ Mbrr) R STREET ADDRESS
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~T1T1T1p1Ft. Pierce Memorial Hos ita 317 South 17th treat
slrr XiNis LeN ~. (~ ~XtrM Doi YeM
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MARIAN MICHAIA6KI ~TM March 25 1969
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w.rl M.,w o..~ Na.. N:..
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11/11/1894
Male White MIDOwED avoR«D
Ills. vS11Al OCCUTATKIN (tort tiNa yrrMt fart lOS. KIND OF RtKINESS OR 111OYSTRY 11. RIRTNKACE (9aft w MtifR tMNM, GtIlEII Or RIMT QpyNtRre
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I~. /ATNER'S MANE 1(1. NOTNER'S NAIDEII BANE
ilr~vailable Unavailable
. ,OCfAI scCYRITr MD. 17. Rt K NtiMATYR[ 'tX's'r 317 South 1?th • street
019-03-070 Mrs. Lillian Michaloski Ft. Pierce Florida
It. CANSt 0/ O[ATN IBala trJE are cwt Orr lirr /w (01. (e) eN/ tr, )-1 INTUVAI NETttEEN
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I 201. INIIIRY OCCURRED mt. /IACC tx YINRY lt. /.,her tAeaf Mv. 2% CITY. TOeIII.011 tOCATKM CDIINTY STATE
MNII.E AT O NOT YrI11l[ ~ jarra.lcdMl. Nrtd. Met NM•. dl.l
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21. /.etendod tAo decoeaed/roal , to
o m on rAe drte stated •taoro: and to tho beat o/ t1lr Ano~IrdN. !tool tAe uuaw ateta
DoeeN oecarrted et
72e iN (Drrrr r fir > 22s ADDRESS i2e. oATE SKN[O
Z Fort Pierce, Florida 3/31/69
jle TIpN. ~ DATE 27t NAME Oi CE TON CREYATOIIY 23/. tOCATKNI(GV/. telr. M tMRt,) 151tattl
Florida
Pierce
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R[rorAt 1//
or
Crema~'~ron 3/28/1969 Ft. Pierce Crema
t it1NERAL E s slwTtlRE Yat~SSFunera O arc RECD. Rr uDtAt REG. TRAR~
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T
y~rtr~u~ F P' rce F1 rida 3-31-69 ~
hsroby ceAify thk to be • true and correct copy of the t.ocai
Registrars record on file in the St. Lucie t,.ounty Health Oepart-
rrMnt et Fort PltlrOer Ftotida.
(Warning: Not valid unless raised seal of the St. Lucie
~y Heath pepartelent is affixed.)
N. 0. MIIIPR, M. Q
- County~Health Officer 3 loci Registrar
~ /li~i~ri~ ~~~~-
Dat~ aPt+h~ lots! Registrar
1
i
7
r
FILED AND RECOROED~ '
ST. LUCIE COUNTY. FLA.
RECORD VERIFIED
,. ~;~,•~~~181243
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a~K 179 ~~ 196
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