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181402
CERTIFICATE OF DEATH
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STATE OOARD o
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REGISTRAR•8 NO.
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..:ecuted 1 . -LAtt O/ OtATN .,I •. STATE FLORIDA e. oouNTr $T LUCIE
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FORT PIERCE YES tq
PATRICK AFB, FLA YESO ND
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NosnTAL 011 385 SANDIA DRIVE
utsTITYTION 6550 USAF HOSPITAL
NAMt OF fTrtE A(IN(t Latt I. DATE Marti Da/ }'tar
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OECEASCO CLINTON p~,g,N HIGBEE t EATN JULY 17 1969
(T/Pe M plat)
S. SEX 6. COL011 OR RACE 2- YAKKED NEVER MARRIEDQ E• DATE OF RIRTN 9. AGE (/r /tart W 1AOER 1 YEAR U~DEA N NRS
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MALE CAUCASIAN WIDOWlD t7 avortcco 12 DEC 1913 55
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p I a 1a1 p IOa. USUAL tKCWATION (Qitr tiala/wrt Irae 10A. KINDOF t1USINESSOR 1Na)STRY 11. EIRTN-U1CE (Stall M fartyR tarah/) 12 CtT12EN Of NNtT t0ly!IiRti
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LT RET U. S. NAVY KENTUCKY U.S.A.
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Dlaett lak (j_ /ATNERS NAME IL. MOTHER-S MAIDEN NAME
.. ELER DAVID HIGBEE EDITH KELLER
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1rp BE
16 sflcuL SECURITY No. 17. tEE~ERU- s aauTVEEE r ~urt't 385 SANDIA DRIVE
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I4• CAYtit 01 O[ATN [&Ittl atu taws ptr IINt /ar (a). (S). aRf (t)•1 INTERYAI BETWE[N
ONSET ANp DEATH
Funoral
:traesor -ART L pEATN WASCAUSEO 1Y:
_-- -MINtT~fES --
) CARDIORESPIRATORY ARREST
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IMMEDIATC t.Atts[ p
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tttleata DIFFUSE CARCINOMATOSIS YEARS
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. i t n the rAirl /art t E•
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r r ~ t s t r • r oDar carts
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Hatiy tAt rRftr- 04E TO (e) _ _ -
1/iR/ tarts Isd. _- '-
+ :: n 1 n 72 O /ART I[ DTI[R SNiIRE1CANi COnp1gNS WNTRMYEMC YD OGTN /IET NDT REtAT[D TO TIIE TgMWt DISEASE CONOITKIN GIYOI YI -ARi 1(a) WAS AUTO/SY
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- : De to r• ~ 20a lPraDS ) 20A. OESCRgE NOw UUURY OCCURRED. (Ealt- Rtlfrrr a/irjrr/ tw Put I a Parl 1/ oji/t.1 /t.)
s . - I nA ani ~ ACCIDENT SUKIDE MOMKIDE
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20r TIME OF lour AlarlA, Dar. Year
'' ' 1 • ~ INJURY a. RI.
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~ 2Od. INJURY OCCURRED 2Dr. -LACE Of INJURY (t. /.. iR M .A.rE Aottr. Zi1/. CITY. TOWN. 011 LOCATK>at COUNTY STATE
WNILE AT ~ NOT wNKE ~ fares, /aetN/, ttrttl. o~te Dlf/_, dr.)
VYORK AT WORK
2t ! att.ndod tha docaatod Isom ~ S~~IlIIt-St9 .. , to . 17 JUL 69 and /aat taw. h~ilira on 17 JUL 69
DaatA oceytrad at ~ __~ m on tha data atatad aborr, and to eh. bast of my Anowbdfs. Iron tha uutsa atatad.
~l i 1s.ra 22o itCNATY JO p Ell,IS(~k,fsArP, Tiy) USAF, MC 2te AooRESS 5 USAF HOSPITAL ~. wTE S~GNEO
~o.~~~c.eA ;,% ,:,~ ,~ .t% G/' ~ - PATRICK AFB, FLA. 17 JUL 69
accurate. 23a CZ:w~At CMwaigw. 23D GATE 21r hAftEOFCEMETERYORCREMATORY 23f IOCATgN(Cif/,tara.o-p•wt// (Stafrl
I~eR.^i:",~~~""3'1 7/18/6 I-!illcrest ~'Iem. Gard. Ft. Pierce t~la.
'~ - ~ • t812 2J +~ RAL ' ~~: ~ A E A SS 2S DATE RECD. aY LOCAL REG. EGISTRAR'tS SIGNATURE ~
Yates~uneral Fiome ~ ~ '~°
;tr.lusa - Ft . Pierce r la. ~~ j~~' i cj L. ~~ +;.` ~i..~-? ~ i-~'.f-~-`~~L~ C,~~~. E~~,
I ~IIER~.Bl' CERTIFY THE ABOVE TO BE A TRJE AND CORRECT COPY OF THE RECOP.D ON FILE
I~ TFIE LOCAL REGISTRAR'S OFFICE IN THE BREVARD COUNTY HEALTH DEPART~;E:~T.
(;.ot val~d•-unless,'tbe seal of the Brevard C.~unty Health Department is affixed)
- ' ~ ;,.~ ~ I~ILEB AND RECORDED-;
' ~ ~ll~=j+*? 1~Sg~: - Deputy Regi stir LUCIE COUNTY,•FLA.'
-~-~~- • I , RECORQ VERIFIED
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'~ '~. d00K179 PACE 41O CLERK C RCUIT COURT"
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