HomeMy WebLinkAbout0516 181480
-- - FIND AND R~CORD~Oj
ST. LUCIE COUNTY. RIA:`
rZE.COPC1 VERIFIED
'69 A~ S PM Z t ®1
---- ~ -') ~ ~ `~ ROGER r OITRAS `'
@I.ERK CIRCUIT COURT
181480
CERTIFICATE OF DEATH
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t. Is MACE os DEATH
INSIDE cRr tw1TST
t. C1Tr, TowN, oR LOCATION r. Is RESIDENCE
uISIDE CITY 4rlrn
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Ft. Pierce
YES® RDD Ft. Pleree TEa Mo
rll.. t. NAME Or fl/ftt iR ~M}(NI. /mot Wtef Mhtr1 ~. STR[ET AOOR[SS -
IIOSMTAI OR
INSTITJTION 211 North 17th Street
211 Nor
th 17th Stree
). NAME OI ISrtt
Louis
[t«`y
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$. WHIDDON 1. GATE A(ANa Dtr Yta
[[ATN July 2~F, 1969
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S. SEX S. COLOR OR RAC[ ~~11
7. YARRtD~I NEVER MARRIED S. D•TE OF RiRTN S A6E (!A /tMt
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Mec~iania
Automotive
S lvester Geor Sa
U.S.A.
11Aell IRS Ij. rATN[R'S WME 11. EgTNER'S MAIDEN IurE
t~}.:rl..r William ~. Whiddon Naamah Keen
16. SOCIAI SECURITY IA 17. W L 114NATt/Rt Att+tp
226-10-2 Mrs. Wi111e T. Whiddon 211 N. 1 th St. Ft Pierce Fla
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ONSET AMD DEATH
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or sehr• r ~ I ~. OESCRIK NOy INIIMY OCCURRED (R.In ^aElrt •/is/sr/ h Perf 1 tr I
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ZOI. INIDRT OCCYAREO >Ylt. tIACE Oi INJURY (t. I•. i• v •A••I S•'w. mJ CRY. 101rM. 011 IOGII KIN ODUNTT STATE
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A11 tt... ~ a we ~t~+v~,ts ~ ~- ua AooRESS 6U1 N
6th St ~`. WTE slcNEo
•r• t°'• .
. 7/26/69
aeerr•t•. ~ ~~~. ~ DATE ?]r EU1MC OF CEMETERY OR CREMATORY Z1/- IOCA 1011 (C/r. fttrlE. a INQf/) ($Ytl
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T • a • 1013 E ~ S T ODR[SS 2S DATE R[CO. rY tOCAI REG 2i. 6KTRAR'3 SIGRI1TU11E
Ill.. foss i~'Of Gl 06 S. 4th St. JAY 28 s 1969 ~~~ ~ ,~ ~ ~~~r~
I hereby eectify thfs to be s true and correct copy of tll~ tool
Rpistrara record on fife M the St. Lucie County Health Dapart-
mant at Fort Pieroe, Florida.
(Wamirq: Nat valid uniess raised seal of the St. tiucio
County Health Deputmant is affixed)
N. D. MIIIER, M D.
Coumy Health Officer •dl Local Rlpktrar
~~~ (?irt~I..~s.~J
V, W1e Deputy Local Re~isfrar
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