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Home My WebLink About0253 - - ~ ' 18349~ ~ st.~ ~a ~$~c~ CERTJFIC~TE O~ DE.~.T:~ s~.~ ~ xa Bureau o! Vttat Statistky F L O R I D F. No /3 s~ pr.tics o~p~ rs• - s: vsv.::. Ju~ n~ - e~cl~ , (~1 ~V Dfttrict N ~ ~ SL¦a (b) ~L ~i ° ~w? ~ ~.P~.~. ~ x 6 ~v ~ ~ i ~ • H G 3 ~a~ S~.c ~ cd1 x.me ae ewspiw a~ mw / as tI! oot 1n ho~pltal oe ~ trsit~ at~eet numDer a~ Ioe~tion) te) Citi~en at 7berl~n eamtr~f i ~ (e) I.a~~th ot stq: 1n Lo~i ~ W At D1~a o[ oZ .~L/L.tJ I! Ja. n~0o~ OOnRttT ~ (Spsd4 i~. montm ac ds]rs) . '+?,a . , $ ~ n. ~ ~ ~vts. x~ or . s w u.~.~. s c~~ soa.t s~+,~w ~ ~:c.L d c. n.o,. ~ ~t~o :o. r.aa ~e.m: f[ ~q RL caax e r , 7~ L f. Lblor ee l !I. I hereb~ cettl4~ tLat I atta~ed tL~ d~e~d R~intM. m~zrM4 wldaved oe w ~ f O~~ ~(y It m~erM4 wklow~A ae dt~'uto~d. L~b~nd d(os) tbat I lMt nw 1~-'P~: allw • am~ ~ v- lhat death oocan'ed m t~ d~t~ aed bOYt afrbd d1~. D~ratlM i(b) AL~s ot M~b~nd ot w1~,, it ~a - ~aae~ _ ~ , ~ T. strtL d.t~ at ta~onttW t~q) cs~) - ~ ~ j~ L Ap: YMes lioatL~ Dys I! 3a~ tL~a cM d~ ' , a4~~ _ . ~ ~ s$ J e~ ~ nu. n _ ~ ~ ~ _ ._.~J - • ~ • ~ o (C14. town oe eonob) q~~7) ~ (~Lschrde presnan4 wlffifn i d dNfb) ~ ~ 1~. QwNI ~ 11. ae ~+d~ ~ ]i 17 - ~ 1 ~ ~D~ ' whieh~dtath li. Bteth (~Av~ dat~ a! ~ i< Yafd~n i li. Birfh tt. I! death wa~ dw tio azteinal ~~II fn tbs lollowloe: ! ~ !i. L~Eorm~nt'i~ 81so~ (a) ~mb~Ws) I?aeidm~ adeld~. 2~omtclds (~Deci~.1 ! ~ IA (~1 (b) Dat~ o! oonuraoa~ ~ (c) Wl~ars did W~ oaaat ~ 17. S~rla1. at~mpatlon a~e, (Ci~T at' ~o'wn) (6tate) 17 (y D~b oy~o -~f- 8 t7 tb !L~ Dld fq~ ocrue tn at aboat lwmw m bem. fa ~dsLl p1aoR ~ ` m Dablfo pLo~* - i Y.s.lio.• 1~. llm~ed fll[~etoe'~ - (~b VD~ ~ D~) ; u w aan..t tu aa m~ ; ~„2 ; ~ ) . `~-~/t.i? s~aetn+. - `;.~v ~r ~ v' w saae~s -~c~+~...~,~ ~oa~. stos.a.~-?.s~~ fI 4 ~ FILEO AND REC~ROED ~ J thk to b~ • trw and aoR~et of tt~ ~ ~ f~, 1 hw•by c~tify ~r 9AF±k.UC1E COUNTY. FLA 'j . ~ Rpiqirars noord on fils in ths St. Luci~ County H~afth D~par~ : ~ 0 a^~~ c a~ F! E r~ ~ r ; 4 ; mNk at Fw1 Pi~~a, Florid~. ~ t ' -jt - ~~ff1~f1Qt NO~ Ya~~ {111~~f ~i~iOd i~i~ O~ ~N Si ~YC~ ~ n1 • . ` ~it`~' ~ " _ ~ ; c~, H..hh o.p.rtm.~r is .ffuc.d.~ ~ 2 4 ~I I: ~ ~ p ~ ! , . 69 SEP _ h , I ~ ~ 183493. _ ; . ~ - - . t s 4 - ; , N. u. rwt~a, M. a : - i CO{M1~y I~iINI Off~f 'jt L~C~I Rpli~fu? i7 G::.' : r 0 I T R Ag - s : r, ~ ` LERK CIRCUI7 COUR~_': ' ~ ~ ` t~ ' j ~ - " r, . • _ . i ; ~ ' IT ~ .•4. - C, 1 . ? + ` OrN ~y ~ RpimK : ' ~ , t ~ ~ ' . ~ ~ ~ i , ,t~''f„filif'r ~ ~ ~ ~ OR 4 BOOK ~SO PAGE 253 . _ _ - - , _ ~ a e_~ ~ ~ _ _ ~ ~ : _ ~ ~ _ .