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HomeMy WebLinkAbout1136 ' 1 184149 ; Oe- ~TAT~ YOARD or Nrw~.TM CERTIFICATE OF DEATH ~lj~co¦~s • ~YRUY OR V{TAL fTATIfTiG ' tTATt FIL[ N0. :•8i1 FLOBIDA ~~d BIRTH NO. RC61tT11AR•f NO. CroParly e a~ e u t~ d 1. ~N1C[ O~ OtA~11 GOO[ NO. t YfYAL R[f10~MCt (~Mn M~rM ~MI. Il www+w: tr:6r~ ?I~ ~+:rir) ,^d .,l' 001" g • 66-025 ~ `~~aint Lucie ~ e. pl.e.a ~ n D~~- CITY. TOMM. Wl IOCATqM IS ?LACE Of DEATM t. pTr. TOMIt1.011 IACATIOM t. K RE510(1KE ~~naat Fort Pierce Florida ~0E `~~rc~ Fort Pierce Florida "~10E ar rn r~l.. . rc_ O ~o . res ~o NAME OF (IJ r! it iM~itd. f~ N?sel ~/4sw1 f. STREET ADORESS 1506 Jaunita Avenue 1506 Jaunita Avenue N4M[ O/ i'i?M A/i//!s L~t 1. DATE XwYI Dy YtV ~iy`,~«`~.tr~ Robert N. Peres ou~ July 13, 1969 s. scx c co~o~ o~ ~,?cc wu.~co Mcvc~ wuu~co e. wTC os w~n~ 9. ?6E (h rtv~ s u~ou ~.w u.oca:. ~.n. !M~ ~iM11~/1 MwY. D~f Mwn Y:.. ~ ~ ~ , ~ ~ Male White ~00 q,,,,,~, p 1~ f n I~ la. YSUAL «CWAT~OM /Qirt tiwt ~/r0?t f~e 10p. KtMOOF W51ME55 W! WOYST~Y 11. NQTMRACE (S? a M ~i?sl/+t ONW/) 1. C11~7E~ Qi mNT tONwfRn . ' i •an~st•r ,~~~~y~~,~•~yl~~ Port ~f .S alll Trinid d Not USA 'Construction Builder P ~ Dl~et l~t 1 FATMEII'S 1UWE Il. NOTNEIIY ~u~D[.M W1ME ~ or v' ~~p•~~st•~ Robert N, Peres Amelia Cando - K. SOCIAL SEWIUTII ?q. 17. IN j NONATY~K t~' At6ru . N 148-09-15 /~Gf.~.~~~'! Yj ~/.~'~f~~ ~ 1506 Jaunita Ave Ft. Pierce P u n~ r~ 1 Il 6~Yf~ K KATN (61Uer ~ Mt tM~M ~a fl~r /rr q). ~1 (v.) ~ ~oKSET ~u~D~oE*iiT ~ ~ ~ dfr~etor ~MTL O(ATMMwSGYStOtYe . ~ WM[OM1E GYSE W ¦u~t ffl• I ~ t~• e~r- • ~ •ICOC't1• ~ ~t t~~{/~• ~ ~ / l ~ 1 o e• 1 tlrt c~tat ( 1 t r~a~str~r +~~V Ne r~4?- 04'E TO (tl ~ - ~ .iania T~ M~I c~ar iwf_ ~ . . O ~Al1T N. OiIEA MI~i1CM1 COIIDIT1016 COMIAIRMG 10 OG11N ~IlT NOt RMTFO f0 M TCtr1YYl RSGY COM01T1W1 iN01 rl IARf 1(a1 . M1~5 AUTO?SY Toutt •f- M - KIIF011ME07 ~ t~r d~atY s YESQ MO~ os Defo~• ~ ° 20.. ~ OESUUE IIOM IIUU~Y OCtU~[O. (ERIlr f~ht?t Nfejr~~ lA PiVf 1 M PYt 1I ~1ftf~ 11.) ~ setin~ aw~ ~ AOGOENT SYIC~OE MOYICIGE ~ d.~pos!- r~ ? ? ? t i o a • f TIt~E OF HNr Xwt~, D~/. Yqr ~ ~ bod~. w~r : ~ m/. MUU~Y OfCUUI[O 7At. /I.ACE Oi YW~11 (t. o~r ~AMt w~s. ID/. CITY. TOwM. O~ lOGT10M tOYMTY STATE MNII[ AT ~ MDT MINKE ~ /r~.l~Mf. ~frtd. ~tt M~/-. de.) ~ ~ ~ ; MO~K AT ~ORK ~ 2t• 1~tf~nd~ tM d~w~a~dlrom . to ~e~ /Yf N~ ~li~~ on ~ i D~tA axu~nd ~t ~ m on th~ d~b ~f~t~d ~Lw~; ~nd to tM bMt o1 m~ lnorhd/~, from tM uuw ~t~t~d. ~ 11 1 t~~• jj~ TYAt ~ ~ .re se 1~ (~~'+rltlk) 2?6 6dtE55 ?2t. TES MEO ~o.?:... . ~o - ~ ~ ~ 6 • e e Y~ ~ t~. 2~- MI~Y. CIIiM~i~OR 23S OAiE 27t. IM~[E Of C[YETCIW OR C1IENAT0~7 23/. LOCATIOM (G1ff1. fMrR. M tNNf/1 ~$~f~) RrOir~L (8lr[i/~l i Y. S. j 017 i ~SS 2S. DATF RFCO. ~11 IOGLL REG. a.~.~ass - ~ t. Pierce F~a, JulY 16, 1969 ~y,~,v .~2 ~w„~~ 18414~ ~ ~ I hereby osrtify this to b~ s t~ruus and aorroct oQpy ot tha t.ocai T LED AN0 RECOROED ~ ~ Registre~a ~ecord on file in ths St. lucie County H~atth DeparF LUCIE COUNTY. FL4. ment at foA Pierce. Flotida. ~ R F!` n~? V E R I F! ~ p - r~;' : (Watning: Not valid unless raised seal of the St. tucie ~:l;,' Counry Heahh Gpartmsnt is affixed.) ' ~ ~ ~:i ` _ ' '69 OCT I 0 PM ' I 9~ t~ ~ ~ j~~ ` - ~ - , N. D. MItIER, M. D. ~j , . ' _ . - . ~ ` ~ Cou~ty Ith Officer'b Local istrar Q~,~ C~ z. ~FOITRIaS ~f'', ~i ~`,,a~•'. ~ ~.-"-f y~t~. ~ ,ti . ~ ~ J ~l C RK fRCUIT COURT `1 j•.• ~ { . F ~ ~ ~ 1+ ~ ~ o.~+r ~«.i a~~u ~ ~.~,3' t ~ n~ - ~ so~K180 ~~1133 ~ - - - - _ ~ ' ~ u_v~.__ ~ ~ ,