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HomeMy WebLinkAbout1573 t y - . ~ . ~ 1844E9 ~ ? nwT~ ~o~?RC oR Mw~,TM CERTlF1CATE OF DEATH I ee~~s • rY11tl?Y O~ YITA~, fTATIf*iC~ lTATt Flu N0. 1 '•j•"•°- FL08IDA e~ T N . A • *r~p~r1~ 1. 1t/1~ KATN ' CODt HO. 2. YfY ~11[{I~iMi~(~~N.rrY~.~lt~ ~.Wi.~W i .:.c~t.a ~w~ •111 ~l~e~~ { i. *•e- R MIr. T011?M.OR 1+OCw1+OM r. ~S ?LACE os oEwTN a Ai1l. TO~II.OR IOCAT1oM e. IS 11ES~OENCE ` •~N~t ' 'NISIOE l1MITSt MSIOE tIT/ WtITSt tll~. 1~ES~ MO? IftSm MD? NAYE Of fM 11~ ~M)Ihl. IIN I' N<trM1 ILMaT11 OI ST~[ET ADDA[SS ~~T~ ~ ~ ON A FARMI ; "'~'T1T10M Ft. Pierce Hem. Hos t. ~r~`rs 2512 Jers Ave. ~res0 Nof] s 3. nwN[ FtrN I~ti/~fe Lyt pATE XwY Dq Ynr j ~~bn Finle Victor Sa~it~h oi.n~ J 1 ~ scx s. ca~,o~ o~ +ua wue~~co Ncrca wwKO wTC os wTM t. ~c ct~ rr..~ ~ usu ~ vw u~ tw ~r~nl x..r. aw ww.. xw, i r• t c• w~oowtD orMOiecco t1.1w1~ 10~ uwAIO~yCCNWy~?1i0M Ciutidynptbu IOC.KrroOi~YSMEtSORwOYSTRr 11. ~MITwII~CE(~IewArd/~~N~ib1) cOao~OI~wTC0U1nn ~ •it~ ~~r- ~~'/31DLe~I't~q~•wn~l~tN~M ¦~~~~s ~'03~@I'C~81. }{81"C~@11~3112'~~ • u.$.1. - . llaalt f~k 1 ~ATNt~Y hAYE 1 MO7M[R's MAIO[N IMM[ " ~f _ sn..rsa.. Hen=y Smith UriObt• ; ~~s occci?sco tvc~ w u. s, iurco ic~as~ K. soc~LL sccuRrtY Na. 1~. eMn • sNwnTws ' ~:~,ea u~....«••1~T T~T I~~ 2 6 w~e?... •rs. ~ - • • 64-42-333 t•w•s.~ ~ snw~ w Kwrw (itie...tr... e...~ ~a r~.s/r.. tN. A). cdJ up~r~uv~.~ ~xcc~ t ~ie•~s~e r~r~ ou?iNVnsu~sco~r: 1"L~2'S.N ; ,~„~a.n ~ Corona thraabosis ~ . ...s r,~. t~• s~r- a,r~..s. ~~„M,.,r..,. ~ n~ Gertera2fzed ArLeriosclerasis • Years ~ .ic. a~. .uN w..~1j ; 1 • • • ~ ~Mt LMx lf~ - I e~sl~tr~e Mt rMer• OIIE ?O •it\l~ 0~ ~IfM qrn 1Mt. 1?O~e f- ~ ?AI~T It 01~1 Srw~cMa Ow~Onq~s OONI1rlrtwa 10 Out!1 ~Irt w~ I~M7q 1o M lEww~? OYUtt Oo~ai1o11'CIrtM t M~r ~(V . w , - ~[~?Ot11[Ot t~f ~~~t\ S ~Q a~kla~•~w~ ~D?.OESdtNfMO~rMUW1rOCCU1111EO. t8tifo~afwt~/~i~pYril~?riM)l~/tM~IW ~ ACGOtIIt 7YIC10t 110MICIDE - - as.~..i- O O :1~~ J~. T~E Os fbar ~fwl~, Dq. Yar Mf~. wNM1 A. a Y 20f. IMJwr ooCUMED ~r. MACE oF wluUr (e. i~ r~t ~r. !Ol- Cm/. lO~M. ae Wd?Tqll oouMTY sT11TE ~rn~ac ~ e~or waac ~ /d•.l~+w~.•asw. N{« ~tM., .rsJ ' MORK AT 1~OItK 2i. J ~tt~nlN tM ~~llrom~~ • . to ~e ~wI l~at w~r ~li~+ on ~e . t DNtA oeaurnl~t 2,~yr( A.H. ~ on tM d~t~~t~t~I ~ier~: ~wI to tJb 1Nt e! q kwo~Nd/~. /ros~ tM c~uw~ sf~tW. ` •l~ ~Ns~ tt~- NYNATWs ~r• t• 1• I~Ma tir4) ?2~. ~0011E~ l7c. MTE SK~Eo e~~>>~s• a Alf7red J. Cornille~ M.D. 903 Orange Ave. 6-2-s8 •s~~e~e~. w+~~a. c~now ri. wtE 27c. wwc os ur~c~r os cuw?TOar l3r. wuno~ tprr. qw~. a os.sr~) (ei.re) i ~u~"r~a~~ June 1958 Hillcrest Mem. Gardens St. Lucie Co. F1oMda ~ r. s. / sis n~c~ s s+~«~ !s. arc +e~ca. ir wcw. +~ca ~cc~w~s srrun~c ~••.~~es Milton w. Baird, Ft. Pierce 6-6-58 • Anna ~ ; • / ' ~ - ~ ~ ~ ` e i FILEO AND RECORDE~~ :,~;:f'~.w ~ ` ~`~"`-:<< ` - ST. LUCIE COUNTY. FLA. : ~ 1 tue~s6y asefify tfik fo b~ a trus and oomrect oopy of th~ Locai'• C C' V='~ I F' ~ p . ~ ttepatt.r~s r.oord on file in ths sr. tR,cie covn .1~4s~fi:3 t; -~j ! rrnr~t at Fon Pieru, Fbrid~. ~ ' 7' ! ~ `I ~ ~ •'l . ~T Nwm~o= r~,?~,~a ~ r~~ s~ ~9 OCT 20 PM t2 ' 8 1. ; N ~Y r:. ~ J; ~~,il \ R COYMy HM~tf1 ~i~1tt1NM lt ~IX~.) ~ ~r ~ \ ~i ~ti ~ ~ : ~ p , k ~ C ~ 1 : ~ ' ~f s ~ ~ L ~ r i 'Si~sj~f7, RnS ~ . ~C~,~~Y_ • ~..i..~~`+r,.~ r. < - t , N. D. MtttER, M. 0. ' - ' - • • • ~t - Coumy H~ahh OfficK Local Rpts~uE R K CI RC U IT C O U RT ° _~jj~7 t: ~ l~~i :t' ~ . - ~,,:r;st;:~:~~ - C~..~•~ao./96~ a.~ ` . . ~ ~ ~ . . ca. o.~+y ra~~~ ~ aooK180. PA~1570 ~ - _ _ - _ . , ~ ~.~r~~: ~..r . ~ . - - _ ~ - -