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HomeMy WebLinkAbout0705 z ~ 1~61~6 F~~Ep ~r~D RECORDED ~ I.UCIE COUNTY. FLA. ~:__^~t?" `:=?~F'EC~ i8~1U6 '69 t~OV Z4 PM 2~ 51 ~ Ta~s ~ pTATE .ow~o or Mu~n~ ' CERTIFICATE OF DEATH co~ea • iURGU OP YITAL fTATifTIC~ iTATt FIC[ 0. ~.s.~ FLORIDA = i)(;E~ r ord •s~n gIRTH NO. pr~pe?lr R~ •a~tut~A l. ruC[ Of Y~AriI CODE NO. 2. YiV?l wit1Y[MC[1~~... ! ~.~„y;~„) •RA •111 1. COYMTr a S7ATC 1. tqiMtY St. Lucie 66-025 Florida St. Lucie tw y~r- 0. pTr. ToKM.o~ Wc~T~ow t. ~s ?uu Os oc~rM dTr, toww.ql ~x~rqr K RCS~DtKC; ..e.ss ws,ac ~-r ur~rs~ ~soc an i~~~rs~ F~ Pierce .fs~ „op Ft. Pierce ,~S t. N~wf OF (!/r/hMqitN, pr~brdNtrssr) t STREET AO~W~ESf ~ ~ ~T~ Ft. Pierce Mem. Hosp. 1702 Behrens Rd. NAM[ 0/ firN pjiNlt L~t l. 01TE XM71 A~ YeY i~~ w~~~~ THERESA HAACK ~ ~T~ A ri 1 25 , I9 b 8 S. SCX i. CO?O~ O~ µtt MM~t40 (,Yw[K~ rNUKO G t. WT[ O~ WTw ~GC (4 i~1 r ~woc~ ~ tw y,w:,~i 1. ~+s. IYIOM/~N~) M~Y4 MM NM Mr1. e• F CStl 1YippM[D «ro.uo arch 15 ,1897 71 ~1~1w1~ 10~. USYLLOGCWATOMICNttiA/NvM~~1f 1~.RWOOi~Y51wESSO1l1MDYSTRr 11. ~tRTM/?AC((9NtM~/tyAtN~Yr~) 1. dT~70~pr~uiaqqnil y .ic• y•r- t..r,~•w.r~/wt~.ihk.ew.yi~n.~n ~n ••p•~~ Home Maker Own Aome Hun a Nat. USA O ll~ck f~t 1~. ~~TMta-S NM~~ li. MOT~F~t'i r~tOEN ~ur[ x Unobt . IInobt . q ic ww~ sccuR~n w. n~ oa ~ N6~~Y~R~[ ,~u,,,, ~ Unobt. ~tirc.t ~'~"f" F~~.~~<<~ 1702 Behrens Rd., Ft.Pierce,Fla. ~ Il CAYK 0/ KATM s.~o..q...~...e s~ . ~ Fue~~~l ~ p~ isi. ~d ~t?.l iwi[av~t tEiw[iM i~~ ~ ?A~T L O[1TM MwS GAY6C0 MSET AlW O(~TM . a t~ 1• wr[oun c~vss i' i~ ~ c~ ~ . C Qd .f' i / U Yr( U c~• e~r- .Zl tlt~e~t• C~~Iiriw.i/o~. ' ¦1« a*• rAid Net q OIJ[ TO 1 • e • 1 ~t n~~e (i). ' r~ststr~r ~t~fisl 14 ¦~frr- plit VO t Q •itA1w 7= z 1~.y s~aN luf. \O V f• • f- O IAJIT N OTKA SK Tq~R CpaTIU~u7O~G T OUiN i;R Mpi Rt47ED TO TN[ iLtyuLL p6fAf[ Cp,q~tq~ GI~{w 1~ ?Yi 1(a~ . M~S A~JTOKY r . a.. a..c~ `~f~~~fy f rF.sa~rror s ~ ~ c~ ~~c.r nS o •r D~ t~~• ~ pEX~~ ~WY ~Y1111E0. (F.i~ta ~Nwt KyJtr~ i~ p~rt I~r Pr[ 11 ~ •~Yl~~ ~w~ ~ ~CC~DIMT SYK~OL NOrK~OE ~/il~~lla . , •.~y~st- r~ ? ? ? I • •f v ~ ~~c. T~rE Of /!s~• Xwk~, pI. Ye~r I ~ uUU~r - ~ ~ p A. t I ~ a0f. NUu~t OCCYR11E0 ~r. ?~11CE O~ YUYII~ 1~. i'~ M Wrt 4~ts. 20f . pTY. TO'~II.OII IOCAiqll Cpi~l7 STATE ' j - MNII[ AT O NpT MNy( ~ ~M~. /KtM~. KisA. sa{u GI/.. dC.) ~ l Mp~K ~T YO~K ; ~ 21. l ~tpndd ~M I~ewNd 1r~ - ~ - ~y -3 ~o • 2 ! •nd 1~~~ wr ~li.~ en ~ 2 ~ ~k D~~tA ocrorr~d ~f 7~ ~lA~ d~t~ ~`.t~d ~Do~~; ~nd fo ?A~ bat d mp .tno..bdp. /iom th~ uu u~bt~d. . i •11 1N~s ~CN Yllt • . ~ •f• t• 1• ^ i~el M~tf) w . 21i ADDII€SS / r+ jjt. T[ S+G - D , ~,.«.Lf aLJ_ o~~ /1i~~~ s'7~ ~CG~c;C J„~ c~Y`l J~ 1G ~a ~ .ce~..t.. ! f 2~. iuwat.G[r~ip~. 2b WT[ 21t. w~rE O~ C[~LT[Nt J~t CRE~tA:AA~ 23i. IOGT~Oh /GV~. fM1. M N~f~) (3af~/ ~ "~u'~i°'a~'' 4-27- 8 Ft.Pierce Cemetery Ft.Pierce Florida ~ ~ ~ V.9./079 21.'NS[ L DW[ 011 TYRC ( 2S. OATE ACCO. W?AG1LR[G. R KTII~IIIYfKMAT{ptE . ' a...iose % • . r~ 9~~ :v. . St. ~ 30~8 .G:~'~..~e.~~. I - - 9~~• t•'f•!~ . . . I t10fQ~/ C~l~l~/ ~Ijt 10 b! • 1rlle afld OOtfOCt 06~/ Of ~N ~OCi~ - . Reg+strera record on file in the St. lucie County Hwlth Dapan- ' ment ~t Fort Pierce. Fbrida. ` i . ~ ~ . ~ . ~ . - ~ (VI/uning: Not vatid unleu raised sea{ of the St. lucis 1'~ . " ~ ' County Health Dapartment is affixed.) . ~ ~ : - . - . ~ ~ ' r : i , j . N. D. MIItER, M. 0. ~ : ~ ~ r ~ ~ , ~ . - _ ~ : 3 ~ County HeaMh Officer'b toca! Ragistrar • ' , ; { ! + ` 't~\ ~ ~ ~ . ~ i Dat~ Depufy lou! Registrar ~ , ~ . , ; . , BOOK ~S~ PACE ~ i