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HomeMy WebLinkAbout1803 ~ ~ - : 1869U5 ` I ~ , . ~ ta~f 4e- ~TAT[ ~owa~ or wu~TM CERTIFICATE OF DEATH ' eo~ea • ~UR[AU OI YITAL RATIfT1C~ lTAT[ FIL[ NO. ~ ~•a•~ FLORIDA ord ¦he~u BIRTH NO. R[G16TRAR•• NO. 496 ! prop~rl~ 1. 1lAC[ O? ~T11 CODt NO. 2- YfYAL R[NY[MCtI~~.Me~.dti~d !!.w.w+.w- Rr.r...W.v.ra.r:..) 1 tiftYtfd ~M~ STAT[ COUMTII .~d .1» St. Lucie 66- 25 Florida St. Lucie ~ s. ~i.e•a » p~~_ A. ar. TowN, o~ ~oG?TwM a rucc os asm C~T1I. TOMM.OR LOG~TpM t. K IIE5~0(MCE ¦~q~~t IMSIOf CITr 11Y1TS/ IMSIDE CITY 11Y1TS/ i r,,.. Ft. Pierce .ES~ w0 Ft Pi r e ~s ~oQ_ ~ f. M~rE Oi (J/ w~f i~ ~M~ihl, /wt Mtset Nbsa~l I. STREET ADOII[SS f Np5?IT~I OA ~ INSTITJTqM F.a,ster Ma.nor 326 North 14th Street ` 7 NAM[ Oi ~M A/WIt LYf DATE A1Mf1 Dq YfY ~ c°T:~«p~,~? Florence • Teresa R an ~*NNovember 13 1969 ~ S SE% ~ COCO~ O~ ~ACE ~ M~II~iED ~ I~EYtR YA~t~EQ • DATE OF ~111TM ~~6E Ilw ~ttl/ i~~ 1 TW wpF~ H~S. Jpf A'sAlq) M~.rM M' I/wn MA. ~ . r.~~• Female Whlt@ rinoorrco~ pYO~CED OCt. 25~ 1898 71 , ~ t•~ w 1~ 10~. usu~ occur~ta~ 1Cwr t~~~ y s«t b.r W6. Kaa as ws~MCSSOR wrousT~r t w~Mruc[ cst.re w/wry~ n.wr) 12 unm~ or .~wt oa~•~ ~ •!tA P~~- ~ari~ wwf~/~r~rtf~ h(t.e~t~l/ref'vd1 i ....e~ I-fousean~e New York USA ~ ?laek !wk ~~TNER'S ?u~ME 1~. YOTMEII'S MAIOE~ IurE ~ William Dickson Unavailable ' 1~. SOtul SECURRr Np 17 INIO s f~itMTUAt A/irw ' Non~ Jose h H. R an 326 North 14th Street Ft. Pierce Florida ran.r.i e~uu K ~uTw(sua.r~..er.ray~.r.r~+.l.). e~..•~u?.~ ~ i~~ urtc~v~u~xccN ~fr•ccer ra~r? oE~rnMnSCAUSEOnf~ / ~ O15EJAMD°E"r" _ / •u~t ~11• IMMEOMTE CAYSf ~i6~~i~ ~ t\• t~~- . 1 ~ ~ ' t i f f t~ t• Cqfitiau. i/ p f. py~ TO (O) j ~ ~ •lta tA• r~iti /~rt ~uji)~ ~ ~ - . - 1 • e • 1 ~Drrt [~ut ( t~aistr~r aqfiy f?e •~Qr_ D1rE TO N ~G ' ~f !py t~rx fpt. ~ - ! • I t A l O 7= O ~AAT 11. Oi1Q SK~IC4Mt fp pUTN Q!I NpT R(UiF M D64SE OOI101i~0U CIr01 M?MT 1(~I . MAS AUTO?Sr ~ ~odrs •t- F l / • fERi01lME ~ ~ ' l~r d~.t~ ~ -1 v~n-~Q-~?A~ ~ ? No ; •r ?eter• res = Ip. ~ t0A ocse~uc Now ~?uu~ oeeu~Ato '~ra s.e N~r 1~ Pwt 1 r Il yYr• •aklsa •w~ ~ ~UIpEMT SUK~DE MOMICIQ ~ , ~Iqut- V ? ? ~ ~ si~• •t ~ 2Qt TIME Oi /fNr M~f~: Ot~, }'M ~~d~• V ItUU11• A. 'o ~0 "'o~~~~ W ~ 20/ ~wlU~~ OCCUR~ED mr. K~CE Oi wlu~t v dwaf Mnt, m/ CITr. TOMN. LOCATqw OOYNTr STAT[ . , MOIIK A7 ~ ~T MpAK E ~w• N/. Y/td. ~~tt NtI.. tlt_) ' Z~ / ~tt~nd~d tM d~c~~wd /rom ~ , to ' ~ 6 ~ •nd lut w~~i?~ on W~rA oceurrd ~t P~ m on th~ d~t~ at~tW ~Aw~: ~nd to tA~ 6Nt d m~ Rno~Ndp. lrom fh~ uuNS ~t~ud. ?]l ll~~• jj~ s1ON4TYw[ •r• te (Ikpe~ ~?W4i ~ ?1b •ODR[SS l7[. D+?TE S~GMEO eo~~l~N ~ / . . . _ •ttY~~tf. 23~ w.1t4.G[rn 23D TE ~ 2Jt N~MEOiC[YET(1IYOIIUIEMIIT Y . ~.!N tNt~!/1 ~bTdt7 RErOYK1Spt ~ 1 ~N kemova~ lIliS% Gates of Heaven ~a ` orne ::~stch~star CQ. Y.9.~012 j! UwEn110~lECTp11 SSIWIATURC ESS ZS. DATE 11EC0. ~1IlAGAL1IEG. REG TMII'SSKMl1TURE ....,aeb a~ ~j~ Yates ~uneral Home • oste.~r Novesnbe~ 13 19 9 .8.~ T i ~ RECORDEO ~ ~ ; N~ j 1 hemby oartify thu to b~ a true and oonea oopy of tM lout T~LL ~CpE C OUP3TY. F~A • . x Registrars ~eoord on file in the St. Lucie County H~alth Depart- ' s msnt d Fort Pierce. Florida. lS~J"~• ~ ~ C, - . ~ (Wamin~: Not valid unleu raised xal of tha St. ~ucie ~M 9. 3~: ~ ~ eounry r~e.trh o.p,n~r?i .ff~Xed.> >~g (~~~t` I 2 _ ` . . - _ ~ , , ~ , N. D. MIIIER, AA. D. C~~""_ ~fi AS . ` ~ ' _ , ~ County Hsalth Offiter'& t~ocal Rpistrar ~.,1?"-~RK C~R~U1j COt1RT _ a ; . ~ ' ~ . ~ . - 1"~ . ~ Datr D~puty trocal Re~isiru ~ . _ . ~ ~ ; ^ % ` ~ ~ : ~ ~ ~ a ~ - ~ . , • , ~ - - . gooK 181 PACE1~04 _ - - - - ~ - ~ - ~ - - _ . _ . _ . _