Loading...
HomeMy WebLinkAbout0218 1 FiLED ~r~~ RECORDEO ~ ~'i. L'JC(~ ~OU~~TY. FL~. ~ 18 ~~(~fi ~ ; r~ ~ 18`79n~ ~ ' i ~ ~ 6 Ai~l ! ~ : 3 3 . ~ ~ tn?s u~-, BTATE eowao oF N~TM CERT1FiCATE OF DEATH r~-`~' eoars • BUREAU OF VIT/?L iTATIQT7Gt ~AZ~I~L~.1I~.:,~~T ~~Ut'~T FLdRIDA 1 ord ¦Aen BtRTH NO REGiSTRAR'S AIO. Sg1 c*~r•~ls CODE NO. YtYAI A[fID[NC[(KU.~l~rrNGw1 !!.u~.~.rw Xr.Jen~.•~.~t~..~w) 1. ?UCC Of OUTN eietuttd STAT[ ~i. C01:NT• .~a .»1 ' CO1iNTM Saint Lucie ~5-025 F'lorida Saint Lucie ee oi•e~a ~ lq ver- D. C~TY, T01MN.OR IOCATqN t. IS ?I~CE O~ GEATH f. C~TY_ TOMM.ON IOC~Tq!1 t. ~S RiS~GFACF :!~S:DE dTY CUa1T5i ( tw>.DE C~Tr l:v:r57 7 •aaeat Fort Pierce " .ESt~: no0 r'Oi t Pierce TiiL _ ni~~y fll~. - tur~E OF Ml iw ~MyYd. ~i~t abtH dl~n+i ~ STpEET aODp[SS Npy~TAl OII lNSTITYTION~t~ pierce Memorial ~tos~ita~ 3129 South Indian River Drive 3 NAM[ O• PnM Vi+':lt LY[ D~TE Alo~tl [hoy S iar o~ccwcco ~TM Deeer~ber 24 I~GS ~ . ~nn~ N p~~~ JOHN A\`DREt~I MALCOLM , S SEx 6 CO:ON ON MCE ~ MAIiRtEO ~ wE\"[P YARA.[OC ~ wTE Of B~A7n 9 ~GE !4 fto~ u IAwA 1 tE4N hr u~;,. a:~ .,~s js~f ~ierl~Iq~ Mw~4 IwM /l~v~ ~ V•.. • ~ i e~ v1d1@ Whlt@ w~oowc. D avc++:ee F@b. 26 1890 79 ~ p 1 U 1~1 ~ 10~ USUAL OCCUPATIOM (CRt liMl ~J ~M~ /00! 100 KISDOi' B45thE550R INWSTNY SI BI.lTNPIACE f 17tlt O/ Nr~Nw CoY~fry7 12 GT~LE~ ff rw~T W~.~tatr ~1Cw p~?- ~ui~~iwata/rWt~¦ h/e.«~a~Jrdtrdl 'i ¦~p~p~ Vice Pres. ~ Gen. Mg . Merchandisin Greenwich, England USA ~ 1 Dl~Ct lnk ~3. iATNf11 S MAYf `It 40TMER'S MAW(N IuM( or t~p~~~lt~r PPtP.l' rlalcolm ~ Marion Stecvart ~ - - - 16 sac~u SEtuA~7r wo n~so~~u?wrs s~cw?TUac wa.ru j1Ly SOlltil inoian tclVC:= Lt1v~: - 76-26-429 -A Marguerite B. 1lalcolm F'ort Pierce, Florida F ane~~l 1• CAYT[ Of OCATM IEUtr ~~(t ~is[ t~we pn liv /v (a). ~%1. ant lcl.} In?[R~AI 3ET'hCCK dl~lttOr ~~pT ~ATM 1NASCAV$[O/r' ~ ~ • OhSET AAD ~EATn •u~t fll! IMY[DIATE CAYSE (~)~L?~'!_. ~ . ~~~~1-. _C,'_ . _ '~+f~`~ _~-.1_ . _ _ ~ ~ ts• e~r- ~ ~ airlc•c• Cow~itiw.+/.+r. .ltA lAe ir~xA /or nN ~ OUE TO (bl - - - - - - - - ~ - ! 1 o e w 1 ~ort twre (il. ~ - . ~ reRlstr~r M~?iw/ Ut r~/tr- ~E TO (r:--- I !p~/ cust /u!. ~ ~ - - ~ - - - ~ i •1 tAl~1 T2 ~ rApT 11 Oi1(A $KIYiKM1i COhdilpNS ~pI~iRWiYr i0 DUTM OIJi IWT R[LATFD TO M[ 7LRrYdt CASUSE CO~O~Tph GMM 4N ~11T 1(~3 111A5 Al::O75Y LOYra •f- PEAfOM~E:.~ ter de~tA u rE5 W or Defor~ ~ ~~~~sy~ •~k~ws •eJ ACC1pENT SUiCIDE NpM:C:p[ ~~~p~~ ~~x ~ypY ~C~AAiD iE.~Rftr aWwl! ~JI~jrI~ i~ Put !w Put 1! yitia 1t.) a~.Po,~- v ~ G ~ - L10A O~ - J 2(~( T:MF OF //IYI ,Llp~(~. /NI. ~~ltl • Dod~. u ~WURY w. ~ i 0 0- W ~ Z0/ tMJUNY OCCU11RE0 7D[ tUC[ Oi I~JU111/ :t. ia a'ont ~owa 2G/ dTY. T01YN. 011 IOUTqN COJMTY Si /.TE WNLLE AT ~ 11QT WMKE ~ l~'~. /~~'f• u•rd. c,Qtat GS~.. rt:.; WOtK AT INOIIR ZI / ~tt~nd~d fM d~c~~s~d /rom - J_ . • to~ -e~~ ~nd Lst a~r •/ir~ on / _ Z D.~re oceu~r~d ~t -~"~_x m on th~ dere sta[e •bore; ~nd !o tM D~af of mr know~l~d~e. lro tM uaea at~t~d ?11 1~l~• fIGIIATY , prr o~ f?1t, :2~% ?G~AESS ?2[. D~T[ S~G~iD ~ ~ •re to D• ~ y ( ~c,,n ~ ~ _ eo.plece a ~ ' ~i•~7 V -C.:~C-C ~~'Y ~ Z% ~c u •e~Yf~tt. 230 6`:R:~l. CA[M~TqN. jb p11TE ~ 21• \~t~E Of CE~E.-iRY JA .'Ai vlT:~d• I}d. LOCATiOM ICY~. patt~. M tGi:4'il 1:lt. REr0Y4 (lyff /~l ' Remova.'1 12/24/196~~~Lakewood ti.enorial Park ,Jackson, ~;ississippi ~.s.rtl1` j ~A~~' ~T~ s °a ate~~~uneral~oraeT c.vcAiCD BrIOC~IREG RE ~sta•nss~4~~S~AE u ~~•.,~~s Ft. Pierce, Fla. i a.ec. 3Q,19F,9 Zl ~__e.--. "1, s - • ~ ~ 1 haraby ctrtify this to !x s true and corract copy c` :ha L~-a~ ~ ~ ~ Rt,gissrors record on file in the St. Lucie County Hoa:th Daaan- ~ ment at Fort Pierce, Ftorida ' (Wsrning: Not valid u~less roised seal of thx St. Lvcia . ' ~ County Flealth Departrr~ent is affixcd.) ' - ~ : ' ! ~ • . - ~ . ~ , N. D. MIItER, M. D. . " , ~ ~ County Haalth Officer & Locat Registrar . - ~ ~ , , ~'r: . 4 " . ~ . ~ ~ ~ ~Q ~OCa~ ~ISifa~ ` ~ • • ` • i • 1 ,1 i; _ ~ ~ %i' 1 'f %i. • ~ BOOK ~~2 PAGE ~ 217 _ - - - . a _ . ~ _ . _ _ . ~.v_ ~