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D•- nwTS wwno oR Hsw~TM CERTIFtCATE OF DEATH
co~ss a YUR[AU OI YITAL ifTAT1fTIC/ ' • lTAT[ F1L[ NO ~
le3~l FL08IDA
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ord •S~n BI T NO. R 61aT11AR•t NO.
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e a e e u t~ d 0? OtATN CODi NO. L YWAi 11[NYpICt (~1~. /rrN y~l b:uM.tr.~: R~:/r.~ N/.r~ W:..:..)
•"a ~"T` St. Lucie bb-12 ` ~~T` Fla. St. Lucie
De O1~eN
! n 0~~- 0. dTt. TOMN.OR WC~t10N t. 1S RACE OF O[ATM e. CiTf.1GIRN.OR IACAT1011 K RESIOEMCE ~
~ a e~ a L Mb~Of C~TY lW ITii pIS10E qTY LIMITSI
rii.. Ft. !'ierce vcsQO r t. Yierce ,~cs(~ „o? ,
I, MAYE OF ~i/.K t~ ~..~iw. MK ~arae ~re~) uNCrN w m~cr ~oo~css
. MOSMTA~ OA ON A fAAYI
«~~n*~ Home 1223 I~cCra~y Ct. 2~'"Y~$ 1223 McCray CourL +~s0 ~+00
3 N~c OF fU~t 1Ftil/k J.~t o+?rE 1Nw4 Dq Yta
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~ Jake Knight oiwn~ Mar. 22 ly5!
S. SEI[ i. OOlO11 011 IUKf 7. NI~RR~EO ~ NEVEII MM111KD OATE OF NIITM AGE (h /WI ~ ~~10[11 t TW UMOEII M Mti.
~ i t• r.ale heg2'O L@C. 25~ 1~jG~ M r,.n. 2~ r... re..
rnoarco ? avaeao
v~• i n 1~ 10._ uwu occv~sTaw co:r N.~ yay.? a.. 1~. KMOOF ~US~I~SS OQ WOUSTtY 11. ~MTWUCE (81dt M
. t c n • r- 1~U+ ~w+M) 1 crtrax os wwr cw.nm
? ~[wMI rwt M~~1~M ~Sk. ar~ 1/ rdir~
••nine ~ C. Labor Labor Ga. U.S.A.
Dl•ek tat FAiwEJ1'S Mi?ME I. MOTNEw'S MAIOEII IUME ~
or ,
°~p•'r~~•~ William Kni ,ht Louise Williams
ir.~~ °?E~iir~..~::~•~•R•~Ei~w~usy~ K. soGu~ sccuR~n w. n. ~Mro s uawTws F1aEt1e ght
`Yes No. I 26L-2t3_t3 11 122 ra t. rt. Yierce Fla
Tun ~ f ~1 I~. CA~IK OI ~tATN (bl~ta ~al/ Ms aYM 1a !hs/b (61. ~st (ti-I NriGtY~LL ~ETNEEM
d 1 e t o f j ?~T L OEATI ~IAf CAy![O ~v 016ET AMD OEATM .
.,,.t r,,. wNCOU.c wnc c.i C rebral Hecnorrh e H -
tAe e~!-
ctrieat• ~ q .
t n t~• r~~ ~.ri r4~.'/~ nuc rn Arte]c•i 1 hvoer -
~ o e. t r..no.~~w aca.e 1~+1•
..~..e..~ f,iy n~K ~w o„E Yaralysis for 26 .~ts. ~
. i s n f• 7~ ~ fMT N. O'f~EM SKK1G11f ~pT10Aef OOiff~YtNi ~O 04iN qR NO'r IKUITm )O 7NE 7F11q1iYl 06E~fE CO~IfOA CMOr /1 ~ARI 1(~I . MAS M/i015Y
Aours •f- F No
t~~ dNtA 3 tERiDwMED7
or p~fer• ` lrES? Mo~
a~ k f n~ aA~ ~p~NT SUKIOE MOMICI~E tOd. asunc No~r wnMr oeeuRRCO. eb~+a ¦.ews Nr,.A?~ h Pwt I u Prre u yYr. ?~a
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e •t TwE OF H~rr XNt?, Oq, Ye~r
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= ZQ/- 1N1VR~ OCt11R11E0 blt. KACC OF WtfRY (t. I.. ~ k~rt 1~at. 20J. CITy. 7'Otll, OA IOCAT1pM C01?MTY STATE ~ -
MN1lE AT rrM~c ~ lM~. f«t.?r. anar. Mcr e~4-. ere.) ~
NORK AT ~OItK
21. l~tf~nd~d flwd~w~Md/rone Jan• 2~1~ 1~56 to "1 " •nd/~~t w~ ~~~linon ~~19~~i7
DMtA oeeurr~d ~t K EOS A_ m on th~ d~t~ sl~f~d ~aor~; ~nd to tM 6Nt d m~ kno~l~dh. from tM uu~a ~t~t~d.
A11 it~~• f/CNATYAt (Dqra~?t1Ns) ?ld. ADOItESS t?[. WITESWUEO
•r• ts 1•
~~•ri•e•. C.C.Benton H.D. ort Yierce Fla. -2o-y7 ~
a c eu~at~. ~T~ jx- MAYf Of CEMETEIIY OR [REYATOR~ Z3/. Lp~ATq11 {LY7. (MA. M assf// (3~ft)
~ii
ia`~`~'' -31-57 Pine 4rove 'r't. Pierc~
v. s. f si~ 2~. N~~ o~ s s~uuTURt ~ooass tS. a~tc aco. ~r wt~ Rcc. ~carw-s s~uunwic
R'•.1°6b ti. i•.Stone Ft. Pierce Fla. , d.r.
3-29-5? Anna Lee yenison
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~~bY ~~Y thb !o b~ • true ansi oortsd copy of t~ t.oc~l %"n;;~. . .
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Registnrs record on fiie in the St. [uae Covntr H~alth D~part-FI~Ep ~;;p ZECOROED '
m~nt at Fort ~ierre. Florids. S T. L U ~ I F C p U t~TY. FLM.. r , + N. Y
(Wamirpr Not valid unFeu raisad seal of ih~ St. luci~ ~ . : , , _ ~ ~ ^ , , ~ , : ` ,
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County Heshh D~p~nm~nt ~:.ff~x«~a 189335; . ~ -
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, N. D. MILLER, M. D. ~7~ FEB S P~, . Og .
Ith Officer '3 Local Rpistrar ° ~ r.~~
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D~pury bul Rpistnr ' ~'F rJiT ~COURT 1.?~ _ .
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, . _ . BOOK 182 PAGE21 ~2 _ ~