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Home My WebLink About2148 1 ' ~ r?~. •e- iTAT[ aowRO or Nu~n~ CERTiF1CATE OF DEATH ~ •Y11GY OR VITAL ~TKfIfTIC~ RA7t F1L[ N0._ ~ ' i:i:i FLORIDA qEG~~pAR'S ?+o. 230 erA ¦A~a gtRTM NO. jripirl~ 1. ?lAt[ OI C[ATN GODi KO. Z- YiW?l R[f10[MC[1~1.n~rrdAwl IJM.~Mr: R~~wT+~~?~'~^tW'~'^I . ft~trl~~ a ST~TC MYMT~ l'y• iAlC1A ..a .~~1 °0""r' St. Lucie 66-025 Florida • ~ Il~t~• t. 1511ES~OCUCE ~ 1~ t~~~ CITr.TOYfM.dI lOC~1qN t. 4 K4C[ O~ Of~7N t. C/T1. TOWM,011 IOUTiOM uSID[ C+7Y 11Y1TS/ ..,..a iASiOE `•T-" "",T~' Fort Pierce ~ r~l~. r'OY't. ~101'OA rtsPJ w? 'relQ~' f. rarC O~ wt 4 MqitB. /is MrtN d4ew) STt[ET ~OMtSS 1 vorth 1 th Stroet ~MOS~'r~~ F't. Pierco yeisorial Nospital ~ NAY[ 0/ f7rM Mi/Itr L~e oat~ Xwt~ Dq Yra occuuo ~*M A Ml 30 1969 mx«r~•n Carrie I.ou MHod e Boone ~ S. SE7[ ~ OOIO~ O~ iAtt 7. raw~KO ~l1 ~EVE11 ~u1111KOD OwT[ Oi N~Tw f ~6E IJ~ ~ew r u~ot~ ~ ~W waa t~ ~+eS I 11~/1 NrOr D~~ Mwn Mi~. . ~ ~ a• Fema16 Ne rnnorrco0 avo~cco A ril 28 1913 ~ 13 ~lwl~ 10~. uSUµ OCtu?~T~W tOi~r tl~tNr~r~ M~e 10~. Kr~OOS WS~wESSO~ wWKt~Y 11. N~iwI~CE (S~~fe ~r/~rtM~ na~rryi 1. ptnu os wwr tpwmn rlt~ ~~r- tu4/ Nw?!4/A~r.ewwy?atYN) Houso ~+ork Do~estic I~adison, Georgia U. S. A. ~l~~k ~~Y 1 /AiM[A'! M4M( 1~. rOTwClI'S ~~WCI~ YY( ~ •~r:..i•.. Bud Jaekson Ethal Paggett ia. socuu sccwun aa ~t. w~n• • WowTVwc wu.e.. . ~ I~one Jol : Boone 513 x. isth Strsat; Fort Pierce, Florida 33450 ' /~w~f ~1 1~. iAVK N KwTN ~6~d M!I Mt lirM (d. (1). ~~I (tI. IMT[IIY~I ~(T~rt[M . /~~T l Ot~~w M~3 GYS[O ~Y: OwSET u0 O[~i ....•a•• wrceancw~cc•! f i`' ~ ~ i O 1~2_ so.a h3. t~• s~r- tif~s~s• (•~.fiti~b.i/~~I. py[ Tp (~1 s1tO tb ~r~~d Nrt ?y~ h 1 1 • • • 1 ~Dw~ ~~ut (il. ) r~R~~a~~f N.n+/ IM ¦rM?• ~ O4Y ro l•)~ - 11 y t~rar fuf- •1N!• 77 = A J~~? TI y . KRS~Y70ISY J n ~o~o o~'['rw? n~sw,~cot 1~Yf• •f~ M 1G~TPJ ~P~~~ fhC/ Q 4 T~ ~ Y[s~'NOD t~f ~~~t\ ~ ~ ~ •r l~f~r• _ ~n.~.~ Sc~yc iwir rdwrxtvRUO. (~to arav~ yWw~ t~ Prt I~r Ar~ /I NY~~ ~IJ •~kl~s ~~7 ~ 1KCW(wT SYICW( MDtl~C10[ al~~~~t- u ~ ? ? •f p~ 7~rt oI flwr Xwt~. MI. Yr~r 1 • ~ ww~r o = 2Qf. MYY~1 OKY~[O R~C[ Oi MN~t /t. u M~M1NI MAt. mJ CRY. TOMR OA IOC~TIOM OOYI~T~ STAT[ w~~ac ~s ~ woT xNi?[ ~ lw•.l.~r. r.rer. Nke WM~ eu.3 MO~K AT ~fOwK r ~ ~ ~ . 21. /~fqnd~J fM I~eMS~I /ros+ .~o nr fut w+~ A~ • on D~~IA~ cr?nd ~f m oe fA~ d~(~ ~t~t~d ~so+~: ~nI fo fM N~I o/ norNd/~. /rom fA~ uuws ~bf~d. •~l lt~~• jj~. NO Y ' (QtP Yk) ~I1 ADOR~S1. 71t. WTESK.wEO •I• t• Y• V~ ~ e~~~l~t• • ~QJ~ •stYtat~. ~wi~ ~~n j]i tiYt Oi CC~ET[11~ OR C11EM~Tp1 27f. \OGTOM (GSry.IN~. M M+~f~) (Sf~ft) Kr01~t l3/et~J/1 ~ . ~ Pine Grove Cewete F rt Pierce Florida v. s.1 e i ~ : u.~ w s s~w wo¦cssStorie ~ s =S. DATE ~CC0. ~r IAC~L ~[C- ISTAAR'i i1GMATYR[L~~1~~~d a...,ass ' Ft. Pierce,Fla. Ma 2 1969 ~1~~liX.Gt. . G FILED ~ND RECORDED ~ ST. C.`JC1~ C~Ut:TY, FLA. ~ . "-~,~f~~ ' . i; - 18933'7 , - ~ t,ereby oertify tt,(: to be ~ true ~~d oonea ~oopy of th. ~ . Registrsrs rxord on file in the St. Lucie County H~alth De'~t- F E g ~ z•. ; ment ~t Fort Pierce, Florida. Q ~,G ' ; ~ : ' ' - (Wsming: Not valid unless raiaed seal of tf?e St. L~xie ,y~ ~~1~ _ : ~ ~ - ± . • • ~ - - Counry Hselth D~p~rtmsnr i: affixed.) ~ t, ~ ~ ~ : ~ R ~ . . ' - CLERK Cii~C411T C4F1RT~ ' ' - ~ : : , N. D. MIILER, M. D. _ ~ • . ~ ~ , County Fiealt~ Offic~ & Loca) Registrar . '~t 1 1; , ' ~ ~ . ~ il ~ _ " p~ D~pufy Loc~l Repimar • ~ , :~~~li=: BOOK s ° R 182 PA~E2144 ' . _ _ p~. _ _ ; rx. .s~ _ . , : ` 3.~.