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HomeMy WebLinkAbout2849 ~ ~ - ~ ~ ~.89894 2' y 5 ~ tsi. srwr~ ~owau o~ Nsnt.TM CERTIFICATE OF DEATH eoa~s a ~YIIGU OF YITAL /TATIfT7CS iTAT[ ~II.= M~ l•c•i••~- FLOBIDA erd •A~n BI TH NO. RE bTRAR•! NO. - Pr~p~rl~ KwC[ 0/ KATN GODC NO. L YWwt ~IO~MC~(w~w.iwd~t.r. U:..rw..: s.:a..NN..+.~.~ •:~euNd 1 ~ ~NTM a STATE ~n •nA ~111 1~ ~l ~e~~ 1. MV. T01RN. Wl lOCA1qM K KACE Os OEATN c. CITIf. TOwM.011 1DC11T1011 a K RES~DEMCE , iw y~r- •~~~~t IN510E CITY UMITSI YI51DE CITY LIMITSt ' YES 1q ? YiS NO l11~. w?rE 0~ (l/~wt b Mr/itd. Irr ~erat N4w) 1. STRER ADO~ESs kOSMTAL 011 ~ ~ INS?ITIfT1011 4 1 ~ 3. IiAMt 8i ~YY iiii::~ i.~i i. rat:c 'a~'isv :r.s ~ O[C~/1i~0 ~ ~ crn~«,.r.n ~,,y DGRT_S DIGIGLIO °EATM A st 11 1 6 s. scx . cao~ oR iua wuu~co wtvc~ wNUao D~. arc os wrrw ncc c?. ~sa. s wu i rw u~ui b~ws. i ~ IM10W?Iq1 K~.~4 4~ Ywn Ni.. ~ ~ i s. g j~ rnoarco O awncco l~`k1r 1 1 2 0 ; ; y l• i~ f0~. uw~ occw~noM (oiK t1M Nwt pse Kwo os wsu~ss oa wousr~r wrwua cs.u /rw~h a.~rn) ~ crtas~ a.wu ooumm .l e l p• r- t~?i~v ~wt N~~I wrw ~~NrM : ~~p~p~ ousek~ife - Ow~n Home T lor Caunt• Fla. USA ~ ; llaek !wk 1~, /A7Mtl1'! wM[ 1~. rOTNq1'3 ~u~0[l~ ~uu[ ; ~sr•¦•i~•~ JGHV . 2f.OF,GAtJ lV+RY STRICKLA;W ~ ' ~s. wws aa~sco cvc~ M v. s. ~~rco ro+ias? i~. socuu. sccuam ~a. n. u~ • s~aw?Twc TOt~'J Digi(;lio . ~r.....~.......1 ul.....f.....~w.,r.~w • ~ _ ~o A~~ Ft.Pierce Florida T~e~~al 1~. ~AYK OtATN ~AJer MJ/ Mt ~K ya (i~r~r o/ (t).) IMTERYAL ~ET1rE01 6ir~et~r /~~TlOEATMMASCAIREO~r: _ ~T~~m , ~ ,M„EO,,,,t ~ ~a Possible Reaction -to Tensilo ~ .ws rfl. ~ ' tY• e~r- 'i c~na.:. ~,,,;,i.,,,, t~~,,,, o„E T,, Chro:~ic ter.-ainal Pyelonephri~isT Uremia + Several ¦it? ti• r~int p~ r b ' ~ . ~ . ~ .e..< <..«`'f.~. Years • i r~aistr~r lli~c~u~~ ouE To (r) ' ' ~ . ~ ¦o ~ r~~ t~ ~~uT i~. oTw s~c~rwwr taano~ oo~muwirnc m ourn wrt wr w~no m twc turw~t oe~~no~~ r~M*Li~R D E D . w~s ~uTO?sr ~ rc~rem c.r a..cr ~ r. + • ru~ ~w0 or e• re r• _ aD.. ~ tOD. ocsuu~c wow uuwr ottuawEO. (bl~ta ~w~ Nfy~.ry Iw I~yrt J r. qrf~{ d~ 1W • ¦~kfw~ ~w~ ~ Att~DEMT . SUIC~OE MOM~C~OE . . - , ~ -i....~- ~ D O O 10~ p~. TIME Oi HMtI XMIf~. D~1. YM 20 k ~~a~. ~ uuu~r ~ o w. ! } !1 [ ~ ' ~ ~ 2w. wu~r oeeuiueco IOs. nau os nuu~r (r. a... ~e«u a.ne. ~Dl• un. K. T oov~r_~~ SSATE ~ wN~ ~T ~ wT rma[ ~ N?.. /«+.rr..e,ss, a,fa aN., ae.) YfO1lK AT 1ROIlK , 21. l~tNnd~d tM d~cwwd /rom 8 6 , to D@8t.I1 rnd'J~it w+i `b/d.~i~i on ; DweA oeeurnd ~f ` m on tA~ d~f~ ~t~t~d ~oo?~: Oo'W b~~r'OE'~41 m tA~ uuw~ ~t~nd. : i ?Il lt~~• jj~. App~ . 7Ie. W?TESiGllEO ~ s1ow1TYK (Dt~?es ~r lYk) ; to 1• ~•¦a~•~• + nald R. LaPlatne 610 N. 7th. St. Ft.Pierce 8 13 65 + •leYt~t~. 23~ W~MAI.QEYAiOII 2'~. OATE 23C- NAYEOfCEMETERYORC~EMATOwY 27I.lOCAT10M(LY1.[II~f.MCNHIf/1 ~$~ft) ~ ~ AEIIOY~I $pt[tfrl ; guria~ 8-16-6 Fc. Pierce Cemete Ft.Fierce Florida ~ i y s./sia i~. su~ciu?~ oe ~s sK«nnM~l I7:D01f~i1. St 2S. OATE RECD. ~T lAG1l RFC. Rcc~snu?~s srcruTU~c . ~ a••.i96e i+.ilton i:. Baird Ft. Pierce, Fla. 8-1 b-65 Anna Lee Denison, d.r. ' ~ ~ • . ~ _ , ~ ~ I hereby cc~tify thls to b~ ~ true and correct oopy af the loui , , ~ Registrsrs record on file in the St. Lucie Counry Heatth ~epart• ~ ~ ,4, ° . ~ ff1011t a~ ~f PIOKO~ F~Ofli~i. ,!,a''.r • ~~i a, 4~'; : - ~ . 3 ~ • J' ~ . f`4 ` ~ s, (Waming: Nat vatid unku raised seal of tho St.,iucis ~z . ~ counry ~irh a~ernne~r is affixed.)' . _ ~ r- ~ _ ~l,~~` . ; . . ~ , N. D. MIttER, M. D. - v` ~ ~ ~ ~ County Health Officer Local i~ayistrar • ' ; ~ • =y; - ~ _ . ' _ t ~ ' , ss f c~- , ' u :t _ ~ ~ • . Y' ~t' - ~ ~ • ~ . . 5 . ti p~ pspuly Loca{ Registrer ~~~~,-~i?"• , i r~ , ,~'sf~i~ilJ~,lf.. ~ . - , ~ BOOK ~82 PAGE20~~ . ~ - f< • - ~ ~ Y ~ , < _ _ y - ~ F~ ~ " ~ w s~ - s ~ .~a.~.u~. . _ ~ _ t ~