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HomeMy WebLinkAbout0119 _ ~9010~ CER7IFICATE OF DEATH (kp~+..eN .I tk.hL Re1.M11au.e Sey.ice. ~rw7t f~u tio. °rv~°'" °f' wAim F L O$ I D A TV/E. Ol ?NNi IN R[GIiTQAR•• NO. 94 IERMANI~ IMK ~_H~E ~wt russ~t uf SfX CAiE OF DEAM ~ rOwfw, Ns, tt~~ ~ ~a~ , Bessie Green ,F*emale ,February 3, 1970 . . wt?a ~.aw» flF o[wn~ 66~2 ~x. ~ vec+, ~ r ~.w~~ .w. e.n wws *w ~ . N ~ k ~Jecenber20 1 T CM. i0 . OR l TION OEI?M wt+e tm ~rns MOSNTAI O~ OiMEt NSTRUfION- pa wr tere ~ ~''Oat P~L'Y'C@ ~~@3,auw u I1~ ~ STATE Of WM ~ r rp~ ~.s.... .uri Ctl17EN pf Ww~i COWTRY ?1~t1ED. nEYf! MAROED. S1/tVlv Sl011SE ~ r are. on~ r?~ war ~ ~w....~.~. . Ge ,U.S.A. ~:ar'r~c~~..~ A'ndrew G ~o _ +m~. r x.a~ SOCUI MW~ER VSUnI O[CU?AT10?~ ~avi c.+~ w.io~a ~one ~w.w .os~ a KMO Of MlSII+ESS Ot MDIKiRr OCCYYlO W r0~ U/!. l~1EN tl~( [O t ; ~ ~:262-22-1469A ~~m.mon ~abor None ~sw[HCt-sr~?[ toueRr an. Towr{ oe ?ocwna+ ~.ri c.. u.~n st~t rww~e ,.,Florida ,q~a «Fort Pie ,~,~e3 ,.,_110g N. 21st Street ~AiNE!-MMMI ~Nq ryM/ uit MOTIE~-MApEN NAME rMt rMM~ Wt Pet r F?asy~+ C~'esia Asbu ~NIW~M-N~wE ~rw+LN:G wDORESS ~awn ~ sr.~. uo., cn w w~+... sus. :r~ Andrew Green 1109 ~T. 21st Street ~ ~1. • DfATN WAS CAUSED ~Y: ~E /fR r uusE ?Et u+E ro~ (.L M1L ~wo c . a~rw w t u . ( A w~te« o.~sn a.a N. rrfM~4 41qe . ~ • . /C~~ ~ 1,~.1c/K/J-~~ ~I~~ . . • seoue : , COMNIIOM3, ~M~, _ rr~S~ O~~f ~tl~ ~O ~ n~ . Ir~lM~it C~Vl/ 10/, ~ p. « U-~~~ p: f/~nw6 ~w! YM~(!~ ' \nMO UV3t ~~U ~ > ' (cl ?~ti OTffER S~Ga~f~GWi COnWT10~fS: cowwnors co.aav~wc p~e.s. wn „or .eu~ w u.s~ on~. ~u~ ~ w ~f ~ES ~.e~e nro~~at ca+- tRS O~ ~ L~~lO ~w Mtl~rrrM+O GY1ft M ~t+tr U. H~ - VtibsWM KGDEM Gl I~d~rw.M~,7l~~1 +AMKrOE: O! 1ND~IEWilLO NOW {HJYIr OCCUlREO t t.se~ w~we p wwn .n r~at ~ w~~o M, ae+ ~ ' IIt. M. 1~L ~ UWR1/ wt WORK /MCE OF MUUtY wor. r.~.. s.aeer. ~.crw•. tOCwTtOr~ ~ s~un w~r.~. ro.. an w~o.n., aur ~ ~ana~ ns w Mo~ ow~ta wo..nc. ~sncv+~ ~ 7N. 7M. l0~. - . CERT~ TiOW- rwm w rw .w~+ a. reu i n~ir~wn.~ ~ ot~tM Occwuo •r ~w n.u. w w~e ' Q/ ~/~J r ~wo~~ ~.~t.•••o, w ~t asr !~a wu~.seo~~w~.. (J / / / T~t~ a ~ ~ (p Y „ ~ ~ ~ w ~w.~uou, ew J~t. . ro wn uwxni suxa. f.~ CE~TIf ~TqM-MEDIW /EiwMwER OR~~, ~ s w we now a ouw ~eceoe.n ru M• ~ wae , 3 Ot~lw OC(YtlM OM ME YR YIO NR 4/wt C~YNIt1 f1~A0. ~ n• ru. Ab 3 • CERiiflfR-w~ME mre w r~r.n mu OA E ~ e~ r,.wi n. M. D. a.. t,~.~-/3-'~l~ . u.~., a .p. ~ .o... ..1~ ~ 7~~~5~'i n+ . / ~ WWAI, CltEw{Atq~i, ~fMOYAI E[Y OR CifMwiOYY-NAME lOG1WN un o~ qrw ?t~w ;'""~'urial ,.~3ne Gro~ ' . t,~ g'oY''t. Pierce, Florida . OwTE ~.a~w. rr, w~ W ERA1 1WME-NAME MiD ~DO~fESS ~~r.ur w u.~. ro., t~r~ wrw, ~~~w, nr ~ ,.~'e~rtzar ~ ~.~.~e-Pee;~ ~'ortuarv ~ ~ , , r. s.,~612 fu+[ oaKt - itEGUr S+cH~ru~ owa n, ~cc~uut ~ A.,,. iv~o , 1 ' n, Fe ~ I hereby ar~i"ry ihis to tx a truo :r.d correct c~apy af t~e Locai . Rogistrara record on fite in the St Lucie Caunty Hsa{th D~pa~t- ~ ~ S~-_:-;, ment at Fcrt P~erce. Florida. - - . ' f ` ~ - . _ • . ,f~t.'z a . . (Wsrning: Not valid ur~leas ro'~sad ~al of the St._lucia ~ , . _~~r . . - _ _ Caunty Heatth Department is affixad.l~ FILEO AND RECORDED' ~ ; - " S7. l.I;CIE COUPITY. ~LA., 4~~~;~~, , N. D. MIItER, M. D. • 0 ~ ~J~ Z; F' E Q rf ' ~ : ° = County Hea Officer'b l,ocaf i~egistrar i. ~ ~9o~.os - ~ . - t r..: , . • ij' ,ti 19 AM I I 41 ~ ' ~ - pato Deputy Local Qcgistror ' ~ • ' i. , - .:n,:,~~ ?t7fTR?.S ~ C~ERK C+R~!!!T COURT . aooK 183 o~~f 119 ~ ~ . ~ _ _ ~ - ~ ~ ~ ~r. . € ~ . - - _ . . r ~