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HomeMy WebLinkAbout0760 ~ • ~ RM~~ ti; . ~ ~~~.'f • . ' ; • . ~ ~ / ~ . FI~ED ~.ND RECOROtt~ ' S ~ l~C~~~3 y . ~ LU~Ci~ C~U[.TY, FL:. . . -,,-~i:•.~ ic~: r, 'y' - . . fTAT~ O~ T[NN[sslE ~ . ~ ~ O C~~ / ~EPARTMENT OF PUBLIC HEALTH f - ' ~ 0 t'~i~ . P~ . . 3~ ~,?s~,?~«E ~ s~,ro~o E«~NO~ . . , . _ ~~:..(p~j,~ - - oevs~ . ~ ~ C~ `I~f\ C4tSf.LIT LOU~ 1 - - CERTIFICATE OF DEATH TENNESSEE OEPARTMENT OF MlSLIC MEALTM n~s No. + ~ ~ ~~~1 OIVI810N OR VITAL STATISTIC~ ~ ?~t01ERlr OKfASEC - NAME ~~~tt r~MU ust pAtE Oi OEAM ~r0~tw, w??, tw~ ' if0. ~ Jemes Allen Tuck Ju19 28, 1969 N iERMJ?. ~E ~1Ort. utw, •r~ucwM StY ~CE - usr uree~ ~-e•~ wxi OAiE OF i~tTM ~ro~tN, w~, ~a~ ~tt. ~s~etnn ,112,1~tie M81e ~~rwwr ~~twa~ ~ ros. ~wn ~ n r~M. ~ L~:K INK. ! ~OVNtr OF OEwtM C~r, 1OWN, Ol tOCAt10N OF pEATN ~NS~~t un urm MOS~IIAL OR OTHER INSTITUTION - NAME ~ ~3Mdn rtf O~ ~O~ ~n MOf I» tRwl~. iM fTpEt AN ~r11~ltl ~o• 3ePferson m•White Pine ~~.Yes ~d.A e -B StwtE OF ~~ITM ~pr ~M Y.f.~., dTIZEl1 Oi WNAT COVNtRY ~wtt~ED, NEVER YAtUEO. Suhnv~N6 SWUSE ~~r rnrE, ari rw~NM r~ra : its oerci rAY{ (pYMt~t1 WIDOWEO, qYOtCEO ~frK~n~ ' E~t:~.~~o USA ~o. Married Carolyn Lahr v purN ;t~~: , r SOCu?l SECUt~tt NUY~ER USUAt OCCVtAiqN K~~t os ww~ w~e wnrs roit p RINO Oi WSINESS bR INOUSTtY , ,,r,c~. a~~~ , roe~~wa urt. [~tr u~o~a~~ ~~:t ~F.o.= ,:.109-O1-3286 En ineer Consultin ~ si: RESIOENCE - SIAJE zOUNTr Clrr, iOwN, O~ (pG?TION ~~aK an ur~ts STtEET ANO NUY{ER F Florida St. Lucie Ft.Pie=ce ~ fATMER - NAJKf MOTMER - MAiDfH NAME INfORMAMi - NAMf t wp f ' ' ~ ~s. Jacob Tuck Hanna So al Carol n Tuck ' 2~~~Or~ iae' • ~ 1~. r~er D~?~N wns uusEO ~r= TER ONIY ONE CAUSf IER LINf FOR ( ond (c)j NN~r~n ~r*tn~t 1 Nrr r r wM ~ ~rrtMwt~. C , > (ol ~ ~i we w ~ o+HOw~ce o.- ~ . ~ ~ ~ ~w~?tKii ~ bSE O~ b ` ~ ~MMEOIATE GUSE lol.~ ~ rp. p~ w! w os: ~ s1~nNS tME uNOft- ~r~~w cwust tl~st kl ~AtT ~I. OIItER SICIIIF1W1i LQt/0tt10Nf: to~no~s cowtuwn~s ro~twrM wt ~or etun~ ro c~vse M~tw ~s ?A[T I(o) - /1YtOKY ~F VES ~Etl ~IMMINf CpF ? ; t~~.'c~ i; ' nts w w~ w~wn~ ~trt~r~r~M t~nN s ~ 4 t eF ra~._ . ~ ACCIOE111.•SYKIDE~IIO~IOE~ OAIE~OF II/JY~Y IMO~IM, M~, ~W/ MOUI HOW IN.I{~LY OCCL~RED IEMT~~ MAtyl( p IM/y!~ 111 ~At! 1 p~Ali 11. ITf11 tb { ~ OR YMD~ERMINE~'~f~lc i ~ F~~ ~ j : b+ED~UI ~o. ~ 70b: .i,. M. ~d. ~ ~ CER. IIUURtI'wT w0lR ?lwtE;Of`IWU f Mortir~ar, sraa, rwcroer, IOCAtiql n~air oa ~.s.~. ~o., cm w ro~w. n~n~ . OM:LETE ~iMt~n t~f O~ r0~ ouK~~s~g~ ,~m - ~ C[R:'IFI- _ _ ` ° ~t ~ _ :+OURS. t~K1AN : C[111f1G?TIQN ATUR ~eCt ORTE S16qE0 ~rOMtw, W?t. rW~ s~ t E C,i N- ~ ~vtywt~-'~Mf ~ ~+w Nw~ oti~ ~ ~r r~fruce. or r~w[. u~. tai~;i~sf ~ ' s ri-~~~q,,.wl~f0 w!l~twlri7tA' N, ~ [ • 210. .~r~. ~t-.. ,~.,i / ~ b f 4 ,e _/[LOKI1rt7(/WI~IER'-~CNiH~EAiiWt~:.~_i- ;L:r - s~OwiM.-MSs- '.uEO ~Y o~ ~jN_wif or ~ uwr~r~now.oFnN ~0~r ~r? _ _ _ ~RiZED ~~ts+~~no~.'~Nfr~.onMa~F~~iniR oc- - • ~ p~ coun o« rKe an ww~ wi To,r.e cwwero sr~rw. . - ~ _ T,J tERTIf1ER =.NAMf:n~r!_oi nr~ni~.~ ` wiuM6 wDOtEfS sntt* o~ ~aa. w. un o~ Tovr - sr~n zn : ~ : . . - ~.lflY ~ { t.' ~ ~ -:iL 4~ i - ~ , ~ ,R CR i t WlW. CREMATION, lf~ OALE, ~rwn~. ~wr. rw~ ~(~IAlME IOCATION cm w ~o~w s~ ~ r ~trK~rn 1 a.aa Removal ~-:i:~ i,~:'~7-29-69 rema ori~ Ha. Delra Beach Florida W N M- ~nntr o~ i.~a. ro., an o~ ro.~. n~ ~ ~E6ISTRAR - SIGNATURE ~•n ncum n~a~~ ~ n- ' ar F~inoral Home 4lhite Pino Tonn uo. G? ~e F,,.~,~ ._Q, r € ~ ; u ' - ~ ~ I hereby certify`the ati~ve to be a true and correct copy of the original record on file in ~ this Department. Valid Only when~emboased seal of the Tennessee Department of Public ~ ~fiy ~ f' Hea~th and multi-volor seal of State Re91atrar are afii~oed. ~ • ~ ~:i ~~,I~SUBD % . . ~ Il ~ ~ . ~~%K I . ~ a R _AU~ 14 1,96~ ' . . ~ xr;~ 800K Vv P~LE Vl~ mmission4t = ~ i~'~N~ • _ 1~ , • - ~ ' ~ - ~Si~TC REG~StRAit- ~ ' - ' - - - .'~a . _ ~ e~'~:' - - - - ~ _ , _ ~ . ~ . . - . _ _ : t;:, ~ : - ~:z , ..e.~ _ a - . . . -.~`r~