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HomeMy WebLinkAbout0866 Y _ FII.ED RECORDED ~ : ~U,.TY FL:. 1905~0 - - 190590 ' ` F~i i : s5 . , , 3 . ~ CERTIFICATEOF DEATH .-n~-~:. •y~ IAIS N- ~ s~~~a• • DirpwreN ~t Fle~ld uJ RcU.6i1wU?e Serdca ~•~T711~tI1K ~NO... . / ~.R•i••a iM.~,o.~~~Rw~n~ FLORIDA _ ' •r~ •sew """'~'R'L°•""O REGIGT11wp•s NO. ~fep~tll ' t. ~iAC~ O~ ~t1TN CODi NO. 2' asSTAT[ NOtNC[(IM+~rnrl~w~ l~~wwAr..r tr.M.rw/...Iwww) •a~era~~ .l~l 0D1~'~'St. Lucie 66-025 Florida St. I.ucie 1• ~~f~ CIT~. iOMM.OA lOC4T~pN , t. ~S K~C( O~ OtATM t. piY. TOr11.0~ lOdT10M f. K R[S~O(~CC y~1Q( CITY 11Y1TS1 MS~OC CIT'/ l1Y{Tf~ r~~.. Ft. Pierce ,E:tfl wp Ft. Pierce n „o ¦.~c or u/..e r. w~ar. ~'we war ra...) sr.ccr .oo.cu . Ft. Pierce Mem. Hosp. 1006-B S. 17th St. ~ M~IM[ 0/ F~Y wl~tift L~M 1. WT[ XMf~ Da1 Y~Y ~ jjyKMpiM CLARA M. HAZELBERG o~„TN December 25, 1969 . S. SCX ~ OO1011 OA YC[ 7. WT( OI Y~TM 1. 1GE (/11 Kr1 {FO[t 1 7W M.'f[I1~ +M. MAItR~[0 ~ KY[R MI1w1~K0 Wt hr/Wt~ Y~Y~ O~' /w+~ MM_ r. t a. F Cdtl ~noowta~ a~cco Se t. 6 1899 70 ! 1~ t~1 ~ :w. ..;::r' aC:t:?~?T~O~ tC:re ti.~ Nrrt 4ae 100. KaD O! ~:K~wtSS W! u~DbsT~r 11 N~rMK~ (9d~ r_/rn:q sw~6d cn.rnr or swr muann .1 t~ ~~r- tai~~ ~wt yw~~NlyU.wr. y.dirM .....a Fiome Maker Own Home Inde endance Wisc. USA ~ ~ . 11~~Y ~~t 1 l~Tw[~'f iur~ 1~. rOTwC~'f waWtw ~ur( •r u •s.•~•t••• Unobt. Unobt. ' ~ ~i socu~ xtuMTr w: 17. ~Mnwww~T/ ~ wt4.u ` c~~-~`, r/4= . ~ ~n 336-07-524. " - ~F/• .~~~-tlt/ /Y-~~'~as~ -~i.~~ ~ r ~ k ~?ra~~.l 1~. C~YK N KATM (Ewtn Mf/ Mt t~/t~tr t~./r (0). u1 (tl.~ _ InT[~v~ ~RirLU ~ ~ •tl~t{~~ /~IITLOCAiWM`W~[~CA115[ ~IL~ ~ K OC~M f ¦r~t fl)• ( ~ ~ , _.~e.~"~~~~~ ~ ~ a?• t~r- - •lf~s~a• C~tfifiw.i/~~I. py( TO l~l { ~•ft\ tl~• r~~ prt r N~ _ ~ . ?7 1 • e • 1 ~jy fk ~~M- ~ •~sf~tr~~ fI~M tirir tut. OG[ TO !r) i- ~ - ~ • •it~l• 71 = YI a~~r f- O ?IUfT a r.n S~cr ~oia o rw M woT Rc~f* o iwc tiir ~tp~atcw w wt Ky r~s ~~Tprs ~ C ~ Q a~t ~~~u ~ ! n~so~ .o .r ..r... _ r .csp ~ ~at~w~ ~~7 ~~~wcwr w~uot Morit~oc 20~. otsuutMCw u iuco (Enrn~~rvey~wjar~ Art! P llyirr~~~.l ••.~~~t- v O ~ O ~ • •t 24 i~r[ or fl... Afw~. dq. Y~r _ . a~• ~ wu~r • o n. W = 26t. ruu~r ptCU~u[O mr. K~Ct 0/ wu~~ l~. ia ?~w• M~t. 20/ Qiy. iprM. O~ IOC~iq~ COUMiY Si~it ~ MwK[ ~T ~ ~OT YM~I[ O /~NMI. Yrtd. ~~ta W~7-. ayj r-. MOIIK AT 1YOIIR ~ 21 / - ! ~t~~nl~1 tM I~c~~a~d o ~ ! ~y~ . ~a _ - ' •nr ~it us A,~ di~ on O~.tA oceurnd r ~ ~.f~ 6h ~M d•~• st.t.d .Oo.r. ~o M Maf of mr 1~~MIN. Gom tA~ u.sHS ~u~.d. •ll ?tt~• I2~ fIGMATYw[ ttN . aT[ I2 ~ •r• t• 1• / c..~l.s. ( ~ ~ % i ~~~C / ~ l~La.~-~~~ - f I - •t~~/~t~. , 23~ Mas~l. U[ ~t4n. YM MTE 27[ ¦~M[ O~ C[r[TC~~ MI C~CraTOA? ' Z~1- IAGTq~ (GYI.4rw. M ew~f/? (St~f~~ ~ Removaly 2- 9-69 Florida ~:em. Gdns. Mel ourne Florida r.s.~e~~ , , s ~ N. 7th Stt~'..TCcem.tiier ~`~~69 aT~..~:~.T„~ ~ •...,osa ~~.G;~ t.Pierce,Fla. i-- ~ ~ ~ ~ _ ~ I hareby certify thls to bs ~ ttue and c~ect copy of th~ Loui . ~ Registrors record on file in the St. lucie County H~alth DepaK- - ~~r ~ msnt at Fort Pierce. Flwida. ` ~ -----~Warning:.NoiY~lid_..unl~_roi~d seal of the St. tucie ~ ~ r ~ ~ ~ • Counry Heatth Dspartment is affixed.) f _ ~ , - t' „ ,t ~ - . . _ N. D. MIIIER, M. D. - - > > i . l , ~ County alth Offiur'b local Rc-gistrar j - , - a ~ , ts -.~i'~ , : ~ , . j R` ~ pats peputy Local Qcgistrar ' :~S 4 _ ~/.r~a k tL.C.~ ~ - - ' • _ ~ - ~ ~ r. ' . ' :1 , ' ii~_ - ~ O~ rI1UC ~ Y ~ , ~ ' ~ F - , . . ~ . - . _ _ . _ . . . . ~