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T ~ t s e.- nwTS lOMD or Mu~TM CERT1FtCATE OF DEATH
c o¦ e s a ~YR[Jt{J OI VITAL RATIRlq RATt ?IL[ N0.
FLOaIDA
ord •A~n •1 T NO. R~OISTIIAR'• NO. Z87
p r o p~ r 1~ 1. K11C~ ~I wTN COOt N0. Z. YWAI A[SI~tMCR ( AM~ ts+.M M.t !1 i.w.~.t.w> A~.f..MWw~ M~.ri~.)
e i~ e u t~1 OOYNTII iTA~E OOYMTII
~ St. Lucie 66-025 Florida St. Lwcie
a. pl~e~!
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I. lrA~e[ Oi !~J ~IN M 1Ml~r. I~ Nrwt N4tlrl 1. STII[ET A0011[St ' I
IqSMTAI OA
"~T'T~'a" FC. Pierae Memarial Hos ital 1019 Ma flawer Road ' ~
7. Il~rt ~1 FIrM Xi~Nt L~M ~E MrW Ds1 Yea t
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i M+j ~QLDRED VAN JOWgtS oE.TN June 1 1969
. S~II ~ COld11 O~ ~ACf 7. MMRI(O O M[1K~ M~IIRKO ~ OATE Of ~111TN ! AC[ (J~ ~rMI 1lw0[~ 1 ffA~ Ur0[wf~ ?rlt.
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t c+ - u. ~noowco av~cco AU . 17 ~ 1992
p 1~ 1 w 1~ 10~. USUAL OCCWATIOM (OlN lii/ r/wr~ ~MIt 1a. KBIOOf' NKYIESiOQ MIOYST*II 11. MRTMKACI l$~lt rr /Mf~M [MW/1 tlt1i01 0~ UMI?f COIMIRri
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~ Tlamas C.,Fletcher aret Yoiaig
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-62-8472 l~c~s. Parker 1019 Road, Ft. Pie~rce, Fl,a. • i
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- - I~taM~d tM d~a~s~d /rom , to VT11~1~ 1969 •na f~at N~ hN fir~ on J1]I1e ~ 1969 i
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a 706 N.7th St. Ft.Pierce Fla. 6/2/69
• c c u r~ t f. ~u. , jk ~4E OF CEM CIIEYATOIIt j3/. ~~TpN fMnt. M eraY~) (8~tt)
- ACM~Y (3/KI/`1
-3-69 Ft. Fieroe Cem~t .Pieroe St.Lucie Co.
v. s.! e i a t w c s ru¦c ts. arc uca n~oua uo. Kriu~~s ~
R~•.,osa ~G 06 S.4th St June 2, 1969 aGL~l~I.
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FILEO aN0 RECORDED'
S7: 1,~C~E COU~lTY, FLA.
:iF_CQR[? ~~~R1~~FtJ
~ 191~44
'70 APR 8 PM : 12
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CLERK CIRCUtT COURT: ~
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600K ;
~ R 183 ~~E2769 ~
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