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HomeMy WebLinkAbout0562 1925"73 ' FIlEO AND RECORDED' - ~ Y. ST, LUCIE COUNTY, FLA. k; CQF..^. VEQtFt p s . ~~~~3 ; . ~ '70 APR 23 PM !2 : 2~ i - f'U~c~ ~~O~TR~.S. T~,~ .T~T~ .o~ao a? Nu~TM CERTIFICATE OF DEATH CLERK CIRCUfT COURT~ : co~~s • ¦YRGY OI VITAL ~fAT1YTIC~ fTATt ?ILt NO ~~t~t ~~a- FLORIDA ord •A~w BIRTN NO~ Rt6167RAp•E NO. 30S ' y~~D~tlr 1_ /?AC[ OR WTM G80E NO. 2- YtYwl Y[t10~Mt~i~wnMr+rW. Uwnwi..~: R~JwwNf~Nnw:~.) ...e~e~a ~„r b6-025 ~ STAT~~ oou.~r .n~ .~ii s. yl.eN fw y~f- Gr.Tp~KOw~OC~1q~ 6/~CC Oi Of~7N t. GT1'. TOM~N.QI1 LOG?7~ t. ~S RES~O[~CE . •~N\t U~S~DE CQt UYtTSi Ih5~0[ GTr UY:iS1 . ~ ri~.. Fort Pierce •cs~{ .aCl F~r?=t res w i ~urt Oi (//Mf hMrpqf./iMMrW Ni~nr) L STIlEET ~DWltif ~ ~ Nosnr.~ o~ 1~ j t ~ . Y~ST~T~TqM 1•~IIIOT~~1 :QO Ave M , ~ w?r[ oI iirrt 1Ji~ts L~,t D~r[ Xwt! U.~ Y~n- ~ ~ occcwsco ~ .TZFI28 '1 1 p ' ~ ~~1rn « r~•?~ F~ma i~ay v Oi13 S ouTN i S. S(lI ~ f C~Dlpl OR IIAC[ WIIR1[O Q KYC~ M4RAILOO O1T[ OT MATM A6[ Ih KM~ I! ~h0[~ 11fIJ1 u~0[J 1~ MS. !Yf Wf~/) Nw~~ O~M Nwn IlM. 7 t c. rnaorrt wvo~ecco ,1 ~ L• ; D 1~ l~l ~ ~0~. uwu occw~rw~ ~Cw ?~.t yw.~ a.e IOC. [~wOOi C~Sw.[SSQR IwOYS~~Y li. Wi 9~ft t~A twY?/ 1. Crt~W 0/ ww~t m+~t~n i . ~ a. •..:q ..w y.«~w +?k...r. y:.d.d~ ~ ....~s t. NOri@ Y. • , ?l~ck 1~l 1~. ~RTM[~'S w~Yt )1. YOTnCII'S ~u~OLN 1Mr[ ' 1 ' t~~~~f1l~f ~ • i' • j li. SOCW S[CY~ITr ~p. I). 1 IuM NGwAT ¦ AA4~N ~ : r 62_88- A ~ r~~•r.~ - ?~.-swss-~s-ousx ja.r«~s ~S•1. c~~_••~ cct.l u.tc~r.~ ~rca atr~ea~e /~A7L OCATN Y~SCAYS[O . D(ATN rsl. ,~ucw.T,c cwvsc w_ DO A( Natlz~Cal Causes , a~rtc.c. c~.~'ri....:l~+r. ~ out ro .~c~ au ~sr~ ~ i • e • l ~6~.r• nsst (i). ' r~Ri~tr~r +~~tW !Al i~frr- Oli[ TO (d . f~ia~ n~x IW. ro~r ~w• t~ ~ ?MT N. OTR~ SK~~CMI COMO~T~P6 00111NIRK 1O O4TM ~IR MOi RC41[O 10 TML T4~1W\ p1tAS[ C01~11~011 GIrO~ 111 Mlli 1(V 1M~S AUTWSr - t, I[Ri011Mi^01~ a~r •~•c~ ~ rts? uol{!' or ?~f~r• ? ~ ~~~s ••t~•s ••7 ~ •cuacwr wKwc worK~oc 2oe.asuucw~rwu~roccu~aco. t6.+o.rv.y~..saA..r~rArrllMY~.u~ •t~o~~t' u ? ? • ~ •l S . i 2QC. TiME Of !/w• ~/IM~. Di7. Yt~? ~ wu~r o w: = 2Q/. WY~r OCCURR[O 70t. K~CE O~ WIU~~ Ir. i~ r~wt N~r. 20J. QT~. TOKw. pll IOCATpII COYMTr ST~Y[ UINR[ AT O 1qT MNILE ~ ~A• ~r1. k~etf. ~~[t N/j.. d[.) ~ - MfOaK ~T 1~OI~K 21. 1~~und~d tM d~cwNl /rom ~ ~ . to •nd luf w~? A,T d:.~ on - D~~tA oecurnd ~f ~ m on tA~ d~t~ wt~d ~60~~: ~nd to tM ANf d m~ lwo~J~d~~. 1rom tA~ uuHa ~ut~d. ?13 ll~~• f TY t• (I1tI~t~MfYpl 72D ADp~[SS 7It. 011TES~GMCO e~~P1~t• • ~ I^ ~ e C~unli C~l~'t ~.S W~ d'v ~ •[CYf CMM~~ ~ QAT( Z~[ MYC W CCY[TCRY O~ G~lCMA7WY t3/. WGTAn (Cr). Iwrw. r aw~fp (~~[I RQ`.~`~,~Y~`y Juno 20 1 6 ~Iic:~or~ Iiill I.eon County Florida Y.l./A19 2~. i~ pRtGT011 SSW TuR[ ~pp1[SS 2S. WTEIt[CO.~YWC~IIIEG- ~ GKTIUII'iSIGM TY11[ a~r.toss ~28 Ave. D 31u1e 18~ 1969 . ~~~l~~GG~ oe~ttty tht~ ro b. • trus .nd aorrecr aopy cf the t~ocat Registr~rs retord on fii~ in th~ St. Luci~ County H~}~ p~~ . m~nt ~t Fort Pierce, Florida. - - (Wunin~: Not vettd unleu roised seal of tha St. Lucto . Counry Hesith Dspartment is Affined.) ~ . . - , ~ - • _ , . ,~j _ N. D. Mt.tER, M. D. - ' CouMy Health Officer d. Local Rt~pistru • - ~ ~ . ; r v. ~ ' Deputy loul Reg;strar . ~ ' ~ ~ ~ - _ . _ ` ~ ~ ~ ;~~~1: ;~.'f . ~ . ' „ ~