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' ~ FtlEO AND RECORDED J ~ ST. LUCIE COUNTY. F~a. ~ ~+:.f'~l~?n, "E~Zi~'C~ % ~u , , '7Q AP~ 30 PI~ 3: 18 ~ 192`~'~3 ` ~ ~EF~'('f~bJ4~'I~~ OF DEATH S~ls 0~- iTAT[ YOAIID 01 NGIT}I T (~~~p ' co~es• • ~URGV O~ YITAL rTATtfTiC~ ~+Lt~ C`{~~+ X~,jjr~~ ~TAT[ FILC NQ • 1~R~1•N- ^ CLVjtj1~~ e ora •~~w BtRTN NO. R[GISTNAR'S HO. ~IV~I proy~fly 1. ?~wtt Of OtATM CODE N0. Z YtWI R[NOtMtt(~aw.1..r./li../ lf:w:w+..c t•N.~wM/.~..~w.r1 e a~ t ~ t~ A COUMTY SYATE OOYMTv •^a St. Lucie 66-025 Florida St. Lucie e. ,i.~.. l• p~t- dTY.TOrirK.q1lAC~Tq~ t. 6 K~CE OF O(ATN ~ t. pTY.TOVr.O~ IOC~TIOM t. K R[S+OCtitE •~e~~t WS+DE CM~TY ItMITS1 WS~OE CITY liYlTSt r,~.. Ft. Pierce YES~pi wO Ft. Pierce .rcs A~r[ Oi W b ~M/it~l. /iN ~lrut ~(rtNl l. SiREET ~ODIIESS +qShT~l W pST~TYT~QA Ft. pierce Mem. Hos . 1819 River Prado ?UMf O? ~?~f Ali(Ilt LM/ D~TE Xw~N Dh YW iT;~ « pw~ AI,BERT W. JOHNSON ~~TN Ma 16 , 19 6 9 S- S(X CO1011 OA ~C[ 7. ~O~1 t. OATE Oi pRTM ~GE 1/~ 7~M~ f/ ~I~O[~ ~~W UwK~ i~ NtS. YAR~4Dd ~.[M[AM/UU~(O /YtN~/~M~) Mw.Y~ D~~ Nww Ni~. • r i s• M C8u r+~oo.rco0 avwcrn d 31 1902 66 p 1. s s 1~ ~oe. uw..~ occw•Taw tOiK ~~.r N srt a.~ ~Oe. Kuo w ws+wtu o~ wousr~r 11. r.~Twutt (St~u r/.rey~ cwan~) u~a os ~nwr muwnir , ¦ltl~ ~~h Iuiy~wf~/w?liNh/r.nt~1/itfbtll Machinist-Car enter Sho & Bld . Pawtucket R.I. ~ USA ; ll~tlc lw? 17. fATN[II'i r~Y[ ~ 1~. rOTNC~3 rw~QCM AAY[ i •r o,,....~.. Claus Johnson Hannah C. Johnson . • ~s. socua sccwe+T. ,w. u. .r~. s s~o ~wc ~J .u..a. ~ 039-0~-362 f .d. Ft. Pierce Fla. ~ ' ~ FYY~t~l Il CAYK O/ KATN [b~fH ~!l/ MI tw~t Ji~t (e~. lC). as1 (t .r II~TfAV4l • 'F[M 3 :i ~11AT l OC~TN w~.T CAYS[O ~Y~ V . ORfEiY/Q D iM Z d1~~~tof :~a.~~t tllf IMMCOYT[ CJWS[ Z. t.L<~f- ~t ) " ce• e•r_ ~ ~ n` . tltle•c• Cwl:li~u.:/ws. '/(1~-C~l-~.a~c~ 1.. ~~C ~ ~ft~ t\• r~id ~w • t~ ~ ~ 70 (1) w u~ ~ y 1 s s• l ~Dwt t~aK (i). - r•e~~tr~r at.r.y f?~ •~ler- Dut TO Itl = II~M t~r~t /W. . W~S~UTOIS~ 1 t Al ~ 11 ~ /11AT H. OT~ WrAI1W~ ('4C~tO~i COM~W~RaK TO DL~TM ~1/f !W~ rl[41[O TO TR 1L1r Wl 0~7G1Si COO~nOw CIIIOr O IMT Ky LJY~• F . • ~C~FORYCO~ 3 ~ res81 w0 o r?~ h r• _ ZG `n a 2GA. oE ac wuRY octutua ( a s~tw~ N++1M~ b Pw[ /~r Pr1 !J N Y~~ /IJ .aklo~ .a~ w~dM MOrKWC ~ s ~ tf~PHt~ u ? ? ~ G ~ 6L{.~'Y /u-c~ -•r J IOt TIM r... x«.r+. c.~. r... o l1 5~ .5~-12 y ~ Y i 2ot. wu~r octu~em 70r. ruc wuu~r lr. i~ w?wt w.e. m/ r. rp~n o~ wut~ r srar ~ YtH~IE AT O MOT WNRI . ~trtH. ~,7kt Of!/.. dt.) ~ _ ' ~i Lj. ~ ~ MIO~IC AT 11IOIIK ~ - - "L ~ 1 ^^'L ~ r y 2t. f ~rand~I tlw d~cMNI ~om ~ ~i ~ 'L ( • < , to - i C-- •wI /wt w~ ~ ~ ~/iu en ~ - - t r: D~~tA xcu~~~d ~t t m on th~ d~t~ ~Af~d ~60.~: ~nd te tA~ iwt e/ m~ F Nd(~. /rein tA~ uu~u ~t~~~d. ?11 it~~• jj~. NaNATY ' (Drpe rIYG~' , ^ ~ ~ODRLSS /f ?1t. W?T[ W.KO eos~l~t~•~ ~ ~ ` J?~'~ ~ ~V'~ i,~i•~li-: ~i- i~'L'~i •CtYf~t~. Ll~. W~u~L.MratlOti 230 WT[ 2k INMEOit[w[TI~Y011C~LMATOAr 23/_ lOGT10M(GYI.fMra.M (St~tt) 3uria~`"h~ 5-19- 9' HiZlcrest Mem. Gdns Ft. Pierce Florida Y. 4. jbf Z ~ ~~L p~ s S ~,qt [S~T '7y,~, L~ 25. DAtt It[C0. ~Y tAG~I ~[G. Ii. TMR'3 S~GM~TU~[ ~f i 7 V 1 ~~f . 1.+a Jt . t,// . -i a".lo{~ .4 Ft.Pierce :la. N.~• K~ ~ - ~ ! hcreby ccrtify ihls to 6e a true and corr~ct copy o,; tho l.o~:ai ~ Rogistrars record on tile in the St. Lucie County Hc,atth Dc~art- ; ~ _ t mant at Fort Pierce, Ftor+da - = - , (Warning• Not valid unless raised aeal of the St. tucie ''~~~j' " - Counry Meahh Depertment is aff;xc~.) ~ 7~s ?s - . ~ • - c`° j . • :;:'~ti- - _ - `t ^ t'. ^ , _ . , + , N. D. MlLt~R, M. D. ! .`i•_!.: f.• . " , County H - th Offittr'& Local Registrar ' .3~- , ~ - . • . . ; ~ ' . . . • - - . . a ~ Dat~ Deputy Local Rcgistrar ;V ~ 7~` a%~ ~ ~~~.;s -~,,:~;;t~ ~ ~ - ..~;r;~ : . : ~-R ~~fl ' . - !~'';i;';~:;`,1~~~~. ~ S a f _ _ _ ' ' ' ' . - - ~ - I ~ - - _ i ~ . : . _,a . - _ ' _ , _ . . . _ - . .+:Wi