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HomeMy WebLinkAbout1664 . _ . . _ { ; ~ 19332 ; ~ ~~~EO Ar~r~ R~c~t~o ALACNUA COUNTY DEPARTMENT ~-'~~iF ~o~=~?.. F~-a. .~~ir, ~.c~,~~1C!'~ i-i~A.. ,`Ci/~1T_~ S~Q~ViCtS 19332`7 BOX 132T. ^''tiESViIl.E. FLORIDA 32601 ~,.v I~ JO N J• B•.'~0.1~f_D.. M.P.k. D:rector AftEA CC::'_ ^Ct TfLEPHONE 378•5321 ~ y ; • 'hlTt~H$ r~~RK~CIR~Ili'T COURT . - CERTtF1CATE OF DEATH :k~...+~~ of t t~pi~h •~d R~I~.lahu~~.c Se..~cr. ~ srwTe F~ts No. n;v~<n~~ or- ~~rri.iu F L O R I D A . OR ?RiNT IN ~""o~"R'LQ•~`Q° . REGISTRAR•J NO. ?:~~t:.~t;HT INK S;E `j1"3C'vL FOt ~~=EASiO-NM+E ~~~i~ .~wou • ~~3~ SEX DATEOf CEATM ~~ow-.. o.• •r.~t .~r:~ct:ors , WILLARD GRAIv`T SAI~~FORD i t. Male March 14 IS"! ?ACE ~w~l~, w[G~O, ~rl~K~'+ ...ou~, ~ wGE-ua+ VwoH ~~[u Vw0[~ 1 O~~ OATE Of HRM 1~~, N~, n ~ ~•c. ~3rttv~~ •••~~D~rl~f~~f~ ~u~l COl1NTY0i0EATM ~ 1 ~ Caucasian ~3. ~~•s ~ r~. I ~ ~ s. 44 s~ s. • A ril 19 1925 A14chua C~~, TOWN, OR IOCAi10N Of OEATM ~MS~O/ CIT/ ~W1f~ MOSa1TAl OR O7MER PJSTITUTfON-NAME ~~~~!q~ ~r~ l~7.1~, Gnf S+~tet ~rq r~vr~tt / S?lC~~~ ~ti O~ w0 . t~,. ;~_ainesville i~~. ves 1~. Veterans HospitaZ ~ ~ STAiE Oi 81RiM ~ ..0~ w v.f.r., N~r! fC'~'Z:N OF MIMAT ~C'JNiRY MARRIED, NEvER M/1R~T[EO, ~SU~VNWG S/OUSE ~u wNf, Ory! .u~M~ wr~ ~ Iw~DpwED, ~NORCED ~ sntr~ ~ ~ Ohio Li~S A. ;u Married Carol Foden ~~~~.ue ~ p~~~„ SOC~wI SECUS~t`f NUNt6ER ; 1SJAt CCCUaAT10N ~crve cwo p w~c tr~[ w~~.rc ros~ o~ KIND Oi 6UStN:SS OR iN,~USTRY ' ' c:c.e.n ,w . Wo•~~~+o urt, ave.. i~ ~u~reo ~ tt 296 18 36 38 ~ Plumber Construction i; aI: ~!.':t ~IIOf~ i~'"' REStOEraCE-SIwtE CWr?i1/ GTY, TOWN. OR IOCATtON ~MS~Df ~'ry {WI~S STREET wtrD NUr6ER . j L~', ~ ~ vua. •es o~ ..o rI ( j ~w Flor:.da I~.? St. Lucie I~a Ft. Pierce ~'es 702 Atlantic Avenue ~ I fAiMER-MAME p~1t rWW! lait MOTNER-AMIOfN NAME tniT' r~DO:! 41T I :~;1.- ~s Louis San~ord Enice ' Dalton ~ 1 NfOR,NAN7-NAME ~ E NiA0.1NG ADDRESS ~:»te~ o~ a.~.o. «o., an w~o.n., s~.tt. tw~ - ~ ~,.VA Records (~n VA Hospital, Gainesville, Florida 32601 YART t. DEAM WAS UUSEO S~: , fNiER OMl' ONE UUSE IfR lWE fOR a, b, ANO c ' •+non..~n ~n'uw ~ l 1 ) I ) ( )1 ~~n..i~~ o..s~r ..o oe.rw , .u..eoun uuu I ~ Chronic M elo enous I.eukemia ~ 2 2 Years l . . .i . ,.ua,. ~ o : ~ coMOn~o..s, u .~n, rM~CM G~vf •~st t0 (bi i ~..~eour~ e~use 101, ~ p~! TO, W~S A CO~SEOVlrK! p: ~ s+~r~Ma rw~ v..otn i ~n..a c•us~ ~•s+ ''c'. Icl /wRT n. OtNER 51C,NtfICANT CONOiTIptrS~ ea+ana+f edn.+~un.a ro q.M ~v~ ..er ~euno ro uuu o'.eM n. r~n ~ a~ AUTO?SY If tES ~ere ~IMOIMGS COM~ ~ ~~es p~o~ s~ou~o oni~r~~~..o uvse M O[wr¦ i+. YeS . ~n Yes I?.ebebbl wCUDfNi, SuK~ OR DA INJU ~ rO~r., p•~, ~a~ ~ t1~ MOW IN1UR~ OGCURRED ~ t..nte .utvrt o~ ~Mw~. ~r. nn ~ o~ r•n o, mr ~ i nW~iGOE: Ot UnDEIEa~n~ED 3 ~ ~ ~.hr) ~ 2k. M. T01. ~ IN/JR1I At WORK ~::~'E Of tN1URY ~t ~W..t, r•u. srnn, rwe7oe~, IOCAT1pN ~ snen o~ ~.I.O. MO.~ un o~ rorw, s~~n ~ ~s?ecu• ~es oe Mo~ o•• ~.oe.,ett. ~sne~r~ ~ 7G~ _ • 7Jf . ~ ~C'.°,T1ilC!!]SX ~A iO"'•w o.. .e,~ ~ ..o..m w. .e.~ ~ Sf?C4C~i{`SXA'}9X1+:?L~3{?[ ~ ea/o~o wo+ r~rr rwe oe.iM oee~~.eo •r ,.~e ?ue~, w n.~ > ~ t':''~..•J" TO ~ r0'~tM D~• ~!M ~00~ /1~Tt~ Ot~~M. IM01/~1 O~If. ~~0. M~I ~f1f ~ ~ctchfuQtwo~o T~~ Q p~ r~ tr+pr~eOGf, out a_ o«<.:~o ~.o..Feb. 12 1970 ~,arch 14 1970l~~.. n~. Did 1~ LS ~O TN( UVSl~11 S~~'!D. 1 CERTti~Uirp?~-~O~CnI Ex~iwER Ox COROr+ER: a+ r..e ~+s~s o~ T~e ~q,~. or o~.r,. ~M( O[CtW~+f r~1 ~~Or~OVMCtD O~~O l~~~Mr~~'f~M OI fM( b~t ~NO/O\ ~M~ MYISiI(AiM'JM~ IM Mt QIINI~~1~ rQMIM O~~ ~y~ - ' o~~*w p(~V~~tO OM 1M~ D~Tt ~wD Oti! tp ~w! ~aVSE~l/ S~~ttO. ? : T~ /Yl T7~ M. CERTIfiER-NAME mn O~ ~+~~n SiG ~t} 2E oewn o. nne ATE SIGNEO ~rP+~~, o.., n.n ~ Armand B. Glassman M.D. ~rn a ~-~•.a si, ~ t~ a ~ NMIW~' aDOR:S -~EPi~! srneT p~ ~ ~.o. ..o ~~r o~ iowN ~rwre 1~rmanc~ B. ~lassman, M.D., Veterans Hospital, Gainesville, Florida 326~1 ~ ~ auK:wt, CRE~t~pr:, nEru+pv~t ~CE~nETERY OR CkEM~?tORY-~v,wtf tOCwTiOn em o~ ro~... y..re ~ ~ ~ s.eu.T ~ ~ Removal ~ r.?. Hillcrest Men. Gardens Fsrt Pierce, Florida ~ ['F - . ~ ~.~i~i~ O~TE ~.o.nw, o.~, n.~ ~ fUNEIUI HOw+E-N~unF ArvO RD01tESS ~ sf~{a q a.s.~. ~.o., c~ir oa ro~+.., sr•n, tv ~ March 14 1970 ,s..FT P~IItCE FtT~~AL HO~E FT PIERC FLOR~?A ~ ~r'„ • ~61'1 ~lA'1EQ • DiRE -S7('iNAfUAF " R[GISidA? . _ , OATf R[CE~vf ~1 lOCwl REG~STRwR ~ iy70 ~ . Y. 7S. Q~ ~E. r ~ ` ' ~ - w~' ~ / ~ _ ~.,•t. . : ; _ ~.~i;~,=t .~Q-;_,,. . ;s , r~.....~.~~ ~ , r ~ I HEREBY CERTIFY THE AB~T,~'~0-,$E A-~'t~LLTE =AND LXACT COPY OF ~ THE DEATH CERTIFICATE #~=~15'.;':~~'I};I~'i-~ICE,.~ _ ~ _ . t00K PACI ~66~, ; 1 r ~ ~;;~r - . . ~ r~, , - ~ ;r ~ ;;onn . Bianco, M.D., M.P.H. - LOCAL REGI$TxA,R ~r;;";; ,-~le Trowell - DEPUTY REGISTRAR ' DATE : v ~ ~ ~~1 >