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Home My WebLink About0141 i~4343 f CcRTlFICATE OF DEATH S Uepul~twl Ilealt6 awd (C.-{wLilit~li~e $n~ien RATt /IL[ NO. w~~~~?~':~~,~~ FLORIDA TY?E, OR ?t~NT ~N ~"~`~~"~O ~ p~a~~ry'RAR•t NO. 2~J6 H~MANiNT INK i SEE IYliDiO~l[ i01 +•asr rrou ~~s~ SEII OATE Of OEAiN ~ roMU, w~, nu ~ ! asraciars Ai :`~u,. '-~,y_s i Male ~ Ma~? ?9 197J RACE wn. neaw. u.~acu~ ~w~.n. wGE-us~ ~•+c~~ ~ re.~ ~..a~~ ~ wv DATf Oi 4tiM ~rwr. w~, COUNTII Of OEATN. 66~2 !K. ~ iMtMt ~ ~n1Wr ~ rWS~ Vf. O~rs MW~a ria. . ~Ie r~~ s. 47 k . June '.9tZ Saint Lucie Crt11. iOwN. Oa tOGiWN d OEATM wwa cm iY.~n NOShTwI Ot OiM~ NSTti1li10rt- ~r pot w tawe~. ane sutu uo wrt~ i sncwr n~ o~ «o w For4 Pier~e Ye;s FJrt P;erce Ule;n•~ria2 Hos iial ; 3TwTf Oi Mli11+r «Ot w v.~.~., «u.~ OT~2EN Oi Ww~T CqX+TItr w~tR:fO. NEYER ~tEO, SINVNNG S~OUSE w wa, o~n .r~rtN wr ~ cowm ~ w~OQwfD. o~tGEQ ~ wun ~ •?„~„u~...~~ . Fto~ida • US4 nrl:t!'C1C~1 JosDltine La:~nb rwr Nca.xe ~ une. r«.r SOG~I SEtub1Y MJWEI USU~I OCNIwTiON ~are awo a rrw~ oow owwo .wo w KY~D Of MlSIHESS O! wD115M OCCVYlO M bO~l~rOlW~ WfM M yWfy 1 1titAN1.Ow. GM M . ...~...,c....a. 252-33-4536 u. ~Orsf~w~. RESIDEtiCE-STATE COUNiY GiY. iQvlN. OR tOCAT10N r~sN cw~ arwi S7ffEi AND ?NMM~EI i.~.~ ~wc~. ni w wo . ~a Fio~ida ~wSain: Lu:ie ,4 Forc Pierce No ~902 Avenue ~'S" fAi?1fR-NAME Hae ' rw0~t uSt MOIMER-MADfN NAMF ~rft ~re0~t uit . n Bariow ?~:i~is Edith Un',cnawa I WORMM~t-NAME MAaR+G ~1DOtESi ~sm~. w tr.~, w., un oa w.M, u.w. [r~ ~ ~r. Josahine ~~.vis ,n 29~3 A~?enue "S" Fori Pie:ce, Fiorida3~43~ ~ fAtT l p[/~TM W/~, ~/~y~0 ~7: (fN7F~ O~UY ONf UUSf Kt lNE fOt h1~ AL ~ k/1 ~tn.etp onfar ~wi ot~rw -1/. rrth~K GWf! / C j~ Lc_ r f ~.,.-i c_^: r~ l o~ rs . . • x cowai~ows. u .w.. ~ . ~ ~i r ~}v~~ ~~S• ~/1I[(` ' ww~c. a~n ufe ~o ~ ~ - ^ (i.~s t t/ ~ ~ V ~i'' S C~Q /1 Gl.i: r~l0l~it C~YS! b~. OY! W. W AS COMf~OVIMC~ p: ~1~tIMG tMl YMOl~• ~ lfIM6 C~YY l~S~ ' / IAfT 11. OJIfE~ SK,NIf1CwHi COPrO1T10NS: e~o..ano/..s eo.aus~i~.w ro x•r~ w+ .wi ~euno ro ewu amr .n ru~ ~ w if 11ES riee ~~MPINOS CON- i:~7 e C'.s Z( _ ~ ns ~ s~~a~to n. yn R.u~wc uus~ ! p ~l~1M ~ Y 1A l~ .1 N~ C'~ - K~i. ENT. ANCrOE ~.a+iw, w~, atu ~ nOUe HpW IMAi11f OCCUttED ~ t.m~ wnw o~ uwn w?u~ . w rw n. ww u~ ~ Ot IMOETEWWED ~ ]K f20[ M. IM. . INIU~Y wT wORK /IACE Of iH~Y w~ wW~t. I~v, fi~FE7, !K~ an, lOCwnON ~ u.ea w wo.. em w~o.y, u.n ~ ~sret~n tis oa ~.o~ owict Mea.ett. ~vK~n~ ~ M~. 7M CFRTlfKwT10N- ra~n~ w~ reu ..orrw~ w• ~w wwY up~s~r s..r wr/re~ u~n oN ~ asiao w, .r. ert oc•rM oeeuuEO .i ~w[ n~ce. a. ~u INrfK14M:M0lY MF ~'t T~ M W? RY MC~ ~IRf Ol41M. ~ ~wOV~I O+h. nNO. M bt ~t3~ ti~ eue.see ~ro. •~~Q %Z-•l ~ 1`~ ~ u:~• :i. f ~ t~~~ ~f ~7 • i c! i. or awo.ntou. out i tie. ; if ~l. <1~ tl~. ~ ~ t 14 1~ ~~M- ro me ewse~s~ sn~to. . i Cf4TIF1GTKW-MEDKJ1l R OLL COROr~ER, p+ ~,u a+.s.s v rwe p~.n, ~ twt Mc[OeM wy ~~p~Mes oe~e tsut~uhd~i p Mt qOr ~M/O~ M MrlS~,Wi.ur~, w wi OrMW~+. ~ M~ tt~~ . . O!~?w OCCWMOOw Mt O?R ~MO W! q ~ME UYSl~S1 3U~lY. - ~ rr. m ;Y~? f ~t'7~ l[. CEliWER-1~v~Mf ~nre o~ nr.n ~ S:GNAiiIiE ~ , ow+ee a u OwTE ~ m. w~, rt,~ M. :k ~ /?.1;},2~7 osr Er~ . :.,c.~.~:~. s~ ~ _ x~ G 1 7'0 ~ MAIIMG ADD~SS-y tEtTY s~ui. ~.~.o. w. an a~arN ` _ ?~t ~~~I'Y ~ll.fl/ ~{S ~ ~ - s~~a- ~ ' -•ti: li ~iY-r(' ~14. -i ; t ~Ui1Al. ClEMAilOti. lfMOYAI iERY Oi ' 70iY-N/.w~f lOCA110N Gh q qwM Sun ~ ~ fnan~ - :a: B- N..p' . - a~.. Fort Pi g~ - - ; ~ OATE ~np.nw. orr. nu~ WlhFial nOr+f-IWwtE wiv~ ,tDpRcSS ~ suen o~ ~~.o. wo., un q rorr, n•n, i~r i ~ ,.,.Junr 4, 1970 ~.L e Pze:c iVlo: ~uar~r 7t8 Ave. D, Fort Pie:ce, Fiorida 334~J Y• i61'j' f1/i Ot- i ~r RiG1S7".,~LGNAiUff ONTE HCEIVED ~1 ~OCM fEGIStY! F R~v.lYTO ~ ~ .~Glii ~-c.'~ y~ ~ ~ ,dk ,w. June 4 1970 ~ haroby aertify th~ tn bs s true ar~cf ccrroct copy af tfi~.:~ L,cwf Registrars record an fiie in tt?e St. Ltt:.~s Couny O;;~t~~ - mst?f it Fort Pierca, Flotkia. 'i''~ . (Waming: Not valtd unlass raised seal of tha St Lucl~ ' ,'~f . CONf1~l 1'10a1t~1 Depirt(riC11t tL a~lX@d.) L ' , , s N. D. MILIEtt, M. D. ' • ~ - - ~ _ _ - ' Health " ` ~tY Officer ~ Loca! ist~u . • ' ~ • c ; ~ • : : ~ ' ; . . r D~ ' Deputy bul Ropistrar , ' . ' • ~ ti=-• . . . . ~ . FI1.E0 AND RECOROED' ~ ST.RECO~n ~E~7F ~o`~ 1~4349 '70 Jl1N 9 AM 10:33 ~ C~ERK C RCUtT COURT 800K~~~ PACE : _ .n~~~~..