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HomeMy WebLinkAbout1716 ~ ~ ~ - ? ~ _ _ ~ 1~~511 ; , :a,. 0~- ~TATt .owRO o. N~?~M CERTI~ICATE OF DEATH j ee~ea • ~U11iAU 0I YITAL fTAT1Y'i1Ct lTA7[ ?IL[ NO. E 1ea•1 FLOAIDA ~ ord •A~n el T NO. R[ 1 TRAR' O. t} properl~ 2. ~SiLAI R[110[NC~IRW~++~~MM //wM.r+~w? f~~/MW~nww+v f •a~e~t~A 1. N ~TM COD[ NO. •w~ •~71 ~~TM ~ l- STATC OOJMTr 1• ~l~e~~ t ~ ~ CIT1I. TOMM.011 LOC~T1011 t. K?UCE 0~ DE~Tw C. dT11. TO1NM.011 LOCATqh f. IS RES~O[MCC 1• ~~t- ~KS:D[ Ci7t ur~TSt • ~KS~OE C~ir :~r~Ttt •~~~~t YES tU~ Y[S~ Iq? t11~• I, M~YF Oi ((JNI iA ~NrhT. /~t ~lV~lf ~QI~tN) tC?~GTN Of ~ STIIEET ADORCSS OM A FAiIYI NOSMTAI Ow STAY MI 1?' r YES ? MO O INSTITYf 10M ~ ~ NAM~ ~I ~?rt w/i!/tt LYt DATE ~Iwt? D~1 YtM KtCA~t~ L ~ l~/K r/~~ C~i.LLll W• ~'J• OEATN . SE7[ ~ COIOw Ow IIAL[ ~ YwNR1ED y~ 1i1t[~ YARRKD ? ~ MTE Of ~iRTN ~ qIt MWNI MwW • 1O~r Nwn~ X r i s• Female Wh e Mnoowco ? a~~cco >>~iwi~ 10~ USU~IOCCW~TIOMIQirtti~/~f~[~r2M~[ ~OA awoos~s~wtssosu~wsTer 1t. ~,~tMrua(g.er~rM~v+ow~dr) 1 an:rwa~w?TaaMiwr? .i:~ *~r- ts?6VwtN~~Iqk.waiJrtdrd> Cler ~l~et f~! 1.~ATII[~'3 IY11E • i~. YOTMC4'S r• tur[ • tn~~rlt~r P Is- MAS OECE13[Q [VEA M Y. ~I AAYEO i~CEST 1~ SOC~l1l SECa.RRY w0. 17. IM?YR S NCIM~Y~[ y~~ T ~ t I.w r. ~ s~irw~ Ul r'w a+ ~r ~lMi~ ~rwr~ ~1lA i~.i,n_ ~!Vxe r • 5 ~ 7-3~-l?5~6 A.a.« I~e~T~~ ~t. cnus[ N wn~ (a1a...tr..r c..r yn iia. p i~I. ~S). a~1 ([).J {hTt11YAi ~Ef~E[A MAT ? OE~TN M4S CAI/S[O ~Y- ET A?iD UEATM u•.«.~ ConTestive hear~ failure ~ keeks •wa rii• wrcou?1[ wac cy e~• e•r- •tse~•c?• ~'~"''n~N°p ~ T~ ~eUI~dt'1C ~82'd1L1S 1 s e • 1 ~ `~f: ~ . r~R?~tNr t/iy naar Md. ~ DuE TO td • f a\i• 7= O ?A~T tt OTNt11 SKM~RJWt Cp10R10NS QOM1MJiwG 70 DUTw ~1R MG7 RCUiiD TO rM[ TtlwrWl OtSUS[ OOIIDITOM GMUI U?Mr 1(~l wA5 AUTC~PSY \~Y~• F hERfO11M(~Or7; t~~ ~~~t~ ~ YES ? M01N •r 1~Nr• ~ pEkRllE ~prr yVy~~Y pCCuARED (S1fe? f~fr?[ O PIt I M PMf II ~/If[~ !I.) ' i •~kl~t u~ ~ 110C~0[~T SU~CtDE MOYKWE .i.....- W p D ? .r " ~ 20t T~rE Oi Hw~r a[w[?, Dq. Ytrr •~a~. ~ auu~r o t. s. I" W Z 2{)! MYURY OOCYRRED mt. KACCOF if.~~~Rt te. 0.. i~ w~'~nt wut. 7D/. CITt. TOWM. O~ LOUT~OM ODiiMTr ST~TE w~4[ ~T ~ woT ~~e ~ fp~. f.cu.t. a.se~. ~~tr~ uy.. ar.~ MIORK AT MO~K 21. I ~tam/~d ~ly d~waa~d/roppp~~ 2~2 ~5t! . ro ~ ~ ~ •ed l~~t a~~ ~ ~ ~ti?~ on ,3~L+~~$- awth exurr~/ ~t V~~~+ P~ m on tA~ det~ ~t~t~d ~Dor~: ~nd fo tM Dwt oI in~ ~no~NdN• ~roa~ tA~ uuw~ ~f~[~d. i~ •1~ la~~• NCMA711~[ (De/r~~~r[it:ti ?ID ~OORESS IIt. DATESKAEO '~r• t• 1~ a ~,lva D. Orr H.D. ~ 616 N. th. St.Ft.i'ierce Fla "-21- ~ •ee~r~t~. 23~ ~.r~ai. UL~i~OK 2~ O?TE 13r ~rE Oi Ur~ETEltv O~ CpEM~TORr 23f. LOC~TiO?~ (Glt~.lwc~. a cwst/) (3W) IS 1 Remova~ Mar. 16- 8 Fort Lincoln Wastti o • 5.+61~ 2~. iWE~AI ~S SKK~TWtE /1DDIIESS 25 WTE nECO. lOG?L 4EG. t6. RE6tSTM11'S S~GN~TYQE . . R~~.I96• ,y-1 r Fi`l ~ 8 1 i ' ~ffY thk b b~ • trus and comect copy of the Loca! " ~ ' ; Rapistr~s rooord on fil~ in t~ St. luci~ County h~.afth Dep~i~ . ` ftNfl! et fOA Pi~fG~, F10~I~. • r~ ~ 3~` ~ ~ (IAl~ni~p: Not v~tid unteu raised teal of the St. L~xis - s~, r. #,`r' 1~ . : f Counfr H~atlh Oep~rtmar~t is aff'~xe~.) ;••t~,:~ ~~~.1~ ~~~Y: i' _ _ .y'y.'~= , - ` 9.• . r ~ ~ • a ' ~ ~K i ~ N..D. MIIIER, M. D. ;;'~r :a~: ` .a~-i` ` ~ ~ : ~ ? ~,r;ft ~ • ~ ' ~ ~y,14•' . ~ ~ County Itn Officer E~ lou) itspistru ;i ~°:~,i s':,. =3:: , ; • ~ ~ . . .7 +~~'~X~~ • s- , ~ ' ' ~'r-, O~ra o~pu~y t~out rt~eo~rn.r ~ i~~~ i~.~1 ~ ~ - . --•.«<iii+; ~~~,?,i ~ . • ~ ' ~ ~ . ~ ~ ~ Fi~EO aN0 RECASOED - ST, LUCIE COUNTY~FL~• ~ ..~~1r. _ . ~ 19~511 ~ '10 O~T 8 PM 3: q ~ ~~PU~~ ~ ~occ~ :-~v,;~as ~ CLERK CIRCUIT COURT ~ ~ d00K 18 / PAf,E 1~r16 - _ -