Loading...
HomeMy WebLinkAbout2882 FIlEO ~NO RECOR~E~ . ST• ROCER PO TNA3~ , CtERR C1KCUIT COURT ~ ~ RfCORO YEa~P~EO.~.~= ~1 ' Ocj 30 9 ~o AN'10 2t O3~ ~ . 2~:O3•~ i DEATH CERTIFICATE OF ALLEN EDWIN WIISON ' M ? CERTI FI ED COPY ~ ~ WE NEREBY GERT~FY YNE COPY REPRODUGEO BELOW TO BE A TRUE A?VD CORRECT COPY OF THE ORiGINAI RECORD ON F1LE IN TNE BUREAL~ QF VITAL STAT15T1GS OF THE STATE OF FLORI A. DEPARTMENT Of HEALTN AND REHABIUTATVE SERirii,t5. DIVIStON 4 ~ OF HEALTl1 AT KS~NYIL,t~.i, FLORiDA. ~ _ ~ ~:4 . INOT VALID UN T 1TAT[ OF FLDRID• OEPARTMENT OF HEALTH ANp REHABILiTATIVi S[RVIC[f. DIVIs _ , ; ~ ~~';1, _ ~ ~l\ 11 y?.. 1 - - ~m ~Y1 .~r t \I~L N \JV V~~ ~«~.v I U CNICF. CUREAU OI VITAL sTATtTiC! . ~ 1 ~ ~ ~i ~ F f ~~"''-i•-~ , I-Y ~ ~~l. ~r~ ? STATE R[GItT11Aq. DIR[CTOI~. C~Y1S1pN b/ ~ , MEAl7N pt~ARTM~IT O? N[JITN AMD ~ 11[NA~ILITAT111t ltl~Ylnf ~ ' r~ ~q•~~_ - - ~ _ . - - a , ' s~t~ so~a or ~ T~'ICATE OF DEA?H s~~~ ~i~ rro._ ~'~Q~_ ot ~'ttit stanauc~ F L O B I D A RegistraCa No. L`: ~;S . r. R.ACE D6ATH - - - - - - 2. U&UAL RSSID~7CS (~R UEc'F.ASSI~. ~ e~, c~e..~, Fi r=..,.~:Ld.S - n,..r~e~ .ra .i~-~ ' ~ s~e.__ ricrica ° iD) I4eelnct JG!:1=:L~10 Precieet No _ ~D) Count> w L::CT Q 1 ({~rlte name. ~t numAa~) ` ~c) C1t)^r ~Y Yii:JB nV <el C1t~ or ~'o~n _~=r~__LL'^...i 0 Tww Tosr lio. ' (it outs~de dty~ or towa Ilmrts~ ~rtu RCEiAIJ ~ f~J 1a~ d~~ or m,ctc~u~ ~oLO2'~:I;a :~cl~i~litTB ~20^. ~a~ e~.~ -Ho. + ~(If wl tu Ao~plta! ot in~Ututiae. wrlte rtreet i~Der or Ioest lu rarsl. t1w loeatSaal (v l:rrts ot ,u~- L 1o.v1u~ or re;un,t~on C+4 ~ ti/a (e) ausea ot ror.l~., coa.tr7~ 1: C ; u.~. ~t da.~,. y~ -o O o r. j ~ Icp,.rdp .A.:Cer ~ean. moetLr or da~s) u 1p. Ym~ caoatt7 - - ! szrt.t. Y~ or nDCS~sen r1i:.iui. , A~~~m Edw~~ ~ ~ yl, JG'i ) i ~ a ~.a It .~ur~n, a(D~ 8ousl e.a.zv . - ~ ~ na~ne war _~G~'3~? riiLl` ~1 !10. G61~2E~F~J~ ~'ZUL C~iT~(.AlION ~ _ _ :~o- Date ot neatb~ l[aat~ .i -r Day 4 ; frs ` I::.~.ls s_ cow. ur .aee Z- tq rear 39!~!. esv ~J_:~/ i~_y~s. ~ ~ !1. I A~e~D~ a~ct![~ tLst 1 atLnd~e~ t~ {ecw~d tran c a.sk. .n...ka. ,..b«e ~ e~..~ne _~a.PM~ JW1o 10~ ia 44 ~n, 7~..t1 4 !4 ~ i W!f marrf~A. ~fdo~ed or Qlvoeot. Aurt,~nd ot <url ~a'.='~G la ~vIIe~ .Il~SC31 ~+t I I~st saw b- ~ _ af~R m ~ u . ~ i(D) At~ o~~a0d ar sttc. If alt~ _ ~w aad ths! death oceurred oo tb~ 1ay so0 DaYr atattl a4a~. p~ L7nlOldla4 f.~uM Ot QMI~ i~L+~~ 1 L~ 1 ~ L m.ss a.a ot aK.a.w ~~~.g~ -~~Q~- (monu~~ ~eas1 (s~ar) ~ l Ap: ?~a~s 1[ostlr ' D~~ If ~w clsai ao~ ~al - - - - ~ vL ZI 3 . - _ ' - En. a~ - - - - ~ . ~ ~ n T. + • _ ~ ~~wClt~ ((:tty. w~n or ntY ) (Btau or (ore~ couutr~) Otber condlt ~au ~i0 'L~ OZ'~1 ~aZ ~ t lEi ~s t0. L"sYat ~rcOWtwo ~+VrC~ ilDt - (lnc2ude Dr~o~acl ~nir 1 nwntha ot Oe~W) _ t.abotic ~yi,o . ll. GAoalrY ar puda~ Y~~or fin6~~' - - ' u. ~t.m. , -~•;r2n ,i11tOII or operaua+s EQZ'4 L~OL'O"hQI'0 c~rr.il.~ - ~ . ~ r, tl BSrteptar~ _ , i tFa~ 1'=~T. J:. ~ J~ v• w~rc~ 4~tb ' lO~ndat~ot.peraUoo/ s\~~IA ~e r~ ~ ~ ts. If~ld~e w~ar ' -_ot •~tow)• _ 21~^O = n"f^SR ~ ~G i3. BlrUfp:aO! d~~/a~L.klia,~ ~/4• 1 _ _ " > 27. tf death wae due to Rtrrnal ~au..s. flll In tAs /ulluw~ey~ t Sv:~^t • et tan ~ . ^ " '~G" tr L'! : ^21 ~ ~~"_'y_~ Q~#y- ~ ? f ~ rProt.abiy~ Aedd~nt. ~afclde. h.,ma~d~ (r,.,cif~~ - J~ bl Addt~ ~ ~D) Dau of orcurnrw~ ~ - - • ~`s .~L l . Ic) K'Aen d1A Inlury acvr' ]T- aTl~. tM~1~lj0~ Of RI00~\1 . ~ 4 ~C1T~ O! L01r0) (l~• Yl1ll~ ~~at0~ ~ t ~e~ ~114 III Y i1 V Laee jul' 4 1J'!4 1T /4) Sti~~ClO 1 rf ~ur le or ~pout 1o~R on tartn. ~n Indu~~rla1 ~laos u~ ~ • ~ LL hf.•ral nlr~ci~w s Elsnslvre puMl~ plac~' ~ ~ ~y' ~F,pe. Sf y~k o( Ula~el ~ ~ 1! fv AEdres~ ~ li ~11i RbiM at ~arlt• e . 1~~ ffME 7'~~ 19 . 81*oawr~ i~ ~L~ Y:.C~~: i-.~Q31,~, Gl V~ V. "ti . L~ca! R~s+.:r,.. ~ ) uarea.l( , 't' t~ ::v. 1 ~ ~ . ~ - - ~ ''L'_- - - rtAu Pi~n.r '°v ~ ~ ~ doaK187 ~2881 . , . . _ . . . . . . . _ r^~. r