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HomeMy WebLinkAbout2216 i! . _ `o~~1~NEA~l,yofA ..,ORANGE COUNTY HEAL'CH DEPAItTME~NT~- . 'j ' e~"o ~ • ' " ' ~ft M'e~t Ceetnl A~~ ' - ~ 2~{ r ,~c ~ P. O. 8~x ~IAi • , p ~ ~ . Cllemr 1-N11 , .0~[~0 ~ , ORl.ANOO. ?tAltlDA • . ~ _ - . 2G~82`~ . KATt ~OARD O~ MSALTN CERTIFICATE OF DEATH ~ ~u~swu or v~Tn~. ~rr~TUnw F L O B I D A srwn ~t.s No. r ~ 01 H NO. ' 1!<OIiT11A11•! NO. • 4 1. w~ct ~r w?TN toot No. ~~siKMt[ t~b.. w...w A: n~ : R...Mw w...ri..w) °~""TM ~ Oran ~ e 58 084 F a Or ~ ~ e_ urr. TowN. oR wut+o~ a ~s •u?ec os oc~n~ e. aTr. rowN. oR ~ouTw~ e. K Res~ocNCc • Orlando ~i?cs~ ~~o~ 3+1 3 an cm~ irs~ I. NAME Oi UJtM! Iw ~M~iht. /it ~ErMt N/rsM) I. STII[ET AOO~ESS 11pSMf~l OR INSTITYTqN ~rrin ton Nuz~sin Home ~ 7 D t . I ~ NAM~ ~I FrM XI/~ff LMf OA1[ MMf~ D~~ Ytr ~ nr~"« i•r.r~ LI'.'~?A S'~"4NS SOFNSTOtt ~TM ~darch 3 1958 . ' s scx t oaae o~ ~u?a ~ y~~~p ? I~veA wAll~so t. oArie as MIIrM ! i~ ~MhNW~r!' r..+. n... w.~.. r ~ r~emale 1rJh3te .,,~o ~~Tov. 1? 1875 92 - " j ~a. uw.~µ.~ocw?•Tw~ ~ or. tr.~ N.«R ~..s KMO or ws~css os wousrnr n. wTwLncE caws r prrM~ ~•M1 a+~ or .w?T mwn~r• i Lou86P1~~e~"''~`'"r'y~"~' O~rn Ho~,e Cbica o Zllinois II.S.A. ~ i3. iATi1[R'S 1li1YE MO7MEA"s MAIOEM M~rE ~rie Stone Unlflnown ~ u socu~ sccu~m eo. n. w s s~wTwt .w.w ~ ' 62-58-1208 ~Gr. John A. Johnston, 200 N. Lake S bellia Dr. ~.iaitla:~d rla. ` s•r.s ...a?~ ~r.k...h... ~w« cu. c~~ ca.1 5:.:UClE COUM FLA. ~rca,r.~.ctwr ~ TM r.~t ~ oc~n~ ~?~s uuaco ~r~ ` ROCEfl P wrcou~t[ cwx W RECORO YERIFIEO ~OyR,~C c«~ww...+/ar. ouc ro A1 2t~i829 ~ 8 10 49 A!!' - .r.ns, e~e ..te.,. ouE m ta Z My arae ~«r. o T n. ana s~cw~ oo~arna oomwWrwt ~o n~ wa ~ Itu?~w ~o n~ ~ o~sus[ Cw~w w Mn Ku . w~ S d ~ ~-I' ~ JJ-~ /EIIfWt11ED1 . Y + ~r~+'~ YES ? MO ~ Fr-„ IlD~. ~ . oe Mc Mow w~r oau~~t~. (1~ra w~twt yt~/sr~ 1~ AMe / w M Il y~sw /1~ a ~ccac~r swacc ~K~a v ? ? ~ IOt. T~wE Os Hwr 11(w~t?, pq. Yp? v uuusr s. . o I- w. ~ ~ m/ MUU111f OCCUIMEO mt. KAtE Oi NWI11/(t. ~..1~ M~Araf Mw~r. mJ MY. 70~. 0~ IOCAT1011 OOIIMT~ STAi[ 1RNKL AT ~ 1qT wN1L[ O I~etM1. IhNf. dt.) ~ •O~K AT ~OIIK 21. / ~tbnd~J tM d~wMd /rom ~ . ro ~n1/Mt N~ ~ ~tir~ on / ~ DweA oceurnd ~r • • w~ on 1M d~t~ ~r~hd ~lo~r; ~nI to tM N~t e/ ~ lew~Nrp. /roe~ tM uuw~ ~t~t~I. _ * (arr?K ~ m . us. aTC s~cMCo 3 t3. w~r.~_ e~c..ra~_ z~e wtc tk w?rc os arcTCRr o~ e~eM~ro~r ix. Tas ecirr. aw. r e.srr~ ear.a~ Removei~°"""' 3-4-68 Palms Cemetery Ft. Pierae Florida ~ ~i • laC OIIi ~~L1Y3AY`818 =S. a?rc ~cca w~ocx aa. ~e[amu~'s , 1968 ' . - - - _ . - ~ , , - ~ C~RTIFIED COPY . . r~ ; . ` ` . I ~~,3' t.;~'-~'~ s s? - E d ~ ~ I hereby certify the above to be a true ana corr~ Rsgistrar~s record on file in t,hs p r a n g e t ; z Orlando, Florida. ~ _ 2''~. " ~;y ;;~s • ~ ~ wARNINC: Not valid unless raised aeal o! Oranigti . is afPixed. . . , . _~:'"~p~t . . . . :z .i: ~ ~~~/~r~~~~ir ' \ • y . i ~rt~ Y{~~~. ~R• . . County Iiealth OfPioa ~ Loo~l A,~~i~t=•a'- n ~ 1JIAR t, ~3 , ~ = ? ~ ~ Date Iasued ~ 0 R ' 4, • `'K ~ , . 600K~~ I~E DsPutY Local Registrar ~ ~ ~ . _ . _ - _ - . ~ ~F.~~iu-nz`+.~ v~' h~ = ~ y _ _ t „~•_a ~~s~~~~~.~-r~ . , . .~-z`Lt-..~.~-_