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Home My WebLink About2383 ~ ~ . ~-i6, .~9y _ ~1939 CERTIFIED COPY Cox W[ MtRE~Y CERT1~'Y T ~~`~~Rt'iDUCED sELOW TO Bit A TRUt AND CCRRECT COP1f OR TNt ORiGI LE ~N TNE •UAEAU O~ VITAL sTAT18TICi Of TME STATe O~ RLOR10 ' ~ ~..T!{ ANO REHABILtTA11VE SERVICES. OIYISIOK OF H!£ALTH . AT ' ~ i . . ~,r~t~ sj - (NOT YALID t1N A. DErARTM[NT O~ MGLTM ANO R[N/?~14TATrit l~R111Cp.O1V1~IQ~[~ - ' : G- C3_. ~ ~ ~ -WL•.~4L Y/L V+'_~ - : y - cHw, w~ww YITl1< fTAT~STICS ~ ~w ~,t': - rt ~ ,y. . ~yi` _ . y~.~ ~ . - ~ sr~a ~s~wrut: awietew. awaow ~ . MrwLn~ ~ o? ~w~n~ wwo . %k{^; r ~j~t , C ~a~w~uTenv[ attv~ep r .T~T~ ~OAIID O? Mt/1LTR'~~ ' = ATE C~F DE14TH - 69' 0 41 ~ a 1 w~~?u o? vnw ~rwrim ' srwTt r~u Ma sIRT NO ' FLOSIDA pEa~s~~R~s NO E~J t~A 'u Oi KATN COO[ NO. 2. YfYAL ~[fIKMt[ 1 R'v.~ M~rs~/ Awi Jlwrrrw: f~dw~ a.w ~rr,~ ~M~ DL~V'~ 2~•OHv • STATE . COUMTr . D:...._ 0- GTI~. TO~M. OR lOC4T~0u r~5 ~iaCE Os OEATM ' G~TY. TCM1~. OR COGTqM • e~+£S~DE~CE tMS~DE C~T11 UM~TS~ F~ tr~r L~v,~ Jacksorroille ? ~E: ~,b ~ Jacksonville E~.~ 3 r, ~ 1. IU1ME OF (~I Mt u~ ~My~t~t. f~c MutWr~N~ f. STREET AWRE55 _ MOShTAL OI! MISTITYTION D.o.A. st Z~s 10557 at~ant~c s~v3. 3 1Ya[ M - i1n! Xi/frs tat - DATE afw~t~ Lq 1 ia OF t~se r s~i~) ~ ouM J 22 %~5 . S SE% 6 CQ:OR JI! IUICE 7 MARNIEC ~ uE.ER IuNR~EO Q~ OATE Of f.RTM 9 46E /l~ !t~?I i~DFl1 ••c~ i.l?'7Ea b~K !~R ~/t1) X.rb G4 ~ ~..n ' .Y./. rnoo~cc ~ aticACCn Se t. 7~ 1920 - ~ IOe USUAL OCCWlITq11(QiNtraf .7Jrert (at ICD K~MOOi M;SNIESSO~ MiDi.ST~Y IS ~tRTNrU1CE ($jl~tt M fM~y~ pt~fr/) 12 UtltF.ti ~i ~w?' S1~ra:• ~ariy y~ratia/lyt. aea if rerirtll . house~ife GTilliamsburg County, S.C. ~ 13, iATli[w S NAYE 1~ VOT11E11 S VAIDEN MAYE ' Philli lsrd Annie ~iae Marsh !b SOCUI~ fECUR~T~I 110 17 pN~ • f~O1MTUA[ A~Irta rir, lhomas ~1. Cox 1~ 57 6tlan~; c Blv3. Jacksonville, Florida 1~. CAYf[ N~fA*1/ (Evs?s~ItMt er~tiat}r?p~tly t~~. a~~ ~.c:.) • w twTE=•~. ~fTrEf~ ?4RT I. OEATM *AS CA:r3ED ~11- - /r] ~ - - - - ?,~h'~ ' ~£AT~ . tYYEDN~E C~uSE (~1 ~~~/T ~ifw~~ ; n: OuC TO (0) t--- - i .e..< <..,."1.~. ~ ~ ` - J4` .e. ` ,e.r+,vv a~e ¦.rr.- a~c To t~~ - = td.~ ~r..r tar. - - - - - - - - - ~ /AIIT 11 OT~[R SIG~lfK?f~: CMMt1016 CpNtb~Jfl*y 'C p(AiM RR ~C* RCUStQ TO tn( TI'R~IUML Y 110N GIIIEII YI ?MT 1(t) ~ •i1~ST ~ r~ a=yrE: • < ~ES _ w: ~ 20D OESCN.N MOA :MJ.. A N ~ at PMt 1 ~r i~M II rW~ t~.l _ ~CC~O[MT . SUIC~DE M~~IICIOE CiV ~ O G p - ` ~ OCER POITRAS ~ _ ~ 20c 7trE OF Ilwr Ncar~. I a~. Yea - ~ ~~Up7 RECORD YERIFIEQ ~1~ o D- W ~ ZQf WURr OCCURR[D 2(k ?L?CE Oi ~NJl,ll~ ~t . 'rf~j tOCA?IOM OOYMTr c~~~E ~IC ~T ? MDT~K E n t N~ A. /~tlo•~. I'•tM. c~lt ' . ~7 2t l~tt~ndeditNd~cwsa~dJrom ~ 1 - ~ I~~ i,~.- ~ - " - - _ _ _ _ fa ~s..'~ - ' •nd L1t N~ Ai~ ~li?~ on Dti~h occ~r •r ,~n on rh~ d~h ~r~red ~so.~. ~nd ro tA~ b~st o/ a~~ 4no+Nd/~. I~om rM;~.sN ~r~~d u. s~o~u?rv~ r< ~~~~Phillip . ~~o.css :•_csY..c ' ! : ~ c~:s onvj ] le , rlcr{ c r ~ _ ,~c~ ~ z1.3 ww~u. c~cw~rcw 2Y, o~*t 2k ?\V{ O~ CE Vk~te. oa ca~a-:~• 23~ ~oc~TqM ~Cr~.~~rn.r car~:~ ~a~ Mroru ~ ~yrn.y~ _ KeI~'d. C ~ ~ ~~2S DaTE R[t: !r aOC~i REG ~EGKT~AII 5 SiCNA1WK~I s - raus s Puh era 1 Home , I nc . ~ ~-?,/9( ~~r~j~ /J~,~ ~~88 ~~?9 _ - _ - .~~.~...~~~-_r