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VOLUSIA COUNTY HEALTH DEPARTMENT %Z~=JS`~'~ ._„r,
e.. ~TAT[ •o~~o or Hu~TM ' CERTIFICATE OF DEATH ~
Cd"° • •U11CAU OR VITAL fTAtIfTIC• /TATt /llt NO.
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CERT I F I ED COPY ' ;~t.~~-e
I hereb cert i f th i t ~g'..s"~.'~•
y y s o be a true and exact copy c~~.K~~~'° 'Loc,s~='~~,:
Reg i strar's record of death on f i l e i n th i s of f 1 ce = r
: (Not vai id unless the seal of the Yolusia Cou~ty l~e~akt~~'•~. ~
Departme~t i s aff f xed. ) ;.~~3~=z` '
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