Loading...
HomeMy WebLinkAbout0521 r _ , . ~ , ~ ~ ~ ~ _ r: ~ _ : t ~l~.`~, - _ .y`~- _ tri ~ ~t f 2 ~ . ~.i . r.. • ..i...r. . 2n86~9 ` - ~ • ~ F L O B I D< <*wn ~u.s No. ~ e:Rri` R G15TRAR•f NO. i P~ a~TM coD[ r?O. i US[J.:L RESIDENCE (w~r~~wawr.sa uwuww: n.woa~.r.n ~ ~ w Z..iNTY ' STATE `:artin ~y Florica cou~r 2•artin , ~ ~ cinr ~n .w~e. .....n r..a ..w wa.w a?ENSn~ oF a cmr ~u «...w r.w. ..Y. ~uwa ° ~ ro°w~, Jansen Beach ~~ea~'~ TOWN Jensen Beaah ~ i~ y W LL N/W E OF ~It ~a w rNn1 a rrpa~. pw ww.c w~w K wu~ STREEi ~tt nnt. r~w i.wrl , ~ NOSlITAL Ow App~ ~ ~ INSTINTiON ~CABA bA8C~1 1. NAME OR t~~t) 1 fYjddl~l e. (irt) 4. OATE plwtl) t1Hti) (Y~ar) ~ ~ DECEASED ~rot~ g,- I~:ichaelson ~n, Nov. ? 1950 ~ f. SEX COIOR O! RACE L MARl1EC, NEYEI 4ARpEp. pATE pp {IRiH f. A6E ~ts o nw ~ rw N~~M~ tq w ~ WI WfD. IY tCED tb•d4? wi? ? + H..~ ' la~. 0 oy Fe~e1e • tJhite ~,arr~ec~ :~'.,arch 30 19Q4 l~~ ~ l~ ~ 7 10~. USUAL OCCY?ATIOIJ~6t~ Idr d w~ IN_ KIND OF tUSiNEti OR IN- 11. ~IRTHIIACE ~wy~ ~~~p ~Z, CITIZFN OF WHAT ~ °i'`"'~ou et~~``e11°`•~'~•~`"••, At own home ousrar Chi ~o Illi.mis COU~:~.?. ~ a Fwrn~s wwE t1. YO7HEt'S MAIDEN NAMi _ ' Ja^es Betv~et ^ is wws oECEws~ ~N u. s.niw~ Foec.~sa socu~ sECUamr n. ~NFOwwKrs s~sw?n?~ J S Michaelson a y a.~ ~ ~~k..w) ~u s.~ s~w..r • rr..r..dwl NO. • • . J r. ~ ~ ADD~Eif i~ cwuss .~F ~wm MBDICAL C8RT1FtC.lTtON .wr~evw~..a.wrm~ ~ =st~r o~b a.. oisEi?sE oa coNOmo~ ow~cr wwo ouTM ~ j~~ oi~cnr ~a~c ro or~?ni•~, Accidental death broken neak snPPered by ing struc vav~e v e at ng in "~D~ the ocean at Jenaen Beach Fla. = ~ o •r~r. ~..e.~... nuE ro . W .Ml. N wii/ «.iw.a tf ..s. /w.is~ 'i ~,y; sd p iwe l~r. ri» M tA~ ~MN e~M f~! ~M` u ~+tis~i~. e!~ !t w~w~ t~ ~r~/w~/ ~N i~f. ~ ! o u. j;,.,,..~ DUE TO ~ Fllf O 1?M~ ~ECOR Ep ` a~~liastiw~ r a f~~ il. OTME! SICNIFiGANT CONGITIONS ~ w~ c..~a... ...i.a.a.~ r a. l,.u? IIOCER POI~itAS a w +t.+..... .o.s~. IRCUIT COURT o owh os orE~ nw wuoe NNariss oF orr~?noH ~ z._: no~ ECORD Y~ ~ w~ x AYTOKY7 ~ : ~ ru ? No ~ + .'9 ~~b1 l~ti! 21?. M.ACE OF IWURY Lr~~as IIC (CITY Ol ( 3 (STATEI a 21~.~c~pprT ~ ~ 3 M •~K~~ Accident ~cean~euch~`w`~~' Jensen eac (Rural 2~iartin Florida ~ :ia na~e ~~..w ~ a.., w~ uuu~r occua~o o u ~ = ~ ~?u°u.Y l~ov. 7 1950 P. `~::o:~ _ ? C~ Struck b xav~e vhile bathi in ocesn i ~ i y d~ t~. I keseby usti/y tJ~ae I atts~dcd tlle daeeoaed jsop,__, 1~ , to~_~ la tdoe I b.t sav c/u dec~o.ed + •4 a2ive on !8 m~d lha~ dtatl~ occ+atsd ct ~n o~w t)i~ ccu~a~ and w? dle dnls rtaetd above. ; 3 ; 77a. 81GNATURE (D~ew ~e ytL) t3~, AppREif bc. OATESI6NED f ~a N:. R. Cartvri~ht Coroner Stuart Florida 11-L2- 0 ± ~ ~ aa. ~ u a ~ w~, c~w- ~a. a?rE wwe oF c~Erenr oa caa+wTOar rs. wu?non taa. .r «~v~ ts~e.> > n~~~~a~.~~41 +m?• 12 1950 Wavelan8 Jensen Beach Florida ~ ~ a?~ ar~co ~r ~oc~u ss+aiwTUSE ~s. wNr~ aRCCroas s~aw?ru~ no~~ss ~ D q r ~~~i~ i k ~ ~ ~ ~ ' ~ • . ~ ,r..'•~~ ` _ ~ ~ ' . ~ ~ ~s r ~ § ~ ' ~ . . ~ ~ ~ ~ ~ ~ ~ ~ ~e , • ~ ~ ' . _ `i'~ , y c, : ~ : : ~ . i . s v : • ~ ~:f 1 h~rby artify ffia to b~ a fn~ ~nd cwr~d cvp~ af fF :~~;t ~ ~ ' • . • ; ~ ' ~ ~ ,.t''` R~Oit1nra noord on fil~ In tl~ Martln Counry H~slsi~ G,,pstt~ ' -;i*~s~t~'' m~r~ N Stusrt, Horlde. ' ~ " ~ _ , ~ ~!~.i fi~,•~;~~1~' ' (WuNng: Not valid unless raised seal of the Ma~tU ~ County Heahh DepaNment is affixed.j ~ N. D. MIU ER. M. D. Ca:nty Health Offiu~ d~ Locai R~istt~et ~ C~~ .2 /97i . ~ ~i9~ ~ 5~9 ~ ~ ~ a.~ . ~ _ . _ ~ : ~~--~,-x ~ - " , ~ _ . ~ ~ ~ ` ~ ~ z _ _ . ~ ~