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HomeMy WebLinkAbout2810 . • - , ; , ~ FILED aND RECONOEO ST.lUC1E COUNTY FIA. ROGER POItRAS , , CIERK CIRCUIT COUNT ~ RECORO VERIF~EO ! t ,lc~ 1 10 is ~N'11 _ ~ t t~i. ~rwn ~o~wo ~ Ms~TM CERTIFICATE OF DEATH eo~~• • ~YIItI?Y OF YITAL RATir17q fTATt FILt NR l•s•l ~•a- FL08IDA • erA •A~w SI N. R~GISTRAII•f O. *~ijiel~ 1. KACt ~I ~fATN GOD[ MO. L YWAL A[N~[NCtl+~~wrYYwi. I/irr:wr~ N:/~~Mlf~+~i~iwtw~l •:~l~It~~ ~ t STATE OOIIMTt ~~i •111 ~ ~l~e~~ l~ 1~ dT?. TOI~M.OR 10C~TION t. IS rIACE OF OfATN t dri. TO*R O~ IOCATIOR f. IS ~itOEMCE .•.•ie ua~oc cm ur~rn r~s~oc cm uw~ra rii•. C • res w rca ~o ~urc os ~ry.~t t. ~w~.t. Nw ~er.~t .eaa.) sTUCr ~oo~css Iqy~TK OII IIIST1T11TIOM 1 w~r[ oI lYrs /HWk L..t wn XwY Dq Yer KCtAit~ ~ ~~M~ JOtiN JQSF~H ~h'ARIK °fATM t be su t. aaa~ a~ ucc 7. ~,~o ~cvc~ r,wco ~ o+~n as wTM s_ ~ t~i ~r.r~ ~n..~. x+~.. . i•. M. M: .noo.cn aw~cco A ril 188 81 : ~ 1~ 1 w l~ 10~. YSU~I OGC7MAT~011 `OfN tW Mwrt Mt 10~. RMOOi NiwfESf W! w0uS7pr I i. fYliwU?Q (~IW ~r Meys asabl) qfm~ ar wwf aoYlfnn s~*• r- t ~t d wtiy qlk wrs y.rtYM ~arber OFm Sao Pennsvlvania US ~ ll~~k 1~! Il IATM[R'3 IMME 1~. MOTNE1l3 MMOEM NAME ~~,..r~e.~ John Minarik i)nobt. rns auwsco cru n u. s. Wwco w~asT ti. socu~ sccurorr No. n. s aow~rw~ ~ ~T.ti......w.d ul...:..~.w.,r...:.r ~ F_ 1?_i n ri k No ?_61- 0-861 A~~ Ft.Fierce Florida fr~~ r~1 Il CrNN[ M~tATN (i14r N1/ wt haw M Jur M(a). (A). at (d.) UQEltv~t ~EME~ ?IMT L OEA?N wb CMISEO OISSET AIO DEATN w„mu„E c,wsc ca Ar*.. Sclerotic Yeart Dis + i .~.s rsi. t~• e~r- ~ tifie~s• ~ ~ (i) •1t? t\~ I~M 1 • e • 1 ~Iwe twu (i1• ~ r~~f~tt~~ ~ n+ue l~f. OYE TO (c) [ • 1 t O! ¦ 7~ ~ ~A~T IL 0~1~ 9~IrKA~ OO~Mtlp6 Oa1lMlif~i TO OfA7M wR 10T RMiW TO M TElp~YMt DIlfA! OOI~OI110M iM~M ~I IMT 1(y . KAS . ~ i~¦r• •t- ~c~wcp t- ~ e.r s..~~ S rtsD ~QD ~ •r ~~t~r• ~ 7q~. otsta~sc ww w~u~r oocu~Ea 1~1+a..rwe yhysr~ 1~ Prt l r Art Il ylt~ JN .alcl.s ~•7 ~ ACpO[Ilt SYIOOE M011~p0E • ~~il~ ? ? l~i~. - ~ me. ~oi Hwr ~lwN. D4. Ywr a ~ tot. wiwr ooanuco mr. rutc os sw~r c.. ia ...e..~ bwr. 70! cm. Tvw~. ae touT~ oowmr sT~TC , 1rnKt AT ~ wT ~as ~ Mw. f~w+t.•aat. yia ety.. .a.) . ~ 1rO11K AT ~K 21. /~t~~wd~/ fM Iwwwl/wr~ 19 3 , te ~ 9 ~w/!rt Mr Aiw ~llti ow ~ ~ D+~tA ooc~~r~I~t 7= p a~ on tlN d~a ar~t~d ~Oo?~: ~nd te tM 6wt N eq tno~Mdp. /row th~ o~r~n ~t~t~% ~ i i ~ s••• tta s~~swc cww.. r wk~ m~2 N. ?th . St . t~. wre s~+co Ft.Pierce Fla. 3~450 0- 1-66 ± ~..N•e•. Helvin i~olkoxslc~ I~.t'. •s~t~~~t~. Z1~. F~u1l. QEiY11Oi1. 2~- O~l~ Zk. IUME Of CEYETERY OR CII[MATOIIt 2]/. t:OGT10N (~ltl. fwni. M tM~yl ~~fl~) ' ~er"aova~~ ~a3~-bb St. James Ce.Tete Westfield N.ass. j a. t s t~ y~. rwc~ s s~. 9Q 1AOAl'~~7th . St . xs. o+?rc Rcca ~r wcK Rca. tc. ~cc~snu?~-s s~cw? ~ R•••'°°• N31ton W. Baird FL.Pierce,rl2. 11-1-66 Anna Lee Denison d.r. ~ ~ hsnby cKt~fy tha to b~ • trw and oorrect a~py of ths Loc~l --j -~r.~ ~ " `i~, ' ; ` Repistrars noord on fil~ in tM St. luci~ County Health D~pert~ " : ~ - ~ m~nf at Forf Pi~.oe. Florid~• • ~ ~ k+ (1Afarnirp: Nat va~id unless r~isad~~al of the St. t.uw , ~ Cpyn}y ~{M~tfl ~!(~lAfflMi It ~Xed.~ ~'t~'~f s~' ' ~ ~ ~ :d `a . t ! ~ . t f ~ ~..r~i,: I + ~ Y ~ N. D. MILLER. M. D. ' ~ : , ' `r ! Cow?ty Mi~atth Offiur d~ Loul Repistrar ' ic:. `t=,' ~ ~ ~ ~„Y ~ ~ v ~ t ~ , ~ ~ •a~:_ ~ i D~pr~y Loal R~iss~?+r ~ ~s ~ ~ ' ~ ~ ~ . ' yliitN ~i~`}~>L ~ . 3 : :~Z~ ~ aoor. 2~ ~ ~ - - - - - - . _ . - ~ ~ µ _ _ . - ~ _ ~ _ . ~ _ _ _ _ . _ ~