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HomeMy WebLinkAbout1785 Tp~~ fTAT[ ionwo o~ Nrw~n~ CERTIFICATE OF DEATH . ~ co~aa • ~URtAY OI VITAL RATIfT1C~ y~ RATt ?Ili N0. ~ ~•s•i FLO$IDA : ~~~w 61RT NO. R~OIiTRAR'f NO- : ~ r~~~ r 1~ Gppt 2. YfYAI KMO[MC< l rw rrr~i Md R../wr N/w J.rd~) ~ •a~e~t~~ 1. ~~u K~~~ a STAT[ COY7`TII •111 ~ ~l~e~~ U C ~ 1~ 1. C~i1.T0~~40~ WUT~ t. 4 KaCE Os OE~TN t. QTr.TOM~.O~ IOC~T~ t. K ~EADE~CE ! •a~~~t MR~a( t1n 4r'~TS1 /MSfD( CIT? 11Y11S1 i rt3 wQ res w rii.. , 1. NnYE Of (If Yf b~M>iMl. I~ ~trrf NlrsMl 1. STREET A0011ES3 0 NOSI1T~l O~ t IMSTITYT~OM • S ~ wuu ~r ~rt I~islo. L..c a?rc x..r? o.~ Y.a ' Os ~ ~'i`iu`~« e'.a~~ Matz ou~TN g 25 1967 ~ . SE! i CO1011 Ow wA[E ~ YVl![O M[KR YA11111[D / DATt Oi WTM 1~GE 11~ 1~~/1 r~IiO[~ 1 tEY 11~I~ i~ w1i. ~ ~ Ywr~ O~r Mwr~ Yi~. r. t e• w~oorco avaecco -18 82 ~ ~ 1~ i~ 1~ 10~. IKYaI OCn:~~Tq~ lOirt ti~1 Nwa M~ la. 1[1M00~ MKIII[SS OA YIOIR'~r 11. WTMhAC[ (.4~N ~?tM~ ~M~[?/) ' 1. ClI17a ~ R~MT ~IfA~1 ~ .f s~ t~e- ~ar:M ~wt dwrtW h~t. nra 1/rdirM ~ K.anufacturin Chi~a o Illinois United States ~~.et l~L 17. r~iN[~'s ~urc 1~. rOTME11'S rMOEM W?rc ' •t ~ ~,...~,a.. ~t ~ances Rezc sld ~ . K iotu?l SICWUTr wo. 17 ~ M~1MTYw[ A16sa t i ce E. kgtz 27 0 Sunrise B~vd. r.....~ s.wi «.u?rw (ara...a.,•.~••••r•~K•rr c•?..d ca.) wor~c~r~...cT.ccr ~tr••aer r~~T~ oun~~r?su?wco~r: 7U 1J8 S M wrcwn c~nc t.~ ~ tz~• j t~. e.~- . ~ ~ • n~... Years c••~:w••. ~i••.. o„c ro w~ Arteriosclerosis .f t. t.e ..;a ,.rr .a~ ~ 1• s• l ~E«r e~srr 1i1. r~s~~tr~• +~~~I W a~n- ou[ To (e) ~ •!t\fs 7~ _ nw f~. O ?MT ~1. dMiw SK~i1CYR OO~p*O~6 C~MIfIQrtwC ~O 04Tw \R ID? IKUI[C TD M 1[IawY 06U1SE CO~O~nOw ilrtw /?lMi NO .~~S AuTO?SY a~rr~~~a~ ~ ~Eiu'Oar[W ~ ~~f~r~ S trES? ~00 m,. i ~ o[SC.~uc ~qn w~Mr oCCUa~EO csua .we ytyv~ Ar+ J~. P.a !I y~r. u~ ~ •.tt.s ••7 ~ accrocwt w~c~nc ~cr~tro[ - - - - ~1~~~~i- `aj U ? mr T~rE o~ Hwr a(wN. Dq. Ywr ~ ~ wiu~r s ~ i mr ~wu~r occuu[o aDr nuc or +ww~~ tr. I.+. r.~w w~r. Zo/ cm. www. o~ wuT~ow aou~n Sr~T[ 1~MKt AT ~ wpT MMq,i ~ .~~•1~M1. Mrtd. ~~rt OII/.. d[.) OO~R 4T rOwR 21 I~tt~nd~d tM ~a~N1 /roa~ 8~~~ ,~o ~ ~ •nI J~~t w~ A,'a~ ~/i.~ en DNtA octurnd ~t A a on tA~ d~f~ ~~~f~d ~Dw~: ~~d fo tM ANf o/ m~ anorhd/~. /rom tA~ uuMS ~t~t~d. •l 1 f a~~s ~ MOMwtY~[ (pry.et ~r eY41 tld ~OW~ESS ~7c. W?TE S~GMEO t• ' • Francis J. Carbonara,M.D. 5~3 ?th. St. 8-25-6? •ttr~~t~. ~ MJrY.CA[VO0~1. 2~ WT[ 3Jt M~YEO~CEr[TUY011C11[r~T01111 b/ IOCAT101~IGV~.M?~.MtM~~f1/ (bT~ftl R~Y (SYH~h1 Removal 8-2 1So7 Stanley FL.~eral Ho~e Chicago, Illi.~ois ~ a. ieia 2~ su~c~u oac o~ s sKw.nMC Ystl~"~IVner 0~6 2S DAT( 11ECQ lOCl? tti 11[CKTIUR'S SK~UTIME ~ "••.'o~e Saauel D. Steele Ft.Pierce,Flori a 8-28-6? Ilnna Lee Lenison, d.r. ~ y F ~ " , 5 ~ lhis to b~ i.rve and correct of tfie Lxat FILED ANL RE"v R E . ~ _ ~ ~i~y .~?W • ~r ~ $ ~ gT, ~uC1E COUN t k G g ~~tpjtttal's rioord on fik fn ~fis St_ ltxie Co~nty Htahh D~part- ROCER PGtZ1~A! _ ( ~ri~nt it FoA PiKp, fbrtda• CtERR Ciic~~i a6u11i ~ " (yy~re~p~ Nof valid w+~~ss raised seal of the St. luci• AEtOao vE~~f1E6 _ ~ . . cowKr ?+..Frh ap~tm~~t ~s ,ff~x.ci.~ ~ {~+r IO ~ ~3 1 r ~ . N. 0. Mltlfrt. M. D. CouMr iieaith Offket i loul Re~istrar ~,3566 ~ ~ C~_~ - . ~ p~ ~ Deputy ~oul Rpisttar ~ . ~ ' R 94 1784 ~ ~ ~ooK i ~ ~ . , ~ _ . - - - _ - -