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HomeMy WebLinkAbout1513 21~49'7 ~ ~ i LEO AMO RECOR ~ 21'749'7 ~ RocER~PO M~s~`~' c ~~EaK c~acwt oou~~ IIECORO VEt11F1ED.~...~~.. Tni. e~- ETAT< eowwo o? MULTfi CERTIFICATE OF DEATH ~T'`~ I 03' ~'T~ i ~°`~s • aUAGU OF VITAL RATIQTIG~ iTAT[ FILt N0. t i•a•l FLORIDA { ~ ord .h~n gtRTN NO. R ILTRAR'f NO. ~ , rup~rly ~ 2- YfU~I w[NO~Nt~1~~~rrrM.t I/"_'-.--. I.rd..r?I.r.~i.:.eir.) 3 ea~eut~d 1~~AC~ O/ OUTN ~COJE t~J. •nd •Ill t. ~M~ s. ST~T( OOUMYY D• y1~c~A T ~ L`T t € 1q y~t- A. UTY. TOWN.011 IOCATION f. .5 7~t:F^.`.r t.E+~Tri t. GTY. TOWN.Oi1 WCATIpM t. IS RESIp(IKE •~n~at ~\i•~ t~~Y l:"'~•:Sl UWO( GITY ~IMITS1 . rii.. rm I Y~S;•t ~ i ~ ~sq ?aD : OF (I/ Mt i~ ?Myi/1l. /w Wetl s.:drtwi lE1~TM Of ~ i. STn[ET AODRESS OM A MIIY/ ` q551~T~11 OR STAY iN ID ~ S ~ :NSTITuTqM n^ ~'Hti . ~ ~ES? NO . > -i- " 7 3 NAM[ 0I fLd .V~.iSlt Lut OATE XMJ? D~/ YfV . = D[CUKO ~ ` = i~r~«w~.r~ '~rZril~~, ~~FOJp ouT~ ~.8. 11 1 6 ' ; . , ~ S. SEX - 6- t0?OR OR RwCC ~ Y~MN.[D l, AE~[N M~I1N.E0 DAT[ Of N11TN ~6E (Iw Kw~ ~I U~D[II ~ ~U1! yrCt11 t~ ~itS. ~ p 1Yt Mtyq1 ~t..w Da. Ywn Yi.. , ~3 r i t• 1/ }A' MrlDOeE~'~.] DIti0~1CE6 .~~~i . 22 ~ O 0 ~ _ p l~ i n l~ ~a. ySWI OCC~MTqY (Gqt t~w1 oJaHt ~o4t IOD A~MD Oi i~S:NE55011 ~ND~STRY 1 L ~1ATN/U?C[ (3~ft M/MtyA [N~~~l 12. pNEl10I nMT OONMT~'f/ ~ • 1 t A y~ r- Irn~o woat o/ se~t~~I !+/r. s~e+ ij ~Kwr1) - ¦•p•~~ C~: ~rR-O~RATOR JAlpY ~~'r: YC.°.K Y.Y. L'SA ; - Dl~tk faY 1~. fATK[II~S ~YE U. MOThER'S Y~ipE11 MMQ ~ ? or ; - c~o~.ric~r USG:~T. U\OBT. I~J. w115 DECCASEO CY[• ~h 1i i ANMED fOR~CS~ ~C SOC~AL j[~„R~TY NO. IT. lM/ORYA • NOM~?TYt[ ~ ~r..............~ ~u.,..«........r...~...... , Ha.r~on C. Garrup , ~0 wu..N FT. PIERCE FI.~ . ~ u. cwuac or ourN (s~c.. ontr u.M pr, n.~ ~+i. aas ,~,.t ~~cevu ~cr,rcc~ a_ pua~r~l prS(T~NpD[wTM ~~RT L OEATN WAS CAbSED ~Y~ ` 3fr~eter "~*p~' ~ ^ ~ tll. IMM[OUT[ GNSC (~f '.:A..,._..L .,A~ . ~v3A~i:~ N,...ART - cn. e.r- tfflc~a• C~w[ubwa. ~J~~~. 1 pNE TO (D) _ . i t p c A• ~r?K~ ~x r,H q 1 1 0•~ 1 a:oit taru ) _ r~al~trar Kot~~/ ~~e ralrr• I OoE TO (r) ' l~~w/ t~~~s 1W. - • 1 t~ln 77 0 ?Al1T 11 OiMEA 54~:/~C~ GOMGi~OwS COw~7GM;T `G ~0:~(.,~TM ~1lf NGT Iltu~iiD TO Tw[ TfAYYMI p54S[ C01OiTUM G/Y[w W ~Mi 1(s/ MAS AUTQ1Sr ~ou~• F n~roarcryo~~ i ' c~r O~~tA S yCS? ~,piN or s•ror• _ a0i :r..s.ivi X,0 D[SC~~iEKJwu.1~11YOCiu~RED (6nra~~rw~d~*1W~i~P~rtlaPwlJyY~s!/.) ••t?es ~ ACC~OCMT SUKIDE MorK,nc •po~i- v ? ? ? 4 .oa •f `~~1~ ...1 20t TwE Of Hw• 1d~wt?, Dq. Yrd 4 - i~dl. u ~M3~11~ st. . o y ~ - W , = 20/ M:bll~ OCCLAIIW 7Dr ?UC[ 'vf :ti:~_iv ,,t. P.+~ ~ s'w~: La~at. 20/ UTY. T0~1IN.OA IOCAiqM CO~MTY ST4iE - wn~~[ ~T f-1 N~r NM:IE "L"+, ~ 1a~w. lcto•i. wred. c~j.~t a':).. st: ; ~ WORK AT NJAK 2i / ~tt~od~d tA~ d~u~~~d l~om _ . [o •nd /ut w~ w,~ ~G.~ on ~ ; - D~~re «cu~r~d ~r - m un M~ d~t~ st~NQ ~Do~~. ~nQ to th~ Lwt o! m) inorl~d~~. /rom tM uuw~ ~t~td. . _ all ts~~• ~y NCMATYR[ (Inyra~a:~:~ il~ •oDa[SS T2t. wT[S+G~[0 ~ •r• to _ ~ - ~o.v~•~• a P. Def`riest C~:::; Ct::;1~°'Y COGP.T KOUSE 2/17/54 •CCY~~L~. ' - 2.1~ &.n.~t CA[r.rw7~ 2lD DATE .:.k ~+v[:.F [._~r~a.PE~~-~Ar 23/ lOU7qMIC1fI.t~.r~.~rn.stjl tos~i . "`"~''~'.~~'~iI~:'~~_~1~_ 2-11.-0:. r':?Y FT. P:ERCE FLC'IBA ~-~Z Y.$.~617 j~ iuNf~K WM(~T~ SS+4AI11bR ai-'~~' . TZS i~1'i P[~J WG1111[G. 2f_ Ru.~iTRAA~3iw:AATvNL ~J~~v~' l . - :3 `.•.~oee ~:i~Lon W. B.ird z":. ~ 2-2~-bt. ~ An.zz :.ee Denisoa, d.r. 1 hereby oertify tha to b~ e true and corrax aopy af t'~ tecaf ~~;sner~ ~d fib ~t~. sr. ta,c;. counry Ko,~rt, u~.:r~- " mont at Fort Ptero~. Fbrida. (Warnir~: Nat vaJ~d unfoss raised seal of the St. Lucie County Fiealth Department is affixad.) N. D. MILLER, M. D. Coun Fieattfi OfficK ~ Lxa) R~gIstr~r / . : Dapuiy loul Reaistrst , ~ aa~~ 1~ ~15i2 ~