Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1665
~ _ i~LED 4N0-RfCORDE - S~• IUCIE COl1~IT~fl~. ~ 21'759b ~~ER ~~w~ c~,~ ~ RECORO VFRr ~ ~ F?~A.:_-- 21'7596 Ocr 11 9 A~I #11 r~~, De- BTATE Bo~RC o~ Hu~n~ CERTIFICATE OF DEATH i ro~rs • BURCAU OF VITAL fTATIGTICY $TATE FlLS lf0. FbORIDA ^ °~of~~~~ BIRTN NO REGISTRAR~S th0 1:1~ ea~eut~d 1. •UC[ OI O~ATN iGODe thJ. 2. USUwI RCilO[MCf (N'M..s.sr.wtta.wt ii...~.~.r...~ ~t~.~..r?dn..a...~...) ` C01:hTY ~ ' a SiATC CO~~TY •"a 5t. Lucie ' Ct;-k~ ' ~lor~ca ;,t. Lt:cie ~ e. y~.e•e _ ~5 D~4~E W i:iA':~ L C:%~, TOi~'h.OR IOC~T~ .5 RfS~GChCE - in p~t- A. C~7Y, ~ONN.OR ~pC~TqN ~ ' ~ ~hSrJE i:TY 1~4~~i` ' { ~t~SiAE CiTY LIY:T$1 ~ r,~.. Ft. Yierce Rcral ~ .~s~.~ :t. P~e:ce Rural resp ?~0;6 ° = 1. ~?~E Of ~If wM ~w ~apit~I, rre ~lrtH tilrrt~~~ •.E~::Tti Gr , 6 STREET ADGNE55 • t MOSI~T~I Olt . ~ JA ~ fA~M/ } IA TIT T STAY ~I'' ' ^ ~ ~ s ~ ah St. LLCie ~'?vd. t~ •.oi ~t._ L~cie Blvd ~ resJ w;~ _ ] NAM[ OF Ptr~t ~.1Ia,1J:r Laf ~ TI 047[ Alpwll D~/ Yfa occusco ~ os ir„~Mw~.~, John :iZ;ia~ R:~h ~~•T~ 6 1 ly~^ S. S(X S CO101! OR AACE ~ yARp;fJ ~ AE~ER 7rAAA,fL V~ ~ aAT( Oi BIMTM ~ 9 A6E (!R tNN ~ ~~~p :i lT,',E~ i~ ~.AS ir~ J~rfAG~/) X~+W l~.w ` Nwr~ Y•. ~ ~ ~ ~ . .ale 'r~'hite »:ro~~~,r' 3-~2-1~93 ~ 66 ~ ~ . pl~inl~ 13~ ISc~COCCU?A~IONIC1:ttIq~J/LL'WtSOCf111Y wt4pOF8~>.~tSSJR~.~JI.S:RV~:; 6:~THP~~^.[iYatewjor~Wn~orw:ry) 12 uT~iuoi~w~tCa:~rn» •1cA •r- ~ p t~nn~j sut ef rvt~q ly'r. «t+~ r/ retod! ~ Prlnter ~ Y2'c3S 4 ~ates•r ? ~e Va. U,S.A , ~ilC~ 111~ «TN~~ S k~YE ~,SS V~:tifR S M1i'J(N hAM[ O~ •,r••~s~•~ .;ohn :vil3iam R:~a ~ nir;ia ':on Baber ~ 1S. W~5 O[CE~SED EY(11 ~p U 5. ~RwEa fOACES~ .16 $uwiA~ $~~~R~:Y AJ :7 INiORMANT ~ tICMATYR[ J t~~ . S4~.G~S ~ ' ~Yr. ~.irw~ 1I/ w~. nw w ~ tw. A r.sw~ ) Yes. k .:v . ;~1 ~ ~ea,~•• 'r t. -Fierce ~'la. ' Yun~~~l 1• C~Ut[ 0I Y[ATN (Ew~rr esii +qt cr~.u yir:ir,r fnr cz: ,:,.1 ihTERYAi BET:YECh _ ' dlr~eeo? •~pT i. 0[ATM W~SCAUSED ~ ~ . ORSET AND DEATti ~ ' IMMEDIATE UUSE l~) I~GT~C.~~~i3i f:::'O: T~-.C~e :'~ilTli.Le$ ~ ¦u~t t1~• _ * - t~e e~r- Clfteat~ Con~WOnl.~/aAi. ~ p~E TO ~Gi nLGc: ^v$.^,~f:: Cj~:.i s1tR t~e rl~[~ ~ars ~u~ fo ~t I s e• I aJue~ carie lal. ~ r• i~tr~r Naf~at ult reQ.- 6 q~R~ raw~ la~t. O~E 70I~i - - ' •f tnln 73 = - Ml1s AL7C75Y AOYr• O ?AAT ~I OTI(A SiGW1~µT Zp11pTlOwj Cp~TR:iN'.lw'~ TO CJE~~M 8,~: 1~y: FiJ~EJ'O TMC i4Ar.~Jll wSGX GJNCMT10w G~~[~ 1n?aAf i~~) _ ~ ?EAFOR4ED1 i•r a~+ce ~ - resv w~ ;i or D~for• ~ Pr~~D ~ R'3~ 2fi~ DES.:Aibf ~+G+~ •A:,,iY OC:r~~tJ ;F~a~O w~rrr ~(~wp~.r~ iw P~~t I a Ps•t 1lyu~.a r~.j •~kfns •n~ ~ ~CC+:.EhT SU~C;JE 1ct]M~C~DE 1 •Is~o~f- u ~i ? ~ .on oC J •od~. V~"~E Os Hor. NowM. py. )'to ~tiuwr a. n~. _ Q p q ~ = 2G! ~blU11Y pC~UpqfO 2!k PU1CE OF ,r;;;RY ~r. in •:r A~rr.r. ~ 20J C~TY. TO«b OA IOC~iiOh CO.;+eTY STATE ,s wN~IE ~T ~ nOi MH~~E ~ j la•w~. Iattc'7. ~rrett. ~?:r XS~ . r::-; ~ McO~K ~T FORK ' Z~ I~tt~ndeA tM d~c~u~d /1 ~ ~~~x . ro__ C_1;!-i ~f •~d t~~t aa~? h,m •L.~ 0~~`7 5 lTutA oeeur~~d ~t 1~ _ m on the d~t~ itatsd ~bo~s: ~nd to the 6~at ol mr knor:~d~~. from tA~ uusea ii~red •11 1t~~s tj~ flpNAiY11[ t0 0• (Ltjr(t o) tv.l~: . i2% ApuFESS ZT[. J4TE S.u~iD _ ~o.;~.t. , ~ichard : Si.^.not ` " . ~ ~ r'' . ~ 7~~ S. .,t'~. ^ort c::-ce 6-_9- t •eeur~N. . •y• . • • 23a 6~4 aL CJ~Fr~Tp~ jJ~ ~TE ~ 23[ \~yi ~F C[NL: E.~Y vr ~ FE V~~JiiY i jj( L~AT.JIV lC'M~, loYR.Y [OYe!)I 1~y4 . . " ' Rfr~i?~i.lp([t/~1 ~ L . i ':E:'OVG1 V~l~~/•~ ~.;,..1. `n :~•r2? I~2+~l•~c~t.Or~~ `~8~ t -r j S. ~61Z j~ f~Af ~~l D~~-EC~OII S S.G!~ATuME ~pGR(SS , 1. ~aTi RfC? iY .OC~~ PEG 2b. R[G~STA~N~S Sii.NAT4RE ` At~.17~A iiOSC":1 YaLes ~t.. ' ~E':"Cc ~..,1 i tlnn~ .T_.4@ . P.^.i~~.n~ri~r. = 1 hbtB~Jy OO~fif)/ fttll t0 b~ • f?t/Y d~ tOftbCt CG~y Ct !'."R ~.0:.91 - Re~istre~s reoord on fik in ffis St. Luci• G~unty Ha~lth Q;p,;;R. ms~~ at Fwf Plerc~, Fiortd~. (4Vaming: Not va~~~ unless raised ua! Qf ttoe St. l.uci~ County Health Department i: effixacl.) , z N. D. MILLER, M. D. Couny Health Officot b Lc~l R:,~:;irer , ~ ,+~ffGi:.t.~.1~ ~ ~ ~ . % , _ ,.L.~.~_. ~ ~ ~ / 0~ ~ ~ , ~oputy Locol Rooistrei . ; = ~G~K PAGf ~ss~ . .