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HomeMy WebLinkAbout2954 ~ 218505 ~ C~c'~2T;FIC~TE OF DEATH Vey+AS'wl o~ f~~~itE ~cb~{.~:d~tne `e~ur. S'fAT[ rIL[ NO. j ,w~~w~.~w?~r_.~r~~ FLORIDA Slg ~ I~Vf. OQ iR~NT ~M ~Y°T°~•M1O REGI6TRAR'• NO. ~it7AAMlNf INK OFCfnSED-r+~E •:~f* .DwTE Of OE~M ~ rowiw, ~~q nu ~ ~Eu~wc~i~o~aa , JA.'^.:S L. RO~~~TS, SR. 1, ~iale DeCem~ez' 1, 1970 MCE «~cw. ..u~K•.. ~«o~.... ~GE-..~~ -.-u ~ • Owtf Oi ~+~Tti ~.~w~n.. w•, ICOtM/TY Oi OfAin Ou.J~ ~rt ~v~P ~~r.c .+uu+r..~s rr~ ~..J..~s -T.-1 ~a~ Of ~ t'~~lltg !_y~ 5"J ~ July25,1913;,~ St. Lucie C~TY, TOWN. W IOCwt~OW Of OfATM ~+S.LI C~-~ .r.rf nVSTi1A. OA Otnft NSi1TUT10H-N~1ME ~+o~ ~w urw~. ~M f~rt~ u+o ww~n ~ ? ar1::~• ~!t J~ w0 ~ : i t n Ft. Pierce Yes Ft. ?ierce ~iemorial Hosnital _ I . . - - - SiwTE O~ ~.~M ~ e wOt M. u~~~TIZEh Of wMT COuNT~I ,».wR.:ED. NfvER wuRRND. ~SU~VIVNG S1'OUSE ~ w o~n. ona r~+w~+ w~r~ ~ ~ ~a,,,...,; ;w,ooMco. ~~voQCEO.~,«..~ • Kildred Llo d ; ~w..~~~ao.ce ~ ~:110 r lis~~ u ::arried '~J! _ _ y _ .N~e aec~.s~o ~~-icw0 Oi WSwfSS OR ~WUSTlr F ` . .~.~o N o~.n. SOCIAI SECU6Ir Ml~f¦ -~~ISU~I OCCL/w'101v . a.~a or .o~a t~owi an~«o .w~ p i i = oecw.eo ~ouw uy. ne+ uu..~ a ,.,~.,~,.a...~,~ ^l 1 ! ;,»Automotive & Electric ; , ' .ewai.c~ w.oa ~~3 / ~26~21~1 '~L Sal~.~..,a7 - I~SWf?+Cf-Si~iE ~COuMiv C:iv, tOwr.. Oi :OC~t~On °t'°~ ~r~s ST~EfT ua6 KtN+~Et i ~ S/fC.I~ ~I! W MD i - , ,N Florida ;,w St. LuCle ~ :'t . ?ierce Yes 1119 Pine Ave . ~ ~ iwiME[-hww~f .,nr ~•oe.e ..sr i MOtnEt-~wwWfH M~w~f ~rsr ..~eou u~~ - + ~o ~y 3ernarn hOD2Y"t5 'foore - 1 WtORMANT-NMY . MAy~N.^i ADGQESS unu~ o. e ~.o . an o~ ~o... ?..~t ~ri ~;il3red Roberts 11? 9 Pine Av F P' ~ _ _ IAR( 1 OEAT// WAS CAUSFO ;EN':.t ~1'.:P CNvE :4~aE ~ff ~p~E iOf ;o;. ;ei, u~A ,~m.~~•. c..t~* •..a w•+~ f~ .:.~o..n cwu - ! ; 3 ' ;;;'fG/CflO?1 ~ c~ /!/•i• i • ~+`.t • : ~ 4 - e~rra-a: . ~s,..-~_~...- ; ~ ~o«e.,,o«~. ; l+, , - t_ t ti?' Gt~ 5 t'~ St' ' i e~:1-' i c... ro ~ tsl ` ' : ~ . . ; i~ _ _ ~io...e c.au .o.. a.i ~o. w~.~ .-`~o~...~.w..~ ~ , t _ r„ ~.o,. ~ ; ~ i ~ ~ ? ~ Iwti u Oirit~ SKla?~Cu~T COtrihTAtiS ta.a~,u~a .a..~~ .u oi.:~ ~..r w~ .o.r~o ro:.~a e~.v. .ui ~ w~ . wUiO?SY ~ 6 YES ~ne r~«o~..e~ c:.~ ~ i~n~ ~wo~ . a.~~.eo... ui~...~..~..o c.vsi m o~... y :w !c.`. ~w /:'J - ~S-oc.,ur~ c~o[~r. s~.~.'.DE O~-~bw7E ~ii~uWr , .o«r.. c.., .e.. , . r~O~a ~HOw u~W~~ OCCUl~fD ~ ~••n~ ....ww o~ ~...~n r.n . d ~.~r .n. ~ r~JY~C~i1f. Oi IM'DiStUUAfO . ~swuhl ' ]~q ~ 7q ~ Xw M :Oi ~HX~~~ A~ v`Olr T?.nff Oi w~uti~ .r .~o. . a•u~, ..er.w.. :Ch-.~?,J~v . ~uu~ w~ r s »o . un o~ io.., ~e.n , ~ f~~c~~r ref W..O ~ iONK~ ~.x . fK ~ Ve(.n . ~ ~ ~ ~ i 7~i - CtttltiwTM~N- .o.~w w. ~ w. .u~ .•w y. •e~ unn o+ ; ~ aolo~o w~ . ~ +re; at.rw OCCu~UD o-. n.e •..•SStuw ~ ' i0 . ~cxr. o.. rw : war ura a•!w •.w• , u.+~. .w. w si ~es* .n~.ree ~ - ? ~".:i u. r. .~.o~..w~ 7`• o~:e.a~ ru ~ . . . . ~ r ~ ~ ~~~1 ! N~ .~)r a{ )lOt~ I~~ ~J -'f' ~w ~o rw~ e..,s~.s~ ir.•es ~ CE~ii~.C~ipH-r~fDK~i Et~wnE~ OQ C:: ~~•.E c~ •.e o. u.~~ r..~ wceoe.r r•a .~o..ov»ua o~•a . ' e..~....+o. w •.r ~eo. .w~o~ •~.e :«.~ti+... ~ . , w+~w o., •w +o,• 5:,~ . our. occ~u~o a~ w o n...o oN w~+e C~VM ) srva~ . r' ~ l r~ 7h =l ( l~j 7.~ J ~ - CFti+i~E~-~NE mp M ru«n ~ -1 . . ~ S~;G~A71.:E . i. . / q~~~et o~ j,r.t 01~TE S1GKE0 ~.~o..sw o . ~w: - ~ 2 :1 ; ~ , :i, _ . ~ f ~ I%i n / ~ I`~'~.r' . ~ ~ ~,4 w r __1,.~~ ~ - .w.,rwG ~?DC~(55 CEer,il~ i - ' ' - r'' - ' i -j ~ ~ - - :1e ! ' ~ . . - - - ' ~ ; r - .,,t~A~. CiEM/~T1OM. tE~MOYti '-GG~t;tcY O¢:v~µw:J.r-r..wti !uX~T70?+ c~,. w ro~. • ;,,~~~Burial ::~1Zcr,~st ':c::. G :~s. Ft. Pierce Flcrida y - - _ p~iE ~..r+~~. w.. w~ ! f-nf~iwi n'v~.t-vww+t ~~.J a:,i.tt15 . srw~r a~ ..o . ut. o~ ~or., a.n, ur ~ - ~ec. 4, 19~70 ~a~c 90). ti. 7t~ St_ .~t.Pierce,r^1a.339~0 ! o. uee+•to ~r .oeu .ta~s~u? S. ~c L' ~u.fawi oaECS~ SK.~+•ruy~ -~i - >~^~•;~at _ - A~r. iV _ ' , ~r / ~ :~i:.E.'."'..~2:^ ~ 7.. ' ~ :s~ ' ~ / r t /--_T2~- ~ . v1L ~iiJn6~ ~ ' ~ ~ ft - = I ~.aruoy asrti Mis fe b~ a true c!~d c : ~ c : - ` ' ~ ' - ' d ~ u- R~ ~~~i~a~s ~cc~:stra~a record on f+ie ~n the St. Lucid Cc~~ry ~:;,.:..;a :,r;,;.,-t- ~~,ERR CtRCt11t C411Rt ~ ..•''f ~ . ment at Fort P~erce, Fbrida. RECORO yE4t~F1E0 ~ k (Warnirs~: Not valtd unless ra:sed u:.; c: t.`.s i~c:6 ~ 1 ' ; County Heetth Dspartment ~s arr;:.;,C.) g I2 51 P~'~ }Y~'' : ' , # ~ , , N. D. MIIIER, M D. ~~C75O5 . . C~ounry Healsh Of~:c~: u Lx.:: , _ p~~ Dopvty Loui Ragistra: i ~z ~ _ ~ ~ - aooK196 2~50 - s~_