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HomeMy WebLinkAbout0004 ~ U , v ~ 222508 - CERTIFICATE OF DEATH Vep~r~~erl ~1 t1e~111~ ~od K~~.aL:li~.tf.rc $er~kes fTAT[ FIL[ NO. ~ inF. Oi ?nHr ~ u%%:'~~ F L O R I D A REGI~TI1AR~i No. 568 ?tIMAWNi INK ~A~_k~E ~yq~ t~s+ OA?E Of OfAM ~ rortw, ~W ~ SEf IYIIOi00[ i01 •N"K"°'a ~ EDWARD C. DOMI.IGUEZ ~ Male ~ December 13 1971 lwCE ~.un. .uow. wra~c.~. rwun. wGE-usr v..oe~ ~.e.e ~ w+w~ ~ o.. DwiE Oi ~IN ~ra~w. ~.r. COIM~itt Oi DEAiN !IC 1~IfCr~ ~ ~Nf11~~~ I fl~~ f df1 , MOV~1 ' YM ~~V 1 - . Whit~, 76 : i,. ~ {~Dec. 18,1894 „ St. Lucie s6~2 CIIr. TO~MN. O~ tOC~T10N Oi OEAM ra+oe ca. .rns NOSMiwI OR OtNE~ NST~TUt~ON- ~r rr .r e~nr~. cwt s~~e~. ~.e rwe~ ~ vecN. ns w ao , Ft. Pierce ,,Yes Ft. Pierce Memorial Hospital StAtE Of Mt1N ~ r Mo+ w,r.s ...t G111EN OF wtiA[ COU?+TRY I aMRtKD. NfVE! MwRbED. SIRr~vMG SrOIJSE ~ r.~w. oM r~ee~ wr ~ - cow~. ~ w wE0. ~ rac~. ~ ~ Spain . USA 1„'~arri° e~° „ Mary Lou Webb ~~,~.o ,~•~o r x•w SOG~LL SECUtMir M~WEa VSU~t OCCU?wt~On ~u.e a..e w ror oowe ou~wa rwr a Rw0 Of WSIwESS 0~1 InDIKt[r xcu..ee w •aawa .we. na~ n~uro ~ °s~,~w,~.• 6~. „ 266-Q3-4957 „ Mechanic Automobi le .:ra«u ~nae .w.~~s~o... ~ESIOE~-Sf~?E CdNaT~ GlY. 10vVN. O~ IOCwT~On ..sw un i~.n SteEEt N+O NIM+~f~ ~vecw..~~ a w ,..Flori3a St.Lucie ~,4 Ft. Pierce Yes ;14 208 S. 30th St. fw1ME!-I~AMf ~~lyr .uoa~ w~ ~MOTNER-11MDEN NM~f rrst rwpe us~ ,s Joseph C. Dominguez j,~ Manuel Haddras INqWANt-NAMf MA?WG ADORfSS ~fM~ft W~~.~. ~O. Cw~ p q~w, st~R. i~1 Mar Lou Domin uez ,,n208 S. 30th St., Ft.Pierce, Fla. 33450 r~n OEwn~ ww5 CwuSEO ~r ~[NtE~ Owr onE GusE ~E~ iwE ~Ot (e~, ~v+D k?1 NP/f~w O~NI ~~p M~ti ~ ~ y ..rwe uv~e ~ ; " ~e.~..e.~ > ~ -!4 f wr~-.r. za~a~ ~ ^ . w E , cowsn~o..s. •.n. ~ ` al_ ~ T ~w~CM G~q b31 10 ~ IO) J~~~~~ : :..j ~wnlN~t~ C~Yl~ lr, : f~~~~~+G ~r! Yr~~N- NM q. p~l ~ COMflWlK~ M- x ~ AIMO C~Y1~ us+ ~ , ~ . , 7 . ~ /wtt N OtME~ SK,nrtK~uai COr~pi coo cawww~.+c ~o Y~ W~ Mpt ~{1~RO q 4Vf! 41RM ~...ur ~ r~ ~f ~ES ~re~~ ~~+e~~os co..- g ~~v~~ wp~ M~l~f~ ~w M~l~wwrp 4VM ` . ~ W ~b~w ~ ~ ~1M ~ i* . fr..leW 1 wCC~SUK~OE p~ ~Ait~ ~ ro..rr. wr, •u~ ~ MOIN MpW IH1V!• OCCURtED ~~w~e~ wMe p ww~r ~w ru~ ~ q rur w, w~.. ~ ~ M~O-r~K,M~dE: Of Yr~OEIEW~MtO ` j +7k M ~ lb UI 7 ~ I~alUri Ai wORK ~iACf d w1UR~.~ wor. ~.u, a~nn. r.nw•, IOCATiOn ~ u~tn o~ e wo . cm w w~r, u~w ~ ° ~MK~n ns w~.0~ iow~ct Mec.,1K ~nt~n~ ~ _ ~ 'M , P~s CEt?~i~CwtqH- .~o.n. w. .~u .o..,. w• .w .••o ua. ~r .y.iw~ ..M w~ ooh~w~ •r. w ot~rw occuu~o .r nu wu. o» ~w ' ~w~lK~~u: Tp ~ ~'~A1 W~ ~lY WO~ Y1N OI~M. ~wOV~/ O~R. A/O. b M Ml~ F n. OtUw3~(YO~Or 12 2 71 ~r~? 12 13 71 t,, 12 13 71 n~ t~. y%M, o~~„~°'„u;°;~,;o' . CElTIfiUTqr~-r~EWG? ExwMwE~ OR CORO~+ER. o.~ Ns.~ a*.e ..ow a a.r.. r~e oecea~~ w.s ?~o~ou.KSO w..o ' ~ f~Y~Mw14~ O~ O1f q0~ nw0f0~ ~M wvtfl~Wlqw. ~w O~w~W~. ~ r4~M M~ MOU~ ~ Oln~w OCCWM OM Ml M~f AMO OYI b~Mf 4VSl~S~ Y~RO ~ ~ . M ~ M ~ CEtTK ~~~e r~w ~ ~ SK3 TURf qu~ nr OATE SlGn1fD ~+o.a.. w~. ~W ~ . ~V~°`iam~i. ~vieyer, M. D., FACS 12-15-71 ~ /wwMWG ADD~fSS-CEfittrtR s~a~r w~.r o.w - o s~.a . ~ ty r Fs ~ WRW. CRE/MTIpN. lMpVAI Tf~~ OR CRfMATORY-NM~f IOCAT1pN c~n p~ p.. ft~ry . ~ VK+~ ~ ; r.. Burial _~,.,Ft. Pierce Cemetery" Ft. Pierce Florida G,?Tf ~.owe¦, w., .e.r ~ G NERAI NO~.~( N~w~E wrvp ~ppRE11 ~ a*~e~T o. o~o . eir. a~o~~, sun. e~r ~ ' ec. 19 Bair uneral Home 901 N. 7th St Ft. Pierce,F1a.33450; Y, 5. f612 UNff iJK REGIS' -SIG~vwiUtE wR tEClrvEO ~OUi ~t4~Stut ~ ~ Qev.:9T0 -f-~ ty ~2 . 2~c ~ i I F~rsby p?t'rfy this fo b~ a trw ~nd aoRSCr oopy af ths tcal = Re~istr~s rooord on ftl~ in fh~ St. tuci~ GouMy F{erhfi D~p~rf. ft~FO ~~C~ ~EC~FtOED _ m~m at FoA Pt~ro~, Fbrld~. ST. lUC ~ c_•y ~i w T r F l A RCCE- : ~~'~t~1S : (W~rr?inp: Not valid unisu ~al:ed seal of ths St. 4xi~ RF~nF ~ Y~ ~ F~;T COURT~~ - County Mi~elth D~artm~nt is ~ffi~d.) ' ~ ,lu~ [1 3 28 PH'~'1 ~ - N. D. MILLER. AA. D. - ; Hwlth Offiow 6 Rpistr~r 2~50 - GoWr?t~ g : , ~ _ ~ Od~ D~xAy Locsl R~1st?a? . ~ _ =1 - °~ccK 1~ PaGE 4 , ,_i - -