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HomeMy WebLinkAbout1240 ~ - t (Q 1ti~ RECORDEp`Y ~~~~Q~i u~~UHTY EC~[. - RQeEu ~ t~~TR43 c«~~ , ~Q~R~ 223333 ~ RFCf~P,9 Y~+ = ~ 3 ; F~e ~ 3 PM'a~ ~ 2w33~3 ' TAI• N- . tTAtt wnso o~ Nu~rn CERTIFtCATE OF DEATH ~ ee~~• • ~Y11LAU OI ViTAL f/A71/f1C~ ' fTATt IILt M0. ' l•a•~ FL08IDR • t T N. ~~61 No. 396 pr~~~t1~ 1. KI?ts N KAtM COD[ NO. t YWT'11t{IKMC[(~i~rM.~dYr; !/~~r T w+a-tr.M.~~Iw4..rY.) •a~s~t~~ O01"~t. Z,uciE ~ 66-025 Florida St. Lucie i. ~ arr. To.n+.a~ wu~~ow e~ua os a.n~ e. arr. Tm.~.o~ ?oc.T~ ~s ~cs~a.rcc ••~~~~1 u~f~oE ~tv Iw~TL N~S~O~ GT11 4~r~1fT Ft. Pierce n:~ ~o Ft. Pierce ~ .cs ,w I. ~urc os ~a..~ a bqrr. «..w.ww? t srun ~oo~css +~osr~~iu o~ Ft. Pierce Mem. Hos . 3305 Rid ehaven Road ru?rs ~7nt ~If4Y~ lw 4 M~t llwr p~ Yer ~'i~~ ED M VAN DYRB ~TM Se tember 17,1968 . ttl[ t 00?0~ o~ wK[ ~IUKO 0(KY[II ~WRttO ~ Wi~ OI M~7N !~i[ ( Nv~ r uo[~ ~ rw u~aa„ ~ws. W Nrf1/Ml Y~W~ O~ ~I~w Xw ' r r+ t• F Cau ~oo~co oryoscco u. 17 1891 77 •l~l s 1M. usu~l oaY?~t~o~ IOW t1.1 N~ra~ M~ Ir. RMOa~Mrs+M[isO11 M0~7JIr ll. WTwf~c[ I~~tt r IM~M~ cMMN sw~aa o? ~w?r OOra~r~ ~ ' . i t l r- ~.rry .~wt y~nrtMl M/?. ae~ M ~MM~/) I Home Maker Own Home airfield Co. Ohio IISA - ; ~1••t f~t t rAn~t~'s ~urc 11. roTMt~'f r~uo[~ ~r[ . ' •r i Jake Houmel Martha Clark ~ ~ aoa~ xcwa.. ro. ~ . «.wn.wc w.a~» ; ~ 265-48-190 ~ a~+.~ • Ft. Pierce Florida • r.s...~ ~a s~wa ~r ~urn ~cw..h w c«.. u.r Ir c.~. tu. t~~d IIrtE11YK a[T11[[~f a r•~ e~• . riut ? oun~ w~s cwxs n. ~ ~ oascT uo o~n~ • t f l 1• wwcwR CM11t p1 Q •~f- • . _ ' r . tlfl~~t• ~/Yyy.i/n/. 01R TO ~1 ~ •tt? !A• r~ld ~w ?Yt ~ y,~ 1 • ~ • 1 ~Awr twut ? r~~t~s~~r rt'My W ~drr- ~ •1t~1¦ 1• ~d~/ uw IYI. 0{I[ TO (d . ~ ?AwT M. OtrY fINIKMI OpM~I~ Ca1M1RM 10 04TM wlf MW 11Mtp ~O M iUrwK O~Wf[ OOir/O~ MR~ Ir IYT I~~f . Ir~ 11ffOKr ?~r~• •f- ~ KYO~M[Of . t~f ~~~t~ ~ •f ~~~~f• ~O ~ .~r u~ ~ tOr. ~ 70~. o[x~rc ~aa wiwr Otcwuca (awa •~ev. ya~.?r l. M/ r M!I ~wr N.1 ~OC10[nT iY1C~ NOMICIO[ ! •~~~~~1- ~ ? ? ~ I. ' . T~a H..r M~d~, na. Ys.r . i aM i i 20/. NlYA~ OCCL~CO ~r. ~t~tt or ruV~r h~r ~rrt yv. 7q C1?r. TO~M. OA l0Gl10M COVMTr 3T~T[ wrac ~r ~ ~ot n~iu ~ .'•••.l•a.?r..nru../~. Yq...rc.I . • NOAK tT lqilll ! ~fhwl~I tM Newwl /r~a~ ~ . fo •wI M~t M~ A,w ~!i?~ ~w ' ONfA ote~rrW ~t w~ ~M ~tNNf ~Aw~: ~~s/ f M M~t e/ w~ lw~~NIN. /~ee ~M r~p ~t~t~I. ~ ~ ft~~• =L N~rMTYK~• 1 •r• t• N ~ MWk I 1l1 ADO~Ei3 ~ t7t. W7tS~Gr[O 1 s~~~l~t• • ~ n ~ ~ ~.1~ C J { •~~~/~t~.~ ~~uMK. XM M Z1t IYY[0/C[YLT(~Y0+1C~[MATO~~ i7/.LOG7q~ICY/.N1n1.Mew~f/1 I$W) f ' ~c~OVK IS 1 t f ets r ~ s ss ts. arc aco. ~r wc+a Rc~. ¦ a~sTUUy i ~?...1... ~ , N. 7th st . ggp~t. 19, 1968 , i ~ hanby osrtily this to b~ a trw and aonc~t oopy vf the Lonl ~ i Replsh~fs rooord on tik In 1M 5? Luc1~ CouMy Hsshh Drpi,r}. m~nt at FoA Pisro~, Florid~, (W~min~: Not valid unl~s nlsed ssal of tfis St. Luc4 ' County H~slth O~pa~tment Is affix~d.) . . : N. D. MILLER, M. D. ~ ti~aith OffioK b t+ood Rpistr~r 3 . ~ D~ D~pu~~ Loa! R~p~atrar ~ , 8fl~xsy9 ~~~.2~39 . ~ ; _ . r.~ _ . . - _ . I