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HomeMy WebLinkAbout2197 22~035 t~~ r~,c y„rt - ~oQ A ~ ? 7d 6 Y ~ ~ ER?a f , RE40i D VER~ IEO~ ~ ~ ~1' f ~ ~0 ~ li~ii~s ~ ~ . ~ 4 t..~ 1~- KAT[ ~oniw o? Hu~n~ CERTIFICATE OF DEATH ~ ~ ~ ' ~i' te.•• c~ ~uwtAU OM 1IITAL rfAT1~TIC~ fTATt IILi NO. : r~ ~•t•l FLOSIDA ' ~•ro .~•w eintN NO. R~61 www•s No. or.~.rt~ 1. ?4?tt K W??M cooi Na L`swTCUS~~aast?••~.w.~.~.~ ~~w.~ ~...w...r..:..) . ~a.e~a.~ .•..i~l `OD11T St. Lucie ~_D~y ~lorida St. Lucie ~l.s•~ ! 1• ~~f~ C1711.tO0M.OA~OCATOII t. K K~Q Of 0[ATN t. OTII.TOMM.OA WCAT~011 1. 1! 11(3~0C11U I •~~~~t M610C rTt W11Tit tl6MC C1TY U~ r~i.. Ft. Pierce res w Ft. Pierce ~s p ~ a. r.~c w cqw b.r~w. p..e~.r drw~ t sTRUr .oacss ~ T,~~ Ft. Pierce Memorial Hospit 1 1905 N. 41st. St. ~ xwr[ /1pt XWk Lrt o~Tt ~(wM Dq Yw ~~i,~K;?+•n OSCAR T. MODINE i:TMDecember 4, 1967 . x¦ oau~ w~a 7. wuuKrt Q~cvc~ wwKO o~rc os wT¦ f- acc 1h K.?~ r uw ~.w u.x~ H wis. ~ w~H ~trr. o.w r..w x~+. . s. w Jan. 17, 1406 ~ 10~. vsuK occw~row tO..r tuwyw~ ~a. _ swow wswcsso~ rousTRr u. wrwucc taw.. A.w. ew.arl cnm a.rr m~wnn •~t~ Iwi,y.«tyoutwhk.wny~MVM) Contractor Huildin New Haven, Conn. USA ~l~~k t~t ,.y 1/ATN[~ f riW[ I~. wOTMp'f r~~Ot~ ~yr~ „ •r , Lenard Modine Ella J. Anderson ~ soc~u s~cwun w. i1~ s sw~rwu , wu..w u ~4Q-2Q-280 i~ ~l~C~ ~ Ft. Pierce, Florida • rrn.r.l c.wK N KATM ~Swr wy Ne Mar /e~ li~r M W. lN. sd tr)J wrc~r~~ KT~RtcM ~ h~ 1 r~ s N~ r•~r ~ oun~ rws uus[o w~ iI ouTw w .~~t [i~• w¦[w~z uwfc W c.. e..- - ~ ~ . ctfte~a• ~ ~ ~ ~J~+4 i Ou[ To p1 ' •!t\ lA• Y~ I• t a 1 ~Dwi twr (i1. ~ I s d tle ~wler• r• f~a?~• rrI f` .tc~a~ as ~ hiv a~w twt. qie To (e) •~~~r• •t- F ~ 1 O~~oSrWKrw , to RuIIf M1~arw~OWtt d10wI11efKy K~LORrtM ~ ~1 t~I r~~t~ ~ I 7'ES 1100 A ~~f~/• •~Y~~s ~OtqE~T i1NCb( Iqt1t otStayt ~ ~HMIr OCCW~tO. (6lMn a~tws yl~v~ 1~ M/~r M!/ ~llks UJ dt~~~~f~ r1 O ' • •t V ~ ~ 70t Tw4 c/ iM~r 1lw1~, DM. Yw? - ww~r a S ~ - , ~~Ot. ruu~r ouv~uo ~e. ?utt or ruu~r p. 's r~w b~r. 2D1. prr. TowR o~ tourq~ tou~Tr fT~T[ : - Mp~K ~T O IiOT~K M~. N~M?I. Mqd. ~e Of1I•. It.~ . . ~ _ . i =1. / ~H~wI~1 tJr I~ww~ / w. . ee ~wt /ut ~r~ ~~~ilis~ ~n ~ OwM ~eearnl ~f ow fA~ d~N ~r~r~I ~iw~; ~nI N fM 4rt d~y ~we~Nfp. /rew ~M uu~~s ~arN. ~ all ft~~• Y~ : .r. a• (o'~'N~'wrr~. l~? ttc.ans+u~co ; ~..~~.e• • - • ~ ~ + ' tY?~1~. ~~4_ «tt j]~. MM[ O~ C[M[T[Ar OR CA[Y1T~~ ~(~I. q~, Y/M~) ~a~h/ ~ uria~~'"'~~ . 1-7- 7 Hillcrest Mem. Gdns. Ft. Pierce Florida } r. s.~~~ a z/+~c.ac oa ~'1~ N. 7 th S t a. wrc ~cca ~r wc.i ~u. ~asnws , c~1. ~ u. t•..l~fs 1%;~L~ Ft.Pierce,Fla - 7- ~C?'1 ~ ; - , - 1 hK~b~r artify thk to b~ • tru~ and aoR+~ oopy af th~ Loo~l ~ : Rapistraft tioord on fib in th~ 5/ Wd~ Cou~tty H~aftlr p~f . ~ m~ft N FoA ?i~ro~, Fbrid~. - ~ ~ . ; lWitnlrp: No~ valid unl~ss nt~ed s~a! of th~ SR L~ ~~,y ` ~ Coumy HNlth D~partm~nt f~ affix~d.) . . , ; ( . , i N. D. MILLER, M. D. ; { CountY FMaith Offiow t~ Loo~l Rpi~ta~ ~ . ~ . - . . . - Qd~ p~WW~1~ (,pal tb~lan? ~ - 1 ' i soQK199 F~~f2i96, . . : ~ ; ~ . - - - - _ - - - - ------J , _ _ - _ _ . . ,r_