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HomeMy WebLinkAbout2140 ~ ~ d~e~.J ~103 3 _ , ; . ~ , TA1s rr~T~ ~o~o o~ Ns~TM CERTIFICATE OF DEATH eo~~s a ~URtAU O? 1I~T/?{, tTATI/Ylp fTAT[ FlL! N0. '~s`''•°_ Fb08IDA ord ¦~~w DI tH NO. p~oy~~l~ • pEG1iTRAR•f NO_ ~ Zll ei~eVt~i ~ATM GODC N0. . =-~TL~ f/DtMCi(1lwn/.~dM~i, f/~ s~ibu.~d~iri~ •nd St, Lucie 66-025 F3orida 5t. Iucie e. *l•e•~ 1¦ C1T?. TOMM.OR LOCATION l. K MJ1CE Oi OEATN t. pTY. TO~/C OR LOC4TION t. K IIESIOEIMCE t~i.. ~ ••~~¦s Ft. PfeT`Ce ~ r~cs~~ unQ F~. F3.eY'Ce arr uwirs+ ~ MO~S~ITAI QIl (,I ~OMf NI?p~) IfMGTN OF 1. STREET AOO~ESS ON A FA~M~ ~*+T~ Ft. Pierce Mem. Hos ital ~r~rs 1810 Boston Ave. ~s0 ~ . j- ~ ~ ~li1Yt Zsi! WTE )/w~1? Dq YeM (~lr)e M ~r6t) ~ ourM . scx t oo~oie o~ iuec w,~~o ~?~vu w~ao O~- o~rc or wirN .r.~ t~ u.•. r~.~ou ~.w a~s. ' ~/l N~.rM Da~ 1/wn ~Yi.. t t • ~IDOKm ? aY01lCED •1tAwi' ~a. USYAIOCCINATIOM(Qr!'l1~f~M~?~IMt 1~.KI~OFtY511~ESSORWDYSTwY 11. WT ~![ME1ttfAEMl1d/! 1.t7~73J1~rINT~Tt twGy .wt yw?!/r b~r, ara (/~~tib) •~e~l~t o W ll~ek !ak 1~, iATN[I!'S M~ME . 1~, ypTMfll M~10E11 11AyE or t~y~~HNe is. r~s occusco v[~ w u. s iurco ~ccst ~t. sotu?~ sccua~rr Mo. n. u~so a s~ow?TU~c _ J. W. Yates~ t f.w r. wlr+~l Ul w~. w w~ rlr~ d rw~i A/NtN FYA1f\] 1~.'CAYKKKATN(itllh?~/At~ailtM/iat/r(s).(A1.a~I(t)-) 1q/fTaERYAy1ptE71RQ1 atr•ec•r ?•~r~ou?n~w~suusEO~r= 4~ jY'S.TM ¦u~t fil• IM~~~ t tA• e~r- tifie~t• ~yn~Ki~w.i/p1. pyf rp .itA t~• u~ 1 • e • 1 ~ ~ rosl~tt~t K~+N Ue rs/er- OYE TO . •Sth!¦ 7~ Y ~ A o u I• • f- ~ IMT M. O~tf~ SIi1~RYr 0010111016 ~IIIAMrt~IG 10 OEA1M ~Yt NOr 11EU7EO TO M 1[arYYt 06FAfE Cpa7+011 fi1@tA M/Yi 1(~) , wA5 AUTOISY c~r 1~it~ ~ rE1tFO1tMEW or b~t~r• ~ lrf5? Np - • at/st a~~ ACC~CMi SY~C10E MOMICI~ a0?. ocsu~ ?ar wuRr occuw~o. ct~ua w.rw~ yiy.r~ i~ Pwt P.rt t! yrrrs ita a~~p~~i- V ~ ? ? ~ mc. rrE os Nwr X~+1?. Dp. Yar . , ` wuu~r a. n. . ; `o s. w. ~ ~ ml. NWRY OOCYIIRFD 7Ar. rt.IKE OF uWIIY (t. f•. 4 M~Ml ~~I[. m/. GTR. iO~rK. Oit IOGT~DN OOUNTI/ STATE MfNIIE A7 O NOT MNILE ~ Ia~. /~f. r[?td. ~~tt NI/.. dt.l ~RX AT MO~K ' 1~tt~wdM rM d~oMw/ Irom 2~ Z , to 3~l 2 ~ud lut w~ h,~ a!i?~ on ~ ~ Duth oce~~rW ~f i: ~ A. _ m on th~ d~t~ at~t~d ~60?~: ~nd to tM bwt o/ mr tno~l~dp. lrom t6~ uuws ~qt~d. ~ ~Il lt~~• ~~~D ar• t• 1~ ~~`~TV~ ~~~MKM~MfiY 720. ADORE55 °..,1.:. • L.~7. panTilbor H.D. 80$ N. 7th. St.,~`t.Pierce, Fla 3-20-62 •e C11f ~t~. 1~. w~. QOrtT10 ~ 210. A~TE 23r. NAME OF CEMETEIIY OR CREYATdit Z)f. tACAT10N (GY/. fwna. M eMl~t~) i~tW) ~ur~`ia~ Mar. 17 1962 Ft.Pierce Cemete Ft. Pierce, Florida v. a. fsi~ t~. ruwc+w. ssK+utu~c ~ooRCSs . 2S. DATE RECO. ~Y 1.OC~l REC. RECfSTRAR'S SKMATYRE a•'.1°6s Joseah W. Yates Ft.Pierce, Fla. 3-2t~-62 Anna Lee Denison, d. r. ~ hsrsbf? osrtifY this to b~ a trw ~nd aorroet aopy of ihs t~ocsl - , RegJstrara +~ecord cn fllo in th~ S~ l+ucT~ Cpumy ?~ssyb p~~ . ; m~nt ~t ioit Pisro~, Fiori~, f ILEO ~AMD ftEC01t~E~ ; M?wninas Not valid unt~s ratsed s~sl of ths St. Ltrd~ iT. ~UQtE CD~MTY i County H~slth Orpxtnw?t b+ffix~d.) ItOCER P017RA! ,'".=1.: • , CtERR C1'.tCUtT COURZ . _ - Q4CORD YERiF1E0.~-~-.~- - . . • N. D AAILLER, M. D P~-~'~Z` ~ c~+~? o~ ~ c~.t A~R 26 ~ o~' : ~le~ 7 ' ~ 7,c. - ~ _ ~ . . ~ ~ ; Od' f~:f~i~ ~+n Loc.l R~~a... , ~ ~ , ~ ~ ~ ~ _ . . . . . - . ; F ~ , - _ , . ao~c ~ ~ ~t ~ - . ~ _ - _ _ _ ~ yL`i-..., ~ ~fi ~ . _~_^~'sY.__...... 49~°