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HomeMy WebLinkAbout2877 CERTIFICATE OF DEATH ~~1wnN d IbaM ~ KrIrb1Wl~Nvr ~en4w fTAtt PIL= NO. un~cw ~r ~w~ at F L O]t ~ D A ~r?t_ O~ •l~NI IN ~1tO1fT11A11•• NO ?l~MAIMNf IMR A~_N,~IM[ ~N~t rM~ r ~ pA A ~.O~ r •t. ~ ~ SEf IYrIMI 1M .snro~ , WILLIAM KNOX , Male , January 2. 1971 UCE ~A. M~OW. ~Y~K~w .wOUr, AG(-~~P w~w~ ~ nu y.a~ ~ w. DAi! O~ NRM ~.o..... e... COtlNtv W OE~iN fK ~ Wtq~ ~ M~M~~ ~ ~UN~ r01 ~ ~ O~~f rWq ~ ~M ~ ~ ~ White ~ 76 ~ ,Alar h~ 09A Palm Bea h CTr. tOwN. OR tOCwiWN d OEATN c~ u.•n qOSMnt OR OTHEt ~vSfR -n w~ ~~~•y 4M 1rM~~ ...o ..ww~ ~ s?ec~~e .ef o~ ~.o p3 V ~ West Palm Beach St . Mar~r' s_ Hospital__ _ ~ StwtE O~ WTM ~ u No~ w v s~. w~r~ O11IEH Oi Mnul COIM~tlt MAt~lEO. NErE! MAWEO. SUtYNlK' S'ONSE ~~~~M. otit ~o~w w~+ . cow~+~ w~DOWEO. Wr0lCEO , fncr. ~ , New Jerse • U.S.A. ~ N Fern Flewellinc ~ - - - - ~ ~_Ma~cried ~ - eo p~M SOCu?t SEtIM~r ~Rl~+JEt USUAI OCCINA?IOH ~u.e c.+e o~ .~w~ oa+e ovn.w ..os. w 1as~D iu M1SwE15 O~ ~~Knl~ xc~.ke ~wu~+c .~w. e.er u an~w ~ -,°~~~,~a.a^^ „202-07~1190 „ Interior ~ecorator „ _Interior [~coratinc~, _ - - - - ~ES10EaCE-Slatf fOUNiY C1t~, TOv~. O! tOCAT10N '~'~swe c~n ~r~n SIfEEt AHO HUWE~ ~y Florida ~.St. Lucie ~k Fort Pierce ~~..~~~No«p 322Q South~7th Street iAT11E!-N4ME ~~q~ .~Ope ~.s~ MOTlIEf--MA~OEN HAME ~~tf~ r~ea! w~ „ Unobtainable Unobtainable I~MO~MANt-?~IAME ?u~IM~G ADGRESS ~antp w~~ o..o . un oe ro~r.., ar.n. tr~ „~(~rs. Fern Knox 3220 South ?th Street- Fort Pierce, Florida 33950 ~~Ri 1 pEw1N W~S CAUSEO « ~f?+ifR O?rt r ONE C~USF ?Ee i~f fOt (ol. Ib). ~rrD :u1 ~IM~~M OM~1 .ns w•rn 11 ~o~.n c.us~ . - . ~ot R G/.~ , 3 v~: l c~ , • • M ' coNemo~s. rr~cw c.,r~ nae w ~ (s) l H ti• ~ ~ E +Z ~ F L r~ : n. y ~ LA-f~ j+ . - ~ ~-r _ ~rreou~e c~rs~ ~o~, ( o„~ ro. w .s . co..uow•.u a - - ~ _ 1t~hMG tw! vM0l~- ~ lfIM6 CtY!! la~i ~ ~t~ ~w~T ¦ OTHER S~G?~MK~Ni CONWT~Ot+s cw+ano..~ co.~nwn..c ro a.n. w~ .w. ~a.r~o .o c+~u ~+r» ~.o, ~ wsY If YES wne /~MOIMGS cou~ II LOfffD IN Oftl~WM~NG C~Nf! p Of~~¦ 1~ ~ 11~ p'~1~i: a ~»~El-fwW~E~ ! A ~ nOwiw. p~~, s~~~ ~ HOIK ?1QW INIUR~ OCCUflED ~ f~+a~ r+~rW! Or ~w~vh ~w r~p ~ Ot ~~~t n. ~qr ~ ~qMrqOE ~M }K ~k M lY IN1U~~ At WORK rIACE Of NAll~ ~or. vra, ~.c~d., lx~n~t ~ sneo w~~ o~o . c~n o~ ~o.~». sr.n ~ 11~l4n tt1 O~ w0 ~ OMK! MpG . f K ~ SMC~IV ~ ~ ~ ~ CEl1~ICAt10N- ..wn. o.• nu ..o..w~ o.• .e•~ ..o us~ y.~ ..r~ Mt~ •u+e o.. ~ M+aMrv~~.r nn oE~M OtcunEO 4I Mf MKl. 0~1 ~M! ~wri~C~~w: TD ! ..wn. w. nu ?oor •rre~ w.n~ ~~ou~~ o•n. uo. ro~we ~s. ~~'1er~OtC twe l p r~ aMOrt~OGt. OYt 7N otce•ua r~or ~ E C /'r 7l 'tq"'~A I? t~. 7A ~ ~ y/ / tu D. p ti~ : t4 a0 ~o m~ cwseo~ s.•.eo CE~iKwT10N-MEOKAI EXw~rEt OR CO~OWE~ ~o.+ u.s~s d*~.e ~.oue o~ w•n. r»t oecroe.n ~.s rwaw..cee w.o t7ArM~/Wq p M WO~ ~w0/W tM! untlt~wrpr+. ~w r~ bwW.+. +d+tw O~~ rt~~ ~Ou~ se~m occuato w e~e wa ..ro ou~ ro'w c.use~s~ sr.no ~ - - M , t„ M CERt1f1ER-w1ME ~~se w r~wr~ w~~e~ w Tme ~OATE S NED ~+o..n.. o....tu~ n, ~I.D. '~k / :k J. D. P.enrp, ?~.D. ` _ T." ~ ~ ~ MAtNG ADO~ESS-CERTIFIf~ s~an o~ c un sun t~~ 77i ~ ~ ~1A1. ClEMATION. ~EMOv~I fAAETEtr OR QEMATOR1-Nr?Mf lOU~10N c~n d p~« s~.n ~ sratw~ ~ ~ Removal ~Hillcrest Memorial Gdns. Fort Pierce. Florida OwiE ~ rawr. o.~. ~e.~ ~ fUNERl11 MOME-wAME 4N0 ~t00lESS ~ vaa o~ o.a_, cm o~ ~o~r, sure, nr ~ ~ 1 m- o US 1- Fort Pierce Fla. 33450 erno n i ~ec~sr~we y. 5. ~612 fIRJE~q - • ^ 1~ Rev.lY70 ~ ~~'L~.s~~ /I 7w - t~ m - z~s3s ~ FILE~ ANO RECORDED St. lUC(E COUNTY FIA. ROCf R POITRAS CLERK CIRCUIT COURT RECQRD VE~tF1E~~.... M~ 3 I 43 PN'1Z ~ ~ooK ~'0~ ~f 2874 ~ a - ~v: ~ ~ _ hay~