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HomeMy WebLinkAbout1606 ~ i ~ . CERTIFICATE OF DEATH . ~kpNwK~d ~k~~l~ awd k~•tiw~.~~dwli~o ~r~~i~r. lTATE ?IL[ NO _ ~~r~~~ ~w~~w~~~~ ~a~~u~ FLORIDA ~•~e OR ~~~Nl u~l M.a..r.n.~n....... R~GItTQA1~~ NO d ~l~M~fNNt INK OECEwStO N+?iw! .,oo.~ ~SEa O~TE O~ OF~tN o.. S!t M~Ilp~Opl f0~ ~ irS?tuuq~S ~ Wlllle• ' ~ Harper ~ Mnle April 17, 1972 l~CE ~ ..~~...r ~..n..-. ~ sGf ~.s~ ~ T~. tin.. • .~u ~«oe~ . o.. OwTI Oi ~i~iH . .c».~.. o• CpUt~t~ O~ Otal.. ~ t-, ss:::.. ~ ~ a»c.. .~.~t ~ ..w o..~ ~ .w~,~t ..w . ~ , . Negro 56 ~ June 18, 1915`. Palm Bench ~Il~. IOWN Of ?OCAhON CM DI atH ~ .r~.c~ . ~n ~ ~.nSMTqI O~ Ot11Ef NS~ITUT~ON M4a.( r ti ~,.w~ ~n n. ~ . . .,~~n . - . . - ~vo3 ~ ; , , n West Palm Bench Yes Good Scimaritnn Hospitnl St~tE O~ V~~N • ~U~~IEN Oi wnA~ CChiNltr +wwMEO. rtEvtll wutR~EO. ~SU~vwH , S~Sf . n . ~ '•n••,~• ; w~00wfO ONOKfD sn~ w. • ~~~b~~~~ ~ Florida • U. S. A. Married Enrnestine -~e.e oe~~.f~c • . ' .e: a.r.. SOCUI SEWh~v NuMlER ~USU~I OCCU?~1~ON a..~ ....o o~ .v~a oowe no~.~~. .ws~ O~ ~Kk10 O~ WSWESS O~ I~OUSpr ~..~o ~ ,r422-12-II32 . . Common Labor None ' .~~.~»<<.e•~.. y . . ,s c,.. • IEStOENCE-Sta'f ~GOUNIr • ' ~ r ' n:sae tm ~u.ns 1Sl~tE1 wNO ?~NM~tf ,C~ r OwN. OR tOC~liO?~ ~ L~~ ! ~ ~ ~u~~. o~ .a ~t Floridn Saint Luci~,~, Fort Pierce Yes ~~w 912 Nortfi 22nd Street fAiNEt N~.4E •~y r,W.1 ~ MOTH[f M~tp[N N~ME ~~q• r~tp~.1 ~~t• ~s Unknown ! Unknown • INfpRMwNT-HM~f MAKmIG AQpRESS -~fufe~ o~ o .ro . u*r o~ ~o.~, f••n. 7w, - • „~Earnestine Harper i,h912 North 22nd Street Fort ri~rce Florida ?ntT 1 p(~,TM WAS CAUSED iENTE1 prvlr pN( C~USE ~(f IMVE {W ~o: Ibl ~M kl; • ' _ _ _ . _ _`~~~~~IM OM1ft ~wO M~M 1~ ~rWO~~h~~~f1 . T. - _ • • Miliary Tuberculosis involving Lungs, Spleen, Liver, } u • • cS~it~'~ o. ~o..o~•,o....,..~. ! Kidneys and Lymph Nodes. ~ ~ + wr~tw G~re •~3~ t0 lel t ' ~r.eo~.f~ uw~ ~o~. - _ _ - - - s~.~~..c ~rt u..o:~ I ow +o u~ . ca«uowrc~ o. n~..c cwu ..fr ~ I.i ~ I - - - ~AtT M ~T?/[! SIGNIi1~ANl ~~NWl1~N$ co«O•~~~wS [O.n~NU~~~+~. M D~~~ti ~u~ wOr N~~rfD ~O a•u11 ~ o. ~AUTaS~ Ta rE5 ~f~~ ~~r~C~MGf CO~+~ ~ . ~~~f W..O 1 LDlqO .w Wt~~wr~wG C~Vf! ~ ~ _~~r YeS ~ w Ye3 ~ _ (t~op1~ 1 ACUDENI. SU1C70f Q! lOdE bf~M1tAY ..o..~.. w. •e.~ ~ NOUR . ( NO 1W NjUR~ OCCURRE~ 't••ry~ ~••r~ or ~.+w~• ~ o~ r.n ~nr • 11pMK+pE. OR Ur~OEIElMINfO ~ ~3Paub1 ~ 7oe ~ 7N ~ 7~ M ?M ~NJIIRr wi w0~ KACE O~ wlutr ..o.~ .u. ra~., ~.c.o~., lOCwtlOw ~.~en w~ r o ru . or. o~ ~o..., v.n ~fKO?. ns o~..o: o~..n uoo f~C YK~n. 7~ ]M G!'~ilfKwilON- +.o~.T~ o.. war« o.. .e.~ ..~o use s.. ~e~ .u.~ w ' ~ ao ~ow w~ ~ oE~tM Oee~u[D n.e ?~.ce. w +w rM~s~tuN T0 ..o...w o.. n.~ ~oo• ..n~ a.•~ .o.,. o.n. ••w. ro ny ws~ . ~nl~+DfO ~~1 ~ Or r~ twpr~lDW. OY! }1~ ofCl~StO ~~Or 11~ il~~ 7N M~O M~ (~~M S~ S~~qO CEtlYKwT~ON-rtEDKwt EiAwuN[R Ot COROr+fR oti ~~e .w ..ou~ os r ~»i otcew ~~.s • ..cw ne•o ' ~ f)~N~T~O"~ W ~Mf WO~ ~MO~ O~ •w~ ~~.~t5•...~`~Or o• ;,M~M.i... ~ ~ r07/N ~t •1~~ K`~• M CYMf OM AN Y~ wwp 10 '~f :~J1f 1 l•~•!D ~ c~ical ~xaminer 5 a~t i_~7 ~ 1972 9: 3~ _a M_ CElTIf1ER-~+~ME ,nrr p~ r~,... SK'iN I ~ oe~a~ ~ ~OwTf S~GNED ..»~+..-u.. H_ L_ Schofielsi,JL..~M,L).__- -h ~t~L_ . ~ ~.C~ - tk__`_4-24-72 H111t A SS- ERllf~f va~* ~ w s.ne ~ r.r tL ~ox 1196, 1840-25th Street, ~l'ero Beach ~orida- • ~32960 WRIAI. CffMATqN, REMpvwl CEMETERV p~ GREw~T(Nt~- ?~wME IOC~*~ON c•^ a q!~ s.•n ~ s~K~n . ' Burial ~~..Pine Grove Cemetery Fort Pierce~ Florida _ 'DATE o... t•~, ~ ~~Ur+ER~I ~+OME -•+~~+E ~rrp ~pDiESi s•~ar o~ e ti_ c~+• o~ +n.+. s+.re. i~r, - - ~ - Ap il 23, 1972 t,. Lee-Peek Mor u~nr 728 Avenue "D~~ Fort Pierce, Florida 33450 ii iWEtA itEC7pR- r ~ o~t[ tEC ~ a~it Fer.:O?( 15~ tN ~7M • ' ~ ~ 229~98 fll.ED AM~ RECQlIQE¢ ~ S~.IUCIE COUNTr FLA. ~ ROCE~ r^~liR~S CLERK C~~:i,U1T COURT ItfCORD vF~.4F1E0 MAr ly i 5~ PH'11 80QK ~O~ PACi 16Q5 ~ - - - _ . -