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HomeMy WebLinkAbout2763 ~fi ~ 2~30605 . ; ~ . i AATf M~ • I~L1M O~ OEATH w.M~ M raw wwi~'~!A ~LO*iD~ ..~.e nas .w. 6~ _ . . , ~ ~M111; . - _ . . . - ~ ~ Mw~MS/w..~rM..: uq.~r.n.d~... ~..r..~w...r.~..~ ~ ~ a~ida uival . ~ a .aw~ s. o. uoc..~o. K asec~cc wrs ~ JactadMll~ ~ c~.sr~wl~f.lii~+~+M~Y+~+ a slnaT.n.ns ~ ~ - 205 Ri~er Hilla Rd M~~~t~ MIi tw ~ an 11h.M ny Y-.? c~w~Ti~~ D. ~1 ~r mr~ lic~7~ 1969 ~IA: !;p _ y~~ ~R~M~ M~t O/ Mt11 ~st ~h ~ +wt~..ur ~ay Z 6~wMM~ r~r. a.. +r.... r.. • Nal~ Mt1tA wo~u r.o~cm J. rw.? oawTn. r~ wor ~.a~so..~ous+.. ~«~tv~.cs ~s.r.. P••w a..np cros. e. ...t oo~. ~ ~ C~~ 1~' wra V wir~A conattvction ~cntroae 3. D. USA nt~as ~rrt ~ s Mam rrt Diar3d C. Aossar Nellie 'iae Kiser eocw xcYrt~ ~n Mw ,w~. _ Hrs. Ethel 1~. Roaser ?05 Rivsr Hilla Rd. Jackem vi?' e Fla. t~ ~~Mt M~T~ we ewr M~ ~r}r W. ~ai.l - ~rre~ra K•su~ , WT ~ Op M~1[M`~CMI![ W ii~f~p 04S17 u'+. tt~•. t • ~3C~^---~_ _ _ _ _ . . . . . ' cti..w...~~.... ,o a, _~e. of_ aqterior wall_of left ~eatricle ~i 5:w' M.'7.£' r~~., a'`'.~ ac .o iniaratioa of left ventricle n ~ - - - - - - - - ~ w~r s aw s~rw aa~naa co~wwsr w eum wR ~a wu~ ~o ~r n~r~ oeux tar~ cwn ~ rr~ M~i ~~s a~~ors• rtro~+ec+ a~ - rs ~ , KSV ~OG ' ~OdOI~T SYK~Ot wDht~ ~ OtlC~1t ~ YUU~r OCtc~iltD fl~M Ms~ ~I ~~r/ q PVf I M PIf 1I MW~ i~ ~ r b ~c TY~I O~ Hw? 1~~M. 4. YII . ~ - ' . _ ' . . _ . ?O•7 ~ ~~r a~_ _ R rM1f OOCYMtO ~ KKt Of wJtAi a. f~ r~wt V r. iy CAti. 7pr~ O~ tOUiO~ Cd:tin ss ~ ~ ~ O ~Mt ~Wt. trMf. ~p Yy . ~tt : , . ~ tW .~.10 ~Mfw1a~~ ~w ~lmow W ~~w ~M Ar~ RNN~+. ~wf b fM Wt M q lM~4IN. b~wa eM uvs~s ~r~e~! t~~• $ ' _ fb ~as ~~qTB~~ ffi~• $ il~ o~n s~r- ~••a ~~/S/MM', MR O~C[rtit~?OII[~I(r~ro~~ e iia 11J17~VJ , 2Y lOGOOn l(Yt. M~. ~ ewtN/ f3~n- ~ ~ s 21-1 Oaiclatin CeweLe . J~ck~mville Fla. ` ts ls wa rco.~r};g~y •IKCar~u s sw +r !~t $t.P6@t, " i ' . • t M1 ~ ~e:~ 'tt~1.;;~ ~J I hereby certify the above to be a true a~ °}7 ~ on file in this office. ' ~i~rt~~ the record OF 1~ALTH. WELFARE AND BIONEHVIROt~3~NTfAL~s;tai ~ e~ ~-L o~•j~~e DEPAR'Ti~tE:~iT ' OFPICE OF VITAL STATISTICS, JACKSONVII.I$~, J= ~~Sfi~ "~C ~~'TH~ _g~ ~ ~'i~`~' { • ~ : ~ 2S J ~ - } ~ • F i Divi , ~ ic Health ~ ~ Depu[ egiatrar F ~eo ~NO aECpAp S~.lUC1E COUNTY i . R"v_:i ° ~ 11-P.AS l~ CLfRK ~~:~~U~~ COURT RECORC `~E~tF!:0 1 9 36 aM'71 23~05 ~o~C~~ ~?c~2~ ; _ _ .s_ , . ~ E~~