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HomeMy WebLinkAbout0436 CERTIFICATE OF DEATH .t~~ , Dep~e~~twi ~I Ilerlt6 awd Re!uMlt~tlhe Cer~ke~ RATC r~tt r+o. ~~O p~uttrr or~ ~n.a.n~ F L O R I D A 9~ Tv~(, pR ?RtNf IM "~'~MM`~n.~n° 1~[616T11A1M3 NO. t •lRMANlMT INK ..o~,e S'.n ~DATE OF OEATN ~ ~o~TM, .e•~+ DECE ~4NE Si! tlit::^^I Fnt A'~-• • ~ AS7'C'~K , * ~ ~t Fe~^ale JanuPry ?_5. t o7t Doroth S Staf.erd , RACE r.nq. rfGq. ~~I~KUa ...our, AGE-us. ~•,n ~.e.~ ~ ~•.r.. r w• DAT~ W f'R!N ~.oK~. ~COU"1T/ Of D:AtH ' . . ue. . s•ec.•., ~.~.~i~ ..o~. o..s ; .cwi+' ~ •+~nitc t~. 71 's? ~ ik Oct. 8,1 899 Ir. dlar. R~ocr fy v ~ ~RV, LOWN, 0? L«ATI~N ~fATN ~vf'-~ C~n t~~~+f ~JS~I!A~ Qt O.N:Z hSi1~UT1ON-NA4 i~~ !~Or ~w lrrN~, 4n! 1 M~~ ~rD w~t~ ~ /.Y` ~ VlC:~r ~!s O~ MO ~ , ~ Sebastian i:o k 881 Dolores Strce+: 5!w•E Of s'~M ~ M.~0~ w Y.f.~., r~! OT12M O~ K'MA! CO~JV'2'/ ~ MAf<<'~. NEYE7 MARY'C~J. 'SiiNN~ S~OUSE IM tt~~. G~! MCi~ w~~1I _ ~a..„.,! ; Wqo;•;o. ~:MoR~EO ~,•~w~ Harr E StAf f ord ~W.i.~~~.~, . ?~er~ Yor_~c • L'SA „;•:arried y • ..e~r oeu.ua i ~~.~s a.~w SOC~wI SfCvttT~l MJwDER USUwt OCCL•ia`iOw ~a.e a..e o..~c~. eo`i eu•,.o .w• o~-~~iCMD O~ WSt`~lSS W It~DVS Rt ce:~ae ' . y.ow..e u•*, e.e.. ~e•~na • ~~82-~7=2922 Hcuse~..'i:'e At Ho~^e _ a. ss o~. t!S:DfYCE-S7wiE iCOU!it'I ~ndian ~C~+v. i0~'*~. Ot lOCw1rOM ~~~tye tm ~rm STtEE~ IV1D N9MlCR ~ i aht. • •n o~ .w ~1 } L'-~ Florida Rive~ ~~k Se~~st' an t~~~ No 8$1 Doloxes Street s : FATh~R-NLM: r~~L ~'0.Yf uf• 'yO~"L[-MA"Jf~IN~IV~ r:ryr ~.'Y!~[ V.f' ~I ; Eenrv S. St~.r'~c l~~ry P~r^~P! ee ~ INfQiMAN7~1~t~tME ;1~A4NG A9DCcA u..ev o• . r.•. ~+o. or• a ro-~., s•.n, tr~ • 3arrv E. Stt+ffO±~cl '~n8~? Delores Street.Sebasti~n.F1c~.~295Q f r~v- ~ D'~M wA1 UUSED ~v: 'EV•_i Ovlv Q~f e.:s~ n• e•.. ~o~ te;. ;ee ~w~ '.e:..~~ o..~::.~ e~:•- i r+.n•.n uvsi ~ _ ~ r L~,~~; ~ t~ S r~ r7 -~l~~a;~a f; ~ t? n L; L r~ ~ f~ l,; ; . ~-a-s~-~ -rr-~~,. ; .wMMt~OM1. 11 ~M. ~ r'I ~ I , •cr G~.~ ~~ft q , r~fDi~~; C~YfI ~ bdl W. 01 ~S ~ CO+)eOVl~+Cf O' ~ ~~~t..~G w! Y~+~~~- i•wc c•ust ~•u ~i' . ~ ~I ' ~ ?~tT n OtkE~ S~C.+~ViC~wi CO~+O~~!O~+S: ewo.nw~ co~e~~~,~.e ro ee.+~:•.o. ••u•~e •oc.u+e e~~. ~ r~+• 1AV?O~S~ : n r!S ~r.r .~..e•+of ew- p,,,o~ i f.p~4D D!~l~+~r'+G C~-:f• ~ _ * w oe~.• ~~1A 1~0 ~ f w',ni 1l+~\ r~~y~t O' ~'~1J~ 1 ~ O~ ~ ~•f~ ~ ~ p-~:e~Y~ ~Cb~":. S.'rJ w tN:~ ~~w•+. u.. ~,MOw 11fJUt? OCCI'RRED ( ~r_w:ccs. oa vc+'rcu~~vi~ - s. , _ ~ 'v«.y, I~ M ~ rNrJt~ wi wO~C :?uCf O! wx'~r.. w+e. s•an, ..c..,... + tOUnO~+ ~ sven o. ...s. ..o.. em o~ .o~.a, s•.•. ~ ~ ~ f~lC•r~ ~t) W ~O~ 'WK! ND~.fK ~1MC~~~ i I?Or CE~1HKwitO*+- •o-.•+ e•. .e.~ ° o.• . .~o e~ .t~ ..~+t a+ ~ • w~or wr..tw ~.e~ De~~M Otcuw~eo r.r ~u:e, o. ~M~SI~'AM~ • ~O w ~j R~~ ' ~OOt ~Il!\ Ol~M . w':'J~ • „ D~•R. 7 •^lr0f0 tr! - t~y ~ ~ ~ ' ~ ~JY7. ~ ~ / ' : N o• ~~Q~'!Y!• D'• , r. ~~«...o ~.o. ~ f r~? ~ r n. j~- ~ r~~ e3i d it•.1~ t ,e ..e C°_~'~°:U!!p+-MFDUt Eiwar~uEt OR CO~`; o« -.r ...,s a•~e .ou~. p G!~•K ••wt OfClpfrt MOMOvMC~D DI~O ~~u~r~•~O+ W M ~00~ ~M'O~ ~M ~ti.firz.~r~Ow t . pr.r J~.. ~O.nr •f~~ ~O/"• ,I/'~ s ~ . . • of.'+ OcCU~~eD a+ o~tt wo ~t~ q M Uvu~sr at~•to ~F ~ " ~ ~ ~ ! i ~ J M M t~ • ' ~%:;s•si_NANE ~n4 O~ n. 9 : 5'GYAT' ! 4 r we.re o~ .•R~ wTE S'G~E~ rc.~••, o.... Phl? D. Iro3`aatZ r.+ ~i?s !_/-r'`l.~ / N. D. n. 1-2~i-?o7,'. r.er o• . ~ »Q MAIIIYG ~PJC~SS-C /"i r T"+~ •o~• s~.•e e. ~u ~ 8~ 2Sth. StTee± Jero'9e~~!~. : I~. 32 60 ~;,:~Al. G~:VIAT:ON. KMClYAI iI:M:Tt~~ l72 ~i:A1ATOa~-h<V~ .iCC/1:IO.'~ . C~•~ 4~ ~O'.~r~ !~~!t ~ yrC~n ~ t~. ('.~'s;~f3t10T1 it~+ Centrzl ~"~2. Cr~Ta~o«~ `h•inter D£:T~~{s F~2t~• - ~~'E .c.n., w., n.¦i `fUNERAI MOM.E-hA V~ ~~.D i~~+~(SS ~ s...n o. ~.r e. +o., em o..o.r., s•..e. i•. ~ - L rK '1~2~~1 ~rs.~'r-.ri~~srnr%~_i3nl~t•..1h,1QKn 7~}1?~.~~°2'O ,~CQ:Cf'l~FIE?.~2~~~ V. S.IJ~? ~U'~E~AL D'Q"!'C SKsNI'U~E :E:+.S-i~'-~.~.'~1a';.'Ch'_. . ~ IDA'E afCf~rtD ~r JC~L ~~G' ! RtY. :V•n 7~~ C ~~iGV~_.(ti / / • /`7 r r. ~:y~ ~ ~ . . ~ ~ ~ ~ "Z hereby certify the above to be a true and correct copy ~ ; of the Local ~egistrar's record on file in the Indian T= ??iver County Health Depart.^~ent at Vero Beach, Florida." ~ < ~ ~ , This is not valid unlesG t!:e razsed seal of the Indian ~~~~o~~ ~ h~ :2iveX County Health Depar~~ent is affixed. ~ ~ ~ ~ ^ ~ T=-'~m ~ . ~ 1 ae ~ . ;,r ;f ~ ~ ~ ~ ~ ` ' ~ 4~~g~ ~ County :'ealth Dir. Local Registrar ~ ~~~i ~ ~`t ~ ~ f . ~ _ ~ ~ ~ ~ _ ~i c.,~~ ~/C3iy1~ . ~ ~ , , Dep~ ~y Ze^;_s ~r<-~r ~ _ - ~ ~ , W 4 ^J~: ~ ~ ~oT ~ ' DOY11~ fAlll ~ ~ f ~ n rr • e ~ _ _ . . _ . _ _ - _ - ._,L'~"' Nr r