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HomeMy WebLinkAbout1609 v 231$69 H~ ~ ...r _ • ; CERTIFICATE OF DEATH Dep.~.e.l .f Ik.id ..a ReL.bila.u.e $r..kr. sTwTC F~tc No. ,w.wcw c~s ~~sa~ n~ F L O R I D A iYtE. Ot ?tlNf IN ~~~~~R~~O R[61~TRAR'S NO. 176 ~ ~IIMANtNf INK OECEASED-NAMf ~us~ .~oo.~ ~~st OAiE OF DEwM ~ •o..~w. e~~, ~tu ~ - SE[ IWOIOOI F01 i.srwcrars ~ ELE.4i1G:2 CLc±%~~:G~R :Fernal il RwCE ~1~. MfOq. uY~K~w ry~r. AGE-uu w~w~ r nu '~..oe~ ~ wr OAiE OF ~1Rf11 ~~OMM. Mt. C01MTT Oi OfAM ~ ac. ~ wcr. ~ wnw.~ ~ ~w~ i .o~. ' rn wouu ~ ..a. n•~ ~ 6602 ~ «hi te 80 ' ~Dec . 23 1891 Saint L.ucie Crt11, TOvVN. Ot IOCA~ION Of OEAM ...aea cwr ~+un MOSniA? OR OMN NST(ft/T - ~r .o~ w anr~. u~re ~rru ue nwu ~ VNY~ ~~f W MO ~ ~~ort Pierce Yes r~ D. O. A. Fort Pierce ~lemorial llos ital , SiwTE Oi WiM ~ r ro~ w M,w Gi~2EtJ Oi vnui COUt+riY wUtRlEO. ?EvEt ~WbEO. SUIVNNG S1'Ol/SE ~r .we, o~n weer n+r ~ coww~~ wlDOwfO. ONOIlCE~ ~~nc~ ~ ~w..asoa.~n , Illinois ~ U54 u :~:arried Leroy ClevenQer .,~.eu ~ece.se~ SOCUI SECYtl11i MurIER 1lSwu OCC1Nw~~On ~ a~ ar.o a.au eow~ ou~wa ros~ a Kw0 Of ~USwESi OR WDYStt~? ~ eo. r w~w OCCY\NO M rO~lrO uR. MM Y Kn~H 1 ~~u~ti'~•°^~ ut';~available ~y Iiouse.vife ~x =:s.w~.u ~e~we ws~e cn ires SitEET ~t~0 NUWER tESIDENCf-Sf~TE COUNtt GTT. TOMfN. OR IOG~TION ~ v~c~r? nf a w Fl~rida ~~St. Ltxcie ~k:~ort Pierce i~o R 2 ~30.- 2= IwT„E~-N~wE ~w~ .wae us~ { /~WTMER-MAIDEN NUME ~ra~ +~ox~ uw ~s Jnavailable j,~ Unavailable ~wWlruai-~a~wE MArwG wODtESS ~s~nn w~.~.~. .w., cwf o~ w.n.. s~•w. ir~ Lero Clevenc-er S~n Rt . 2 3ox 29b0 r^t . Pier e Fla. 33~sS0 ~?1 luM ! My \IVY fAlT 1. p(AM W~ u~p /r: ;fNiff ONIP OME GUSf IfR lNE fOf (6~, wND (~N Nti~M Ow~lt W N~*w r.tww ~ ~~I 4s'"1~?.i~t.K,i' "Ll^'~ . • corsmo.f, u ~.n, ~..~Cw o~vt ~~a w 1?1 u..ea.n c~vs~ w~. we q. w~.s . co..seaw.rta o~: fr~nwp ue vw~~! \fIMO C~VN u1~ ~ ~ALT M. ~T I~ANT CO~~T~S: COr1MLOwS COr1~MM~Mfi p Ol~lw ~W MOT YuR1 M CYqI GMM w?Yt t ql ~T~ISY If ~ES rl~~ IIM01MG1 COM- , 1'ffJ~ (W~_ ~MOI «.e. MM qllWM1M0 4Y3t • Ib --Cj I* ~IOM•~l~~ ACGDE~,' A ~rwiw. 0~~, ~b~ ~ nOUe ~ NOw ~HluRr OCNeeEO ~l~~ wqMl M u~wn ~w ?~~1 ~ q~~~t n, mr ~ . ~ ~ ! ~ 1G M }Y ~i iNA!!t Al WORK MwCE Of arAr.~ wr. ~.r~¦, r.c+o... I~OCwDOH ~ srun p~.r.~. .w.. c~n u~wr, e•p ~ j 1 iHPA ~tf O/ r01 pw~ ~I~fi..lK. 11~lCwi ~ i ~ ~ ~ ! ! CEMtYiCwT~ON- .orn¦ r~ •w ~ .a~a w, n.~ uo usr f.. rriw~~ u~.e o.. ~~/a~o w~ .nr w outn peeuneo ~i we n.c~. w me j 1M~fKiui: i~ .O~m o.• nu ~ow ..n~ w•~w. ~w~n~ ~.rt. .w. ~o M~esr ~ ~ p ~ p .r aMO~/yDGt. OV! tb wn ue~w~. G 3 ! fl~ 7 I J~. ~j tU 7~~ . 0 M ro nq awse~s~ s~.ra. ` CERTY~UTq~-rEO~C~I E7t~wER O~ COtO~+Et o.. r.e a.s~s a ny ww o. «.u~ r¦e wc~a.~ .~s r~o.~owcte w•e E l~uM~1~0~+ p 1M! q0~ ~M/M Iw! sn~S~~WtOM. ~r O?.+W~.. ~OM~w M~ ~l~~ wOU~ € OI~M OC(VYfO OM M MLL YM OM b~t C~Vf~~1~ fT~MO. ~ M M_ 4 CERT{f NAME ~ W rwn [ S~C~N RE ~ Ot4w~ W rrt~! DATE ~ rw. w~, ~UU~ ~ t7~ ~ l~ w C. D CL~ F' ~ t1~ V E p? ' ? MU~MPI('s A -C 71i i[Her O~ ~.~.0 w0 C~ p i0~'~+ Y~R ry / - f ~i- .j . a ! Wtl~y. CtEMA~IQN. ~(MpYA~ EME7E~Y OR CfEANfORr-NwME IOC~t1pN an o~ p.r.. s*.n ~ ~ VKrr ~ Re~oval ~~Circle Hill Ce~neter 7« An oI I ' ~ DwTE ~.aw•, r~, ,e.~. fUNftAI NOME-N~~F ~v+D ~DDRfSS ~ suen o~ ~ r o. .ro., em w ro~... s~~n. to ~ ,y A il 2 ,,.Ya;es Funeral I!one. 3ox 777 Ft. Pierce F?a. 33~!50 ~ V. /6 iQ i~1 - 3EG -S+G+wi;;4f OwR 4CE~vfD IOGU ~tG~STU~~ R.~.197u ~ d~G. I~. A ril 4 1972 ~ ~ ~ 1 hereby oertify this to bs a trw and corr+sct oopy of the tecal Reglstrars neoord on fils in fh~ SL Luct~ Coun Hesith ~ED F.EGC~OEO ~ ~ mcx~t ai Fort Plera~. Florida. ~ ~ ~uuE c~Urtr F~~ ~ : s ROGfF PC~tT~AS ~ . 3 (VVaming: Not valid unl~ss ralssd seal of the St. t~ CtERK ~~.~uRj CouR1 ~ County Healih Departmsnt 4 affix~d.) P.FC:?h :~r` ~•~f X Z~ 2 l,~ P~'7Z ' : ~ N. D. MILLER, M. ~ - - County FNalth Offiar 3 Loal iZegistrar , ; = 231869 . • ~ ~ ~ 0~ D~puty L~oca! R~aistrsr ~ ~ • t ~ ~ a ~ ~ ~20~3 «~i6ti9 ; ~ ~ _ . . - - - - . - _ ~ ~ n - r~ ~ ~~:~Y ~ _