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Home My WebLink About1620 ~ / . ~ - . . ~ a~ ~uc E cou~~~~. - nacc~ PoirR~?s t,~ p ~ l, CIERK Ci;tCUIT COURt fi` c PFCORD VE~•tIEO.~,_.~,_, ~~~vv ' i. - - .~IM. t~ a ~6 ~H . _ _ _ i : . - GERTIFICATE OF DEATH I 233968 F L O 8 I~ A 'Twn nu No. ? ; OIR NO. REfitSTRAR•S NO. i ~ 1. PLACE OF DEATH co~t No. i USUAL RESIDENC6 tw~..re.wuwa nrw~r.•ww.e.wrw. 4 COYNTY AATfi OOYNfY ~ .`u~wt. ~ Florida- St Lu~-ie ~ ~ b. c~tr rn w~+. r.u~ ..a. sus~ra c. t~lisrn oF a cm nc .r.w ....w u.~+.. .~a. soa.w : ; ; sr~r i~ D To°wN . . Rural .'lnkona - ~ : FI?Ll NAM OF qf rt 1~ MNVi w~ d» Mn~t dirw ~r Mew~ d ST~EET (u ssL st~+ l~aNr1 ~ ~ ,INSTITUTIO ! 1 J7 • ~ P ~DECEASED ~ (rh~t) • L U[wdl.) (I..t) a. ~Tfi (Yo.t?) (Da~) Y..r) I , W o ff'trM ~r Pn~tt w ~ DEATN S ' ~ ~ i. SE7I OOIOI O! 1. MAIUUEO. NEtlER MA~RIED, ~ CATi OP N[iN , 1. AGf ~ta a n nw n~rtu~ ra 3 1MIOOWfO. DIYOtC~D (y~Itj1 1rt NRW1! 1t~lY 114~ H~a~ ~ 1f1~ ; v . ) IM. USUA! OOCUMTIOWWw Nd d wd IM. KIMO OF WSINESS OR Ili• 11. NtTHIIACE (!w~ ~ Nw~ wtr~1 d712EN OF WHAT , ~ ~r A~r1~ ~t d wA1y 11h~ w~ Y ntfw4 ousrnY N ~ Sr A , , ~ ~ t!. FAiHER'f NA1/~ IL MOTHEt'S Dd~l NAMi i a ~ i ~ ov ~ o. ia wws oECEwsEO iN u. s.~uwco FoecFSt i~ socu?~ sccutm n. iNFOwurrs s~uun?~ Y A 1~ ' n n ~ a....~..~.~....~ w,..sr»..r.rw».r«.+r.~ No. wc~aESS ~ oTthl _gto , . u ` '~w .e,~ M 1~. CAOSE OF OEATH MBDICAL GER'fIRiCAT10N . ~~wvw~ ~sn?sor ~ Eats o~b~ eN 1. DISEASE Ol WNWTION , ow~r w~w aun~ 1 p foe (ti). DIR6CT~Y 1FAD1lIG TO OfATH'~ . i~ ~ ~ AqT&~If GOS~f t va ~tAtr ~w ~wt ~t~ ~[~riii wrNti~~. Rf ~ w~iwlDOi TO ~ r~ ~ t~ twi~ N~I• riN N W~MM aw fN abb . ard ~ Lrrt 1s~a~ a~ p w~M~. 1~t ~f. ~ W ~wJniri~~ ~wM iK WE TO e ~ ~ ~.C ~ e~Db«~ r~ t~ t il. 01HE! SICNIf1~JIM COHOiTiONS 1 co ~ °f~ C.wJiww. «.a~suy a u. i«fl? ire wee ~ t~ t~e iNaw os~ditiew JNti. t b~ DATi OF OrERA• H~,. 11AJOl HNDINGi OF OfElADOM 7R AUTOKYI ~ 110N i o ~ ~ ! ~ ~+ww~ ~a«+a~ :~k nw~ o~ iwu~nr c.~..,.,~..,.~ 21a (GiTORTOWN ccouNm ts,~„~ ! l1~. wtc~ooR Y~. Oa*. trres. wnR rr ~Yr.. da) L~.1. wa iIIYLI ~ ~ . a w~aot ? ~ 21~. tt1tE pb+~i Wv) 1trr1 l8~ 21w INJYIY OOCUtiED 1 14 D D U ~ ~ ~ ~ Ii1J{IRT ~ ftltY~T ~OT~nlu } ~oe[ ? ~i ro~s ? ' ~ ~ ~T. t Iunby urliJ~ tl+a! I atlseded t~s doeeosed /rosi~,q~., 19~., to o%_, t~j2~ ~e t lau ,a~o ~ d~ceosed ~ , ~ aiive on » and ~ot deatA oayarr,d ot~~~~ ro~ ~Ae caaaw a~d on the date atnl~d aboue. - ~ ~ ll~. SIGNATU e c~.s~•..• aw~ nou~ss »o. a?ns~u+w ! N • , 3S D Ft. Pierce Fla 2 , 21~. ~ U R 1 A L ceEw?- rs. a?rE wwE oc eFxErEar oa ea~w?TOtr ~w. cou?non ~aa, a..a~ ts~.~ t $ nor~. ~or~?t ~a~m~? ~x # G e ood Trenton Nea? Jers . OATE RE~'O ~Y LOGII REC 'i SIGNATYti lL WNEML DIRECTOR'f f16NAiUR[ ~ADDRESS i ~ ~ D J W Y e Ft Pierce Fla r ; ~ h~rt~r owrify thi~ a b~ ~ t~w ~nd aoerw oofry of tt~s taai ' . itepkt~r~s noord on fif~ In tfw St. Wd~ CouRry Hsshh p~ef. ~rNnf ~t FOR Pbro~. Fbrid~. (YVirr~~ NOf valid Ynba raiied Mal Of ft1~ St. l+IJCI~ i CourNy H~elth D~tm~M ia affix~d.) ' ; ; , . - . - • . ~ ~ - . N. D. MILLER, AA. D. . CourMy H~alth Offiow i Loo~l Rpi~tr~c - . , - ~ ~ ~ ~1hfr~? . - r 1 I . . . _ . ~,f . ~ . • ' ' 1• . . • T ! , • ~ ~ - boRx 20~ ~~~.~6i9 - ; ~ . ~ ` j F , ' ; ~ ' . _ . _ -~___T.__ " _ ' . _ ' " ' . _ ' ' _ - _ _ ~ ~ ~ y . ~S - ~ - _ _ - ~ t",,'~~' ~f s i F ~ ~k-.~r"~~..~~~,.~~~~w~C .s ~ " 'v^?,~ - ; - ~ '