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HomeMy WebLinkAbout2621 . i : ~ . < < ' Er 72-1 ` ~ 7806 ~ 849 • ~ ~ C U ;,3 O ^ ~y ~ ~ . f.l i v ~ l - DADP3 COUNT`Y ~ _ - .F - . ~ , , ~ ~ ~ f DEPARTMENT OF PUBLIO HEALTH ~ 1950 N. W. FOURT6ENTH 8TRBET MI~TON S. BASIAw, Mo. MPM, f - - - - DIRECTOR ~ • • • • MIAMI~ FLORIDA 33125 ~ ~r.~s ~ an~~o~r w~"~~~t~~.~~~~x. ~ M i~K tWMIY Rp~w ~ _ YLM~ ~ - \ • ' E. B. LEA g~~ ~ ~ M ~ • ~ss~~ a CERTIFICATE OF DEATH [arp.rt.~ee~ ut tkal~6 ReL.Wlfaure Sn.kts frrwT Lc llo. F L O R I D A r~ ~"~"s"'~'L°•'~"" REGJ6TRAR•8 NO. ~ GECfwSED-wAME ~~~s~ rcae ~•ar ~X DATE Of DEwTH ~roM~N, o•r, ~e•e~ ZS ~ RORERT it R ICH~fAI`+ : C ~ ~ Tia i e ~ J 1 9 ~ R~CE w~,n, r.eceo, uuncw.. ~..ou.., ~~-~.sr ~ n~~ u.iwe ~ w• DwTE OF tiRM ~rW+M, o~~, ~p~/NT~ pF OEATH _~~r-m e•= e+etn.: n~nro~r ~~e~~s~ rOf. w~s ~ou~s r~a. r[V ~ ~t '«CCD ~ , :~hite ~ 63 ~ k ~Se t. 23 1908 Bade CI"v. TOMR1. OR IOCATION OF DEATH ~sw[ tm ~ruK MpSMAI OR OiHER lJS11iUf10N-NAME t~~ 1~1 IN ~11Ml~, GIY( S1~F1 ~ND NUM~t~ 1 - L~; W i?et~~~ tES O~ MO Ci4 ~'iami ?~each 1'es ~fiami Neart Inst i tute w T? h 7~ ~ ~ ~ STA TE Oi 61RM ~ u ao~ u.s ~•~t dT12EM Of WNAT COUNiRY MARRlED, NEVER MARRIED, -TSUtViVf'IC'+ S~OI/SE ~ n`n"~e, ervt .uosN e.u~E ~ n y~C O caw~m~ WIDOWED.DtVQRCED~sncn~ ~ ON'~~ ~ tiew York , U.S.A. ,~ttarrieu :'.uth Wecker _ 2 ; ~.j ~ S~Ci~t SECURITY NU~MER USUA1 OCCiI?AiION ~an iwo or .+wa oo..e oW~.w ros~ a K?JD OF ll/SINE55 OR INDUSTRY V ' ~ronwa ure, ev[r, n ~en~to ~ „ ~ ? 5•09-0239 Pol icec,a? Law Enforcement ~an!`` _ _ ?E SiDENCE-STAff COUNTT CttY, tOWN. OR IOCATION ws~ot c~*r iu.ns SiREET ANO NUMlE~ ~ sr[un ns o~ .~o ~I . Florida ,~Dade ,k`orth i3a ~ ltilla e ~a Yes 7531 ~o uin~ Drive f.aT~ER-NAiNE ~~n~ rwwt t~S7 MOTMER-MAIDEN NAME ~rit r~OaE usr ~ ,S Louis F.i~hman S`rah Unobt. - ~ ~ I NFQpJMANT-NAME ' MA~IPIC ADGRESS ~smer o~ ~ r.o. .a ~ CIi1 « IOWN~ SL~[. IDI ' ~ „o i:uth R~chman 753~ Coquina Drive vorii~ Bay Village, Florid:~ ~ :.ak• 1 w ~lOUrw~ iw E~vw~ ~ ` OEA1H WAS UUSED ~Y. ~ENTER ONf C Sf rER INf FOR (a). (6). ANp (c)j ~FirF(M ONSli ~ND pl~~M _ _ , ~ ut! UY a • ~ _ ' ~ , , ~ . - ~ ~ ~ • ~ 1 4' O~ • C E ! Gt: COND~110NS. tf ~M. ~ w~i ~ ' L~ ..~c» e.ve nsE ~o J lb) - i +.reo~.~e e~uit ~m, ~ ovE s• w tOUtwtt i". sr.n~a rNe uwoee- . ~.,,u ,.sf - " ~ w j - c~~ Q ~j ; • ~S ~cS,r'~ ~ - ~n •~i OtHER ~fICI?NT CONp1110N5 eo..ana+s cor+ru~un.w ro a.~N w~ »o~ nu*eo io c.vst enFH r.~r ~ ~ ~~Y If YES Me~e r~.. Nes eo.r• ~ ~ ~.cs w..o+ s~oe~eo ~N oerE. e uuu ~ I p o[wtM z 1, ~w Yes ~;hl~. YT, SIIIC~DE OR OA1E OF MUURY ~ ~lOM~M, ~l~~ 1 MOI~ HOW INIURY OCCURRE~ ~ FMTE~ M~fUM O~ ~NlY~1 IN ?~~l 1 01 ~~~i ~I, IiFY 1~ 1 ~i+riC~Df, ~ l TERMWED tSu= 'rl ~ _ ~ JK 70[ M. ~Od !NJURV AT WORK KACE OF WIURY ~t nOrl. ~~~r. Si~Elr, rKio~~, ~Q~ATION ~ Sn[t~ o~ t.~.0. wo.. un O~ tOww, i~•Te ~ S~to~* .~S O~ ~O/ pltKt RDG.,FK tyK~ni 7C ~ !M ~ CERTIFICATIQN- ~01+7N O~~ ~EI~ ~+ONTM D~~ •t~~ ~MD u1~ Lw MIN/Mf~ AIryE OM 1 DO~O~D MOi wE~ Mt OEATM OCNRtEO ~7 Mf ~u17, O~ ~MF /H~i1C'~AN: YOMfM O~f ~[Y ~OO~ ~~E~ Ot~M IMOII~1 D~i~. ANO. TO 1M ~t31 •TlVDlD iMF ` TO ( ~ 01 Y~ [MOwIfDCsl, Q~lf 7~: D[CE~SFD i~OM ~ 1~ ~ L ~71~ ~ \ ~i tlc ~p ~T7 tl~ ~ID W O 24 1~ 2O M. t0 MF GYIS[ISI 3I~RD- CERTI~iU~i1pN-INEDICAI EIVYUNER OR CORONER~. o.. ~wt ~•s~S or rtit wOV~ O~ Dt~M TNF OlCtOENt w~S I~daWNCED Dl~D ll~+~~ti~~'OM Of TII[ YiD/O/ :Mf IH~FSfIG~11QN. IM M~ O~1H10~~, YDMiM O~• MOU~ c:c~~~FO a+ n.e o•t[ u~D OVF W~M! C~~Kl~SI S~~TED ~ 3b A M CER?iflfR-NAME m?t w~nwi~ ATURE ~ . oFC E a mE OATE IGN I+W~M, DAt, ~tYl Fr~ncis 4.'orthin ton nr ' M~i~iNG ~DORfSS-fERilf~fR ua[r w o un o~ ro...+ ' siwn n m~ S50 Brickell Ave. ~tiami, Florida c~,~ 3UO~nt.CRfMAT1pN.REMOVAt CfMETER1/ORCREMAiORT-NAMF LOCAT{ON ~n iorvw s n ~ 5~E='tr ' Bur~.al ~Lakeside Memor:al Park M .~i Florid~ G~ p~tE ~nwrM, w~, n.~~ fUNERAI HOMf-NM~tf AND ~DO[ESS ~ s~ate+ o~ ~.r.o ~o.. e~n w row?~, tT~~e, t~? ~ ?a' 2, 72 n. Ri~-erside riemor*at Cha Ei 19?0 Alton Roa~ Miami Beach Flo ~d j~ ~ o.r[ re • toCw1 ~[G~stt~e 7SbNE~ iU~ `1 2N~5 ~ iN ~ / /7~~ A ; --=~--a li Y_x t _ - - - RECOROFC iN oF~euu ~carss eee~ ~ ~ C-..: e.. ~ F,~ r-. ~ a eROw~xo oourmr. Ftana? M~ = ~c, - ' ~ ~ JACK WHEELI~I~ i~ ~ :'O;• '%,l?`~~ ; ~ 4~'~~Qy~ p • ~~"t' ' ~ CLERK OF CIRCUIT WUIi? ~ ;~;~~~~.o~t~ ~~kFY ABl°1V~ TO BE A TRUE COPY R4IE LOCAL REGISTRAR' S RBCORD OF , TR a . -v , - ' • ~ : E , FHiq~ ~ ; - . r^ ~ l : , ~ , y . . . ! ~ ~ ; = ~ ~ ~o:~., : ; ~i~ 8~~ ~ (~jd~l~alid unless the raised PUTY RLGIST ; . L ~~~1 y~ ~~L'of thQ Bureau of Vital VITAL I~CORDS UNIT ; ~ ' ~L~*;AL__S.~.S~1'tfstics is af#ixed.) DADE COUNTY HEALTH DEPARTN~NT ~ . MIAMI, FLORIDA L~ d ; . - -t ~ ~ - - a ~ . ~ t,,. _ _ . ~ . ~ ~ s~oK ~04 P~~~ ~6~p y~ ~ ~ ~ _ _ - r ~ _ . . - - - _ ~