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D~~tA oeeurr~d ~t ~ ~Q A_ m on tA~ d~N st~Nd ~bw~: ~nd to tM bqf M a~ kno~Nd~. IfOa fA~ C~Y~N ~f~[~A. ,
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•eari~t~. 27r. iiawtt.C~Er+~nOit 235. DATE 23t. wWEOFCEMETEIIYORCREMATORY 23/. tACATqN(Cffl.brw.~r~pa~ti) (8it) ~
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BUR:1?1, lt-1 -6 T. ?~E:~~' C~:ET.~.'F.Y FT. PIERCE FIARIDA
V. 3. f 017 21. ~~ML 0U1E OII'S S~GNA7YRE AOl A~~ESS~~~ . S
i. 25_ DATE RECO. ~T lOG1l IIEG. REGKTMA'3 T~E '
7
a.•.1066 N',i1tOY1 ~d. Baird F:. FIE~C~, FI.A. 4-22-63 - Anna Lee Ilenison d.r. ~
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I hereby certify this ro be a mie and cotrect copy of ths Local `
Registrar: record on fite in the Si. Lucie County Heaith Depart ~
msnt at FoA Pierts. FlOrida.
E~0 A[iU ?~iC4RDf~ _
(Weming: Not va:id unless raised seaf of the St. Lucie ST, UC1t COUMtr FlA.:
Counry Kea4th Department is affixed.) R4C~ ;'~'•jg~S ~
CLERK Ct+::.~t? ~OURt'~\ ; ~ .
, RECOQ? VEF~Ft 0 •
N. D. MILIER, M. -
County eaith Officer b ReQistnr 3~ j0 Z ~ r` ;
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p~ Dspury t~oc,~) R~aist?ar . . ~ , ~ -
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