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HomeMy WebLinkAbout2847 . ' - _ - - ' -.r ~ ; ' . ( - - 1 , :si, s~_.'~ R~T~ .owno o~ N~TM CERTIFICATE OF DEATH , - ! ~~a~~ ~uwuu Or VITl1< fTATIfTIC~ ' fTAT[ /It[ NO. ; ore •e~n FLORIDA ~ , p~Op~~l~ BIR7H NO. REGISTRAp'S NO- 469 ; e[~C~t~d t. KACt ~t K~~il CO~i NO. 2. YiWI IIts10[Mtt(~~..elsr.tAwr U.wa~rw~ trd..r~dn~iww.~.) OOYUTY SiATf iOYlrT1/ ? ~ St. . Lucie 66-025 gl ' • ~ e. p~e~~ . ~ 10 /~f~ ~ CIT?.TOrM.MIOC~T1pN t. ~S K~C[ O~ OEwTw t. dTr.TO1MM.OA IOC~TIOM l5 11ES~D[MC[ ~ _ ' IMSIp( CIT~ UNITS/ IaIS~DE C171 LlYlfsl r,l.. Ft. Pierce .c:~C ~00 Ft. Pierce ~rsfS ' ~ . . . ~ t. lIAM[ Oi (I/wN f~[ ~M1if~t. ~bM w/4ts~) t. STR(ET AOM[SS • _ ~~T~ Easter Manor Nursing Ha~ne 3019 Fairway Drive MArt o~ fart /?fiNts . LW ~ Mtt MwN IN~ Yta ~ ~ ~ iii~«~.~ EARNEST L. PAGAN SR. ~T~ November 12 1965 . S. fEY OOIM W tKE 7. MAR111[O ~ M[Y[11 MARR~EO Q~. ~T[ Oi WTN /1GE (I~ ~tM~ ~~[Y ywp[J 7~ ~i. M CdU ~~,~o[] ava~cEO April 22 ~ 1900 t 68~u~~i x.w. Ww r.,.. ~r... ; r • f s • ~ ~ 1~l wl ~ 10~. uw~l Ottu?~TO~ (OYe ~i~~ yw~~ M~e 100. awoOr ~usui[u0~ wauSTR~ 11. ~urwucc (Sr~r r Iw~M+ ns~t?~1 1 anw a rw~r oaw~r? . r. ....~r..tw.r...t~.e~b.~~ USA .....a ~e~CC~i~nt Own business Oran e Count Fla. ?1~Ck !wt 17. ~ATMtA'1 Mu~C ~ ' 1~. MOTMEA'S YwrDEN ?WY[ ~ ~,,...,a., James A. Pagan Mary Cameron . ~ i~- SOWI SECUIUTr NO- 17. p~IO~M t{/ M~TY~t _1 . Al4ta i v~ 66-44-067 ~ ~~i " Ft. Pierce Florida ; ' ?~~~r~l Il CwYSt K~twiN ~E+la ptt ~ awr ye?fi~r a). (OL ~w~ ~c).1 IMTCArAI ~ETIMEC•"~ z a? r• e c• r rw~r ~ oun~ r~s uusco ~r: ti a~scr rwo orwrw •~~t ~tt~ . ~rrtowtt tausc W _ ~G ~I ; ~ a~• e~r- ' ~ .l ' ~~(fl~'(/ ~ ~ ' ~ tftl~~t• C~s/:ttw.t~u~. ouE TO (11~~L~Y~LLU~l1l C G ~ .ft~ t?~ ~llo? ?~K y - . ~ 1• e• 1 tlert cawae (i1. . ' . • ~~;f~t~~• M!tW t4 •~Ie~- OUE TO (t) fp~/ d~~r lwf. ! C] *~rr• O IA~T IL OTMq SKtilIW1 004pTtllnl COKfM4IfK 10 OUtN ~U~ MW 11tUT[D TO TME RIYIMI 06FAf[ Cd101tq~1 GAfL w?Mt 1(~I tilAS AUTOISr { F, r(11ip1~MC~D-{1/ 1 t~• •~~t\ S . r[S ? MO U •t ?~t~~• ~ •~k t• r- 1Pr.1. LDS. ocsuuc Mor w~u~v occuR~~o. (k~rn ~~rrrs y~~r~ 4 P~rt !r Prt l1 y4~~ /l.)' ~ ~ ACC~D(wT S11~C~0[ ~MOrKME ~ l~~/~~:' v ~ ? ? ; ~ ~ m[ TuuWOi .r 11lwM1. D'q. Ytr + O 1• ~ W ~ . = 20/. OUYI11 O[CYIUEO mt. ry1CE Of ttUU~~ (t. I.. i~ w~Ma! M~t. m/ C~Tr. TOMr.O~ lOCA1~OM tOUMTT STATE ~ _ rNKC ~T ~ wor wNRt ~ M•~./•~+w~, r.~er. Nks 4rt~.. ~tr.) - r011K AT ~IIO~~( , - 21. I~fqnd~IfMd~w~wd rom Q .fo •ndb~fwr A~r ~Ji?~ow,~~:.:f~ - Aie~ T ~ D~~fA oeeu~r~d ~t C~ +n on th~ d~t~ ~t~bd ~bw~: ~nd ro tM Awf e/ mp ~no~I~d/~. /rom tM u~NS ~t~t~d. i •~1 1t~r• j~ NYMA Q [ t0 MK M fYl[) ~ ?I1. ADDR Ilt. MTE 51GM[J ~ ~..r~... a ~ ~-n~ ~'7 it i-r~'~ 'i~// ~11-~'G:,%'l ~ •ftYf~l~• . 2~ RAa?. r~t~Ol : 27A GAi[ I3r M~YEOiU~ET[II16RCRCMATOAY X11. IOGt~OplGlf/.fMen.MtM~H7) - ~STdt1 , i Bu a`~"`y'' 11-14- Hillcrest Mem.Gdns. F. Pie ' ! t.s.~sia ~ ~ c~ ~ "9q9`~S N. 7th St ~ °ATE"ao.~r?oc.~~c~. u. c~srw-ss ATWtE ` + "••.'°•e Ft.Pierce Fla ~'ov. 23, 1968 . ~~~*~-o. 1 I heteby Cettify tfii3 to be ~ true and oorreGt Copy p~f ffi0 (rxal fIIED A?+~ RECOROEO _ . i ~ ~p~~NTY Fl~. ST lUC E i Reglstrers neoord on ftle in ths St. Lucl~ C•ounry He.3hh Depari~ aOGr;. Fr~ti~RRS ~ ' msnt at FoR Pbrc~. Fbrlda. PK C?•:CUtT COURT , Ct~. ~ ' (Wur~ing: Not vaJ;d unlsss ralsed sea! of ths St. Luc3~ RECpa.~ tE'= _ ; County Heaith DepaAment is affixed.) ' 14 i3 N N. D. MILLER, M. D. ~t Couny alth OfficK b Loc~l rar ~~rf•~(~ ( f~ ~rr~~.. . , ~ Ds~ Depury t~ocal Reaimsr • i • ' ~ ; ' 600K ~?`J~ PACE~B~ ~ , , y.~ ~ ~ ~ , ~ _ ~ _ . w. .~z-~~