The URL can be used to link to this page

Home My WebLink About1728 /QO `I~~ y v- ~-~~-.~c-1 G1~ - 2385Q5 CERTlFICA; ~ OF DEA i H ' Depan~ew~ ~l Ik+ltd ~wd Rclrl.~l~kure Sen.ce? iTw:E Flli ti0. ' ,~v1i10\ (K IY:1LT11 F L O: I~ A 256 •T~1E. Ot IflNi IN ~'~~~~R~~~O REG76TAAR•S NO. ?[~MAN[HT INK f[[ rWl~1[ i0t OECEwS[D-/+.WE •aa.~ •~~r SFX ;DwiE Of C1FwM ~•ow~., ~i~~ ~ ~s~waa.s , GEOKGE S::F.~~RBR Maie N.av 30 197z 6~0~ u~ *IMl{. M~OW~ u.~utu~ www. AGf-u~~ '..:e. v.e.. ..~e• ` D~Tf Of htTM ~ V~~w. N~. C011Nir G OfwiN ~K. ~ ...~w ~ ~ .b.. , o.... .o.., , " ~ , '~+Ihite ,~79 t„ I uct.l3 1t392 i,. St. ~.ucie G7Y, tOwN. Ot ~OCATION OfATM ~•.s~:,~ c.n .,~.rs .~*vShiwl Oi O:hFR INST:T~i~ON- ~r .~o~ u. ur.~~, an~ ~~au .w~ rwu ~ . r v~C,~• •ta oa ~.o r n. Ft . Pierce Yes , Pie~ ce ~emorial Hosnital ST~tE Of uarn ~ r~o~ GT~2fH OI WnwT GOun:iY iw.~i:.cD. r.iYEx ~WA:ED, SWrNwG S~OUSE ~+.w. oM r.w~ .wN ~ cowm. ~ w+DJwFD. ~~vJ.CEO ~ wcr. ~ YIYN tflWwC~ ~ Michicran r ITSA ."•Ic~2"~ ~eG~ f~~. ~Id~Y Manders ~ r.~u htt.ua i..e~. r a.iw SOCW SEGlnTY wwiE~ USUAI OCCU?Ai~GV ~a.i ~..a o. rw. no.a a~a.«o .ou w.[.~+D Of WSv.fii Oi w~uSt¢tf OKYlqO w ~'04Y+G Wt. /~'lti M 4t~~{i ~ . ~ '~~K Np „381-01-~528 Press O~erator !,u Printincs ~ tESWEnCE-St~iE COil~vTt . iGT1f, iOwv~Oi i.7Cwi~Gr. '^s~M t•n ~rej iST]EET MD hW~iEt ~ ~ . ~~Yt4tt W w0~~ - Florida ,~$t . LuCie F~ . ~i~rce i :~o 4U 50 OleanGer Ave . ' ?wT~+E~-N~wE e~qi ..uo.a ..sr I ~.J:h[2-/MAUFN NAME rra .~oou wr ` „ Philip Scherrer Catnerine Schr.i•?e I WOAw~NT-H~ME mwau.G ,?JLtESS ~uuu o. •...o. w.. c.n a w.., ar.n. tr~ " Mary Sherrer 405J uleatider Ave.,Ft.rierce,Fia. 3s:50 ~ J'i ...w...~.u . ~ r.. ' ~ IAlf 1. OfAM WAS CJWSED t1f: ;f~'Et C~.? Gn, Cw:lSf Ii) :~ehf /Jt (ol. (eL wti0 (<1. ~~rv~.w o..t~~ ...a o~.r. ~ .Y., u. ..wwu c.wf~ ~ ~ ~ 1 i ~ ~ .~l<~ r,'~ ~ : ~ r~ ~ i- J, ~ ; s e + G o s ~ . ~..a.K, o. „ ~o~.omo.s. .r ~ . . .c+ c..~ uu ro ~ I~i rr~a•~~ uvs~ a~, M q. p~ ~s ~ tO..MtMK~ W: ~r.r.wo t.! rwqs~ ' ~ ~ ~ J \~~MO C~V{~ UN . ~ <<) ` U /~Rf M. OiMER S+GqMKwt~T Cp+pTrO?+S: ew.auo.s eo..~•......~.,; w a..r. •,r «or ..,.reo ro e.rw enu. r. r.~r . yi AIJTOIg1/ r{f YES r~u •~..a..os Gow- . ~ 1~•~s a w~ (s.ei~~a .w Nnm....o u~w . ~ o• oa.r. ~tb i~~J !tb E ~ ~i..eea: ) w(UDE•ti. S;ItCWE Oi ~ A E r+iWT ~~pwr._ yr, n•~ rsu~i , HOW 11+W~~ OCC11~1fD ~~MU .utiq p~wwn .r r.~f . p~ut u, aa.~ u~ E 1-S nurK.dc. Oa woEifarv.tD ' . . t f~. : M E ~ ~ i uLUtr wT wOtt ~~UCt 6F rUW7.. wr, r..... s~uu, .r-,c.., ~.OGwii0.•: ~ s:.~n u..~.~. ..o.. on a~o... s..a ~ ~ 1~~/4n ~ls 0~ w0~ (pN41 M~O.,~K. ~YK~1 ~ r.. irr. i~•: 6 CEMUtCwT~OH- +aww r~ ~w ~ ~o.~n. c.• ; u+a ...sr v~r «.~i.u ....e a. DO/OW n0~ r.(V M~ O[~IM OCCY~IID r.~ •..u. o.+ r~ f /M7fK~AN: TO rJ~~w Yr 1~M ~~0~~ ~~II~N~M. ~i~OY~~ i~f~. ~+i. 1G M NSI S ~.ne»a~o rw~ i,tl 'S / i/ 7•. 7 ~ J L~{( c_L o. ~r .w~+.~oet. a~~ a It. o~u.aio.¦o.. A v ~ i~{~. ~t~127~ ~ a~J 7G.•-~71~ f~~l:~ 7 M.fOtwfCr~L~LSr.1~0. ~ fEliY~C.~iqH-irfD~GU EY,wtr.E~ Ot COQOr.E~. o.~ r~~ u r.a o~ u.n. ' u~ a~:~~»~ ~.a r~o+a...:w ~aw _ . ~..~...s+o.. w nr wr. w/o• «.is.~c.~o... o...w.., .o«~. w. w.i. , r 7~ J e~.rw OCCr~~ea a+ ~e ~•q w ow q rw~ e•~~a~ f~.~ea. 1~ = 7•~ hL ::i ' / . 1`,'• Y Cf4i~tiEi-N~wE mn w ru..:~ , b:.r+wi~if / ~ wcn~ ~a~u ^ ~ OwiE S~ ~fD .~o.~~~~. ~u+~ 3ernard D. Ross, ;•,.D. ~.:~~::,w.:./. .ti ~ ,~l 7x- ~ ~ . ~.~ww:tiG wO~ESS-Cf~irf:sq r..~e: ea ..c t.n w ro~.. r.ri tu PO;+t St e O .i v^.~n=: r +.~s- o-pr+r.A_ ~_02']_G~!i ~~1~~C. •UR~µ. UEMAi~pN. ~EMQVA~ ~GEMF:fi O~ G.kw~w:O~Y--n.wi ~ iOCRi c.n p p.w s~.ry r YK~n ~ ' ' ;~~temoval-SUrial t:~. xO1V Se~Llc'r.er ~e:~ . r'ernGale .:icha.4ar. OATF ~.ow'w. w~, ruu fU~.:twt nOMi-:..tn•: a~~ <~,',ii55 ~ Ynu c. ~.r .o.. u*. o~ ror... sr•q, i•• ~ ~ r.. .iav 31 Q]2 :r BAIxD FL~_:~~!, :?O?~~,9~~ 7th St ,~t.~ierce,~'la.s345u 1 V• S. f6SI /lM~E2 L:t~ QR W FF' ~-Y:,'~wi~:£ 1 Dw/l ~FGf~viD ~OU• ~tv~SiW ~ g a.v.197o - ~ ~ . ~J/- / ~j ,e.,~e_.i ~ ~ ~mv ~ S 3R7 ~ . , c ' 1 t?ereby oertify this to be a mie and corrc:t oopy of tha l~sl p ANO ftE~~~ ~~A.~ ~ Registrers ~aoord on f(le i~ ths St. 4xia Cnunty Hoaft'h Wp;..~? ~~~CIE C011x mct~?t at fv+f Pterts. Fbr(da. IIO~Ea POISA~?= : ` - - / : " " C~E{tK C1RCUIT CO'U ~ ' ~ . ~ (Waming: Not vaJid unleu ~aised seal of tho St. L.uds Atif1ED.•~~' ' ~ tIECORD V~ ~ Counry Health Department (s affixed.) ~ Zg ~~9~. ~ ~ / N. D. MII.LER, M. D. ~ , County Health Officsr & Local Rmgistror 2385~5 , ~ / ~ i ~Q ~y ~-'~c~% ~1'.f; . . i ~ ~ p~;~ Do;wty Locei . isn?et ~ ' ~ ~ - • ~ ~ ° g va~~~~ ~ Ba~K , - ~ _ ~ a~°. : v . .