Loading...
HomeMy WebLinkAbout1902 v 2~861Z - V ~ ~ ; CERTIFICATE OF DEATH ~ • Dr~~~ o( t Iti46 apd 12e~.rl.i~ilalive ~vvires S'TATE Fll[ NO. • ~N~•~.,~x. ~a-,~.~~~ F L O R I D A T~?E, O~ ~t1At IN ~°~4~~~° REG167RAR•S NO. 455 + ~ ?ElMANINi WK- • n~ft rwa~ ~•at . OECEASEO-NAMf SFII DATE Of OEAiH ~ rOMtw, 1~e, ~t~~ i j SEE Ma1bt00[ f0~ ~ ~~~s , GEORGE CHRISTIANSEN ~,Male Sept. 10, 1972 UCE ~n. Mf6b. ~W~K4N uyµM. AGf-c~u wmt~ ~ n.~ ~..ot~ i n~. OwTE Oi WM ~.o..n., o.r. COUNTY OF OEwiN uc. isnc~].t@ ~~~~~.w~~ ~.os. ~ wn '~ow: , ~ NOV .13 ~ 1892 „ $t. Lucie } 66~2 ~ Crtr, i~YVN. O~ IOCATION 01 pfATH c~v ~r.ns MOSrIT~I OR OME! NST~TUTqt~-?~urE ~r nw w unre. c~re ~w~~ uo ..w~t~ ~ E 3~ffN~ ttf O~ MO } Ft. Pierce Yes Ft. Pierce Memorial Hospital STwTE Of Wt11 ~ ~»o~ w ~.s w. .....e Ui1ZbN Oi wnAi CO~M+i~Y W~RRtED. rtEVER w~ROfO. SUtviVNG SPOtlSE ~r wv~. 01K Y10lM M4MI/ ~w.,.,,,,~.,~ ~ New York ~ USA N~arriei~"""~' Mas N. Giqilo ~ `rNtu eece.s~o .~rw. ~ a.M SOCUi SECUtlf~ MMYER USU~I OCCUlwT~O?~ ~an c.+o a wu ow~ w.u+o .ou o~ RWD OF MJS~HESS O! u~DUSTt1 ~ occuws wuwo un. F!N Y ~l1~~lY ~ „266-44-0088 Owner-Operator Auto Electric Service •~"~s~'~'~. RESIpENCE-SiwTE COUNi11 Gir. tOWN. OR ?OCATION »~sy1 cm .rm STtfEi AND NUMKR L~~ ~YlCMt ~!1 O~ MOI ' . ,MFlorida ,uSt.Lucie Ft. Pierce No• ,w 1005 Midway Road r~ fATe1ER-HA1NF ~~ut n~pp~~ y~f MOTHft-MA10fN NAMf ~rsr rpp~t tnyi ' „ Charles Christianse~ Louise Schultz ~ INfOlMANT-NIM~F MAIWG AOGRESS ~sr~el~ o~ ~~.e, wo . cm p.o.r.+, s~.n. t+~ ~ Q Mae N. Christiansen ,n 1005 Midway Rd., Ft.Pierce,Fla. 33450 U 1. ENiE! ONtY OPIf UU ~ff lWE fOR a ~n auu w e~ru ~ Ofwi?~ w~5 GwSED ~r~ i fey, u+D ~~li ~~e~.tt~ onsn u.o a.n. • q wr c.r e C~ h~ \ ~ ~ \sa.-~d~ ~ C~.a~~ \ t Q ~s j~~ ' iw_\Ls ~ . . • t ftout e ~j„~ =MMDIt10w3. ~r ~M~, ~ Y~~~ V i~~.~Li~V 1`./ ` ~ t. o•r[ •~it w~ 1~! ~-~a~ t , IrreO~~t~ [~v11 Iol, I OVt q. q~S ~ CM+f~DYtK! M~ - ` ~t~11N0 Iw~ YMOt4 ~ \11M6 C~Vf( ttff Q ?w!i M. OtIfER SIGNIfIGwT COt+Mi~ONS: ca+ano~+f ca.rwur,.,r, ro y..~„ ,,,p~ ~wno ~o uuu annr. •ut ~~o~ w~~~ tf YES reae ++re~wos co«- ~ ~~lf ~ YN~l~ ~M 01/~~~1y~M0 UYS~ M O~~iw IM V M~ . ls.ebeyy~ KUDE~?. SU1ClDE O! A E ~.a+~w, o.~, ~t•~ NOllt } HOW INJURY OCCUltEO ~ l.ne~ wtu~e p ~wwn ~.n ~ M rur u. rter ~ NOM ~6E; Qt 1M~OETEWII+fO ! ~ 7k M. ~ 141 ~ t IN1UR11 Ai WORK RACE Of NriMY wo.r. r.~., srnn, ~.oo~~. IOCATION ~ tnen w~.r.o- ~.o.. an o~ ~o..., t~•n ~ ' ~sffan nsa..0~ ONKf MYG..~K. ~sMUn~ 7M. 7M 70! ! CE[fIi1CAT1pH- ..w~.M wr nu ra.n. o•• •w uo ~ws~ s~.r ww/w~~ •~m o.. ~ ao/ao ..os .~lr mt DEwM Ottu~tto~* r e~[ ry.ce. p. n~[ /N~f1(I~N: TO ~ ~ ` ^iw • ~!Y . ~00~ ~IR~ pAA IMOY~L y~~4. br~0. M M ~lSI 1~r7lnDlD iwt ' / 7?p~ r~ awp~~tOGl. OV! Il~. wct.slo no+ j Itl?. ~ / 7 7R ~ t~. ~~'c 7~. V', u. ~o r.~. c.,,se~„ s~..~n. CERTYKAT~ON-MfOKAI EJ[AMWFR OR CORONFR: O~ r+.e ~.s~s o' t.y .wr~ o+ w.r~ +e ac~a.n .•s ~www..c~o w.o ~ ~urM~fWM d twt WO~ u~0/M M! r.rlStr.~rOw, .r~ ~r Wr~Wr.. ry+M W~ rl~~ Wu~ OlnM OKY~40 OM W Mq ANO OM t0 iM! 4VSl~S1 f~~~l~. ' M. ~ ~ CE TIf1ER ~~+n olr~w j ~`lv SK,NAT i ~e w,r~n~ OATE O ~ n., r. iwi tH. ~l` ~ ~ ~ t ~ ~ \ 77~ ~a.r. ' v~ ! ~ MA~U~G RTIitE~ r•u, w i..s. ..o c ~o.n~ ~ ~ T~ h ? ~ tL t ~ ( .'Q> t.+ V ~ ) ~ ~ . Wtiu. fRf~twr~On. REMOVwI CFMfTERY OR CRFw~AtOUr-w~u+E LOUiWn un w~o.n+ sun ~ . t srtcrs ~ Burial ,~,Hillcrest Mem. Gdns. Ft. Pierce Florida ~ ~ OATE i..p..rw, ~w., .au~ FUNER~I HOME-NaKE wND wDOtfSS ~ snur o~ ~ r.o. »o., ur. w ior», sT.re. t~~ ~ ,.,Sept.13,Z972, ,r;~~AIRD/FUNERAL HOME,901 N. 7th St.,Ft.Pierce,Fla.33450 ~ y ~b 12 f~E~~ ~E ' ~,~j~ tEG! R-SlCrlVATURE Owil ~ECErvEO ~Ot~l t(G~S1W ~ N~r. 1970 tsi~~~ U: ~.i`:.?Xr ' 2~~ ~w. Z~ ~ ~ hersby oertify Mis ta be e tn~ and comec:t oopy af the Locaf - ~ ~ Re~im~rs reoord on fib in ths SL L~ucl~ CouMy Heilth pe,pa,h• ~611 . ~ ment ~t Fort Pbroa. ~tor(da. ~ ~ (WuninQ: Not vatid unlsss rotsed seal of the St. Lucl~ • County Hsalth DepaAr~snt b ~ffixed.) _ . ~ , . ~ - ~ FILEO AMD RECOROE N. D. Ml lT.tR.UOCCERCPOtTAAS ' - , LLER. M. D. ~~~Y 4~~ b Loat Wgittn+r C~ERK CI:.COt7 COU$T- l~ _ ~ S~GOBD VEF+FiFO . - S~ Z5 3 oa ~'~r1 ~ o.a. o.~? ~o~.t R~a~.,~.~, ' . ; i y B~QX zos PA~F~sss - ~ - J X V4-~-.~.~ _ - ~ - - ~ i ,u:i~.3'~.:~