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HomeMy WebLinkAbout0452 ~ - - - - r - : ~a . r..~. - -r+.~~..~. _ , - .~~.s ~OARD o? MutTM CERTIFICATE OF DEATH ~ • •uw[AU 01 YITAL RA' 'T1C~ F L O A I D!l ~AT~ ~IL[ MO.~Q~ I~It~i ~~e~ nrv~~vV~ erd •A~w SIp7H NO. 1~[OItT11A11•f NO. prep~~l~ 1 KA~[ ~tATN GOD[ NO. 2. ViYAI A[f!~[MC!ll~ln.Ir~r.Ilw.1 b~~.w4e.w Rrr1..rM.nd..ww1 et~eYt~~ ~ ~»TY ~ STATE A. COVNt~ e•a ~.e i Broward 6- 9~ d ? ~p 11. ~ITY. TOMM, OA LOCATIpN t, K K~C[ Oi O(ATN t. C1T~, TOMN, Ow IOCATION t. K R[S10~NCt •aw~~~ INS10E C11Y LIYITS? IMS~OE CIiY L~Ytfst r~i.. Fort Lauderdele ~ES~ ~np ort Lauderd lc ns~ No~_ • 1, MAMf Oi (/J ~ ~~y, ~ ~ry~N NhtY) STIIEET AODIIESS NOS~ITAL 011 INSTITUTION 2352 N. E. 20th Street 2352 N Oth 5treet ] N~Mt O/ ~ FI1~f AIIIQt L~M ~ OATE MMM /M/ YfP O~t[AttO ~nr. M p'r•~~ ALFEtED S. LYON Au ust 8, 1967 S S[X 6 tO1011 O~ IlACE ~ MA11111E0 ? NEYEA MA~~KO ~~TE Oi ~IIITN ~ A6E fl~ ~tM~ i UNO[I11 tUR ~/iqEJN Mf. IYt Ahf~Iq1 N~r4 D~N Mwn Mt~. r. t Male White ,unoowco~ avo~ao Dec. 30, 1921 45 ~1 w 1~ 10~. uSUAI OtCW~T1pM It7iM ti~f ~/rat f~~t i~ KINOO~ MKIlQSSO~ MIDIJST~Y N. ~M1TINLACE (.9Yt ~r ~irllp tN~~h1/ i unm~ or nnt Gpwt~rr •1tA IMriq ww/ yraN~Ihk.nr~ 1/rNhd) ~~w~wt Grower Citrus Chlle U.S.A. ?1~t! 1~t ~j. /ATMfR S N~1YE 1 MOTMEII'S MAIDEN NAME ~~r•••r~.~ Unobtainable Unobtaineble soca. ucu~~T. ?a n a~..~.~ • s~owTU.~ wu~... . a an ar Beac v. Unobtainablc Stephen A. Spear per HItN)e~?~. Fort Lauderdale, Florida 1• lAYSt 0/ ~[ATM ~:~ft~ ~~1~ ~~N t~wt pn N~t ( ~ II~Tt11VAl /E?M([N Iun~r~l h N). 1~1. cl. Alr~et0~ ?~IIT~ OEAiMNASCAIlS[O~• ~ Fi 0 M Y ONSETAMpO[ATN !~!~!EL+!R*~ ~~~KS_ Asphvxiation ;j~p ~Q~ r~~. • - - a~eR ciRcu~~ eo ~ v R[COIlO VERIi1~0 l f rt o.t. c..~ai..,. i/.¦r. Dr s r! tw tA• r~k? ~~r~t r' b ouc To iai m~ming--------- ~ ~.~k~.~. 239684 f~ 11 iz PM'11 ~.s~.t~~~ K~N/~ Mf Y11~t~- fli~I c~rK /W. DUE TO (t) A on ~~n~ t' ~ ?A11T 11 O1NEI1 S~GNfIC4R Cp~p~1qRS tOMiM~UtIMC Tp pUM WT Npi R[{J11tp ip M T[RMMMI OIStASE CppTIpN 61rQ1 M?MT 1(~) w~5 AU70?SY ?[,R~itpI1MED~ t~t A~~t\ S TESI~ MD ? or e~ter• _~~p~ (~C aSS e I06 DESC11~~E ?qM Ip1U11Y OCtU1111E0 (6~/n M~rrit ~/Iw rr t~ Pat /a Pat !1 Yt~ l~.) •~tt~~ •w~ ~ ACC~OENt SUrC~OE ?rp K~OE / I N ~ p p p Deceased dro~med in his swinming pool ?ea~. ~ T~wE oc M~wrA, Mr. t ia ~ - - - nuu~r W 7'UU o-~Au . 8, 196 ~ 20/` IN1UI1~ OCCU1111E0 20t. ~L~CE Oi INJUII~ (t. i~ v~M1paf b~[, m/ C~Tr. TpwN. OII IOCAT1pN COUN7Y STATE ~ YrMILE AT ~ NpT WNKE ~ Res~~erice~N••~" ~`I• Nt) Ft. Lauderdale Broward Flori da • MI011K MeOI1K 2t l~M~wdud th~ d~c~~wd Iw~w+ ,~s •nd l~~r s~~ A~ ~1w~ on ~ua. Q~ 1967 n..~?. «~~...a.r aPProx. I: V~._ , m an tAs d~f~ ~f~t~d ~bw~; ~nd to rA~ b~it ol in~ inor/ad/~. /~om tA~ c~us~s ~t~f~d ?11 1t~~• fICN~TY lMpha~bf~~ SSOC S@ 22A ~pW1E55 t0 D• ZI[. O~TE S~GNEO ~~•o~•~• • 'n° ~ edical Exazniner Ft. Lauderdale, Florida 8-10-1967 •CCY~It Z~ ~~~~t~ b p~TE 2~t N?M( QF CEMEiERY OR tREMATORY j)/ ~p~ATIpN I('~f/. fOr~. N ~~r~f/1 (S7~f11 REr01r (1prr~/~1 Buria~ 8-12-1967 Queen of Heaven Cemetery Pompano Beach, Florida Y. /plZ j~ iUNEM~ pNECTOR S SIGNATURE AOD11ES5 g8ir ~CSS@ ~S a?TE REtO. ~Y LOCA~ QEG Il GKt 11 5 S TU11E j~ "~•.1°6a Ft. Lauderdale; Fla. /y~i ~ a~ /Ly - - ~ . _ . - - - ~ - - - - -L~- ' I. ~ CERTIFIED COPT ; ! I hereby certify the abore to be a true snd oorreot copy of the Local Aegistrnr'e record on fi2e in the BroMSrd Count~ Heslth Dspsrt~ent at + , Fort Lsuderdale~ Florids. f ~ ~ ~ , (Varaia~i'~~~Ia`0?~~~lid nnless rsiaed sesl of ths 8rovsrd Connt~ Health , ~ , ~~E ~ ~~~ar~iy~»t i• attized. ) ~ ' " ,'~J`~~ ~i, ' . ~ , ~r : ; ~ j i - ; : ' , ; • ~ Qt.~: i ~ ~ • • ' r • .`~d, i.:,~ . ~ . ~ ' -f 1 ~t, ~ ; ~ l ~ i ~ ~°v'~a; %I Countr Hesltb 0 iosr snd Loosl Registrar ~ I ~ - • ~ . • ~ 1 / ' R,~~• ~ ' ~ ~ ' ~ ~ ~Z ~1~. ~ ' q~~ ~ .,C~2~~:.~c-- I i . ~ ~b ~ 1 i ; ~ `.i. - h I , ~ ~ , .r ; ~ ~+~nF~~ . ~ . ~ ~ U1 ~ _ gg~~2 PAGf ~ Py?ty Loosl 8egistrsr j , ~ . - . , _ . . - " T _