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HomeMy WebLinkAbout0717 u~ ~ _-y- - _ - - - 239830 - 7Ai~ e.- srwY~ sowno o~ Hw.~x CERTI~ICATE OF DEATH • auauv OF ViTAL ~rwn~nc~ ~rwTe Fa~ Na 1i6•1 FLORIDA orQ •A~a BIRTM NO. RE618TRAR'8 NO. proa~~l~ 1. NACt O~ OtATN GOOE NO. •z~CUt~d 2. YtUA~ R[NO[NC~(~?~w.Mrd~iwr !/i+~e:wr.a RrilwwWi~~i:Nw) •nd •111 ~NTM STATE 1. OOYNTf e. p,.~.a - St. Lucie 6b-12 r lo ida lo y~~- C~TY. TOMM.Oq LOCATYON c. 15 rIACE Of. OEA7M t. C7TY.701rtl,011 LOGTION t. K RESIpENCE •aaqt uWOf C~TY LIMiTS~ IMS~DE CITY LIM~T57 rii.. :'t. Pierce vESCX +a? ct. F'ie ~resZ] Mo~ I. N~YF Oi (I/Mf b~Mpif~I. frt 16ttf KIttN) LENGTM OF STREE7 ADONESS ON A iAIIMT Y~iSS?~ITUTION STAYV lA ~ 11ES ? M~ 21~ \T. 1@th. Street 1 ~e~ s 1 I~ 3. o. Fr.r v;ur~ LNt 1. DATE u..ra o.y n.. ~T~ M r+•~~ llonnie 'r,Iizahe ~'r. 5^.iith °E'T" 21 1. 6 s. SE1I OO101~ OA RACE 7 MARRtED ~ NE~"ER MARR~EO Q~. DATf OF ~lfITN 9. ACE (/R /tY1 Ii UMOCII I fW N~+OE~ ~ IQS. . fYl AirW~!) Y..W. D~r~ Nwr~ X~.. ~ i c• t''e.:,ale khite w~ooweop avoacw Jul Z 1 1 S p 1. i nla tQs. usu~~ oetu.~TaM (airs ti.A yw.t 4¦• 100. Kwo ov ~us~ss oa ~Naustar 11. ~uiT~ua esnrs o~ /wrys cw¦trp lz anu,~ a nur aa~+wre r 1 tA p~r- I~riq wwt N r~rli~/ bk. n~w iJr~tbd) ..~..c Housewife ~ rlorida ti " Dl~ok 11k ~a, F~TNER'S M~rE 1!. MOTMER'S MAWEN tuME er ~sv••~~~•* Joseoh 3tokes Lizzie AleQo 1S- MAS OECEASEO EYER 1N U. S AAMEO fL1NCESt ~6. SpC41 SECUR'T' IiO. 17 ~N/O • 1tOMATYR[ T.W Yates, 1 r.'. ~ n.~rw~ I!J ~ w r~N~. r+rl _ U • :~io A.a.., - g p • g Fua~i~l !a. CAYK 0/ ~[ATM ~Enfc? ~wt/ ~ws c~M yts liwe ~v (al. (D). i~~ (t).) INTERYAL ~ETK[EN dl~~etof ~~I1Tt. pEATNwASfJWSEG~Yv OMSEiAr100EATM /MY[p{AT[ CAyS( Poisinine ~ • ¦Y~t t11• tA• e~r- ~ tltlc~t• C~tfuiw.iJs~/. py( Tp (01 rit~ tL• r~id /us ~u~ l~ 1 1 o e~ 1 ~Daer rswr l~1• } r~sistrar x~i~/ t?r r~4r- 1~ TO (t) •StAlo 71 2 l/iw~ nrn /ul. 1 O ?AIIT 11. OTIE~ SK~i1CANf COMpT1016 CqRM~Ui1NG TO OE~TM NIT NOT ~C1AiLD 10 TN[ T[RYUMI DISGSE Cppiqll CIt01 M/MT 1(~) . WAS AUTO?SY hour• af- ?ERFOIlMEOt . t~r d~wt6 S 1fE5~ 1+0? or s•[er• ~ ~ ~ p~,pEkRI~ENOWYUURYOCCNIIREO. (Ewla~~frrt~/~~fw/iqP~?flMP~rf1l~/Ift~llJ ~ ~~k1Pj •wj ~ ACCIDENT SUKIOE NOMKSOE ~ O Cjl O .a, .r mc TutE Oi lfwr Xwt~. D~/. Yt~ . . Aed~. V IIUY0.Y . 0 oorox. 22- b keaso:~: ~n+'ro:cn I'~ ~q~ ~?D/ IMJI:AY OCCURII(D ~lt. ?LACE OF IHlU11Y (t. P.. i; 0~ a~~l ~Oq[. 20/ CITY. TONfN OII IOC~TqN O~UNTY STATE ~ rMac ~T ?aT rvNa[ M~.l.~+ar. ana,.pFcr ay.. sr:.) - Y/ORK ~.TwoaK Q ro::e :'t. s'ierce, 5t. Lucie, :la. ~ ti. !~rt~nd~d tH~ d~a~»d/~oen Z91+~ . to t'~r. I~ "~U •~d /~~f w~ A,~ ~li~~ on ~lnr_ 1.1~ ~~lK~ i ~D~~tA oeeurr~d ~t 11 : Y. ~'1. m on th~ d~t~ ~t~t~d ~Aw~,- ~e~d to tA~ Lwtt o/ ow Rno~r/~dj~, ftom th~ uua~a ~t~t~d. S ~ • 11 1 t~is 7L. iIaMATY1~[ (Dt{~stt N!Y4) ?Id. ADDRE55 22t. DATE SKNEO E •r• to D• ; ~o.,:.~. • Hichard F. Sinnott t4.i:. 70u S. bth. : ort rierce rl 11-21-56 •CCY~~L~. ~ Wp,~. «fYATpR j3~. DAT[ L3[. N~ME O~ CEYETERY OR CRFY~TORY Tj/, LOCATqM (CSf/, /pt1~, M 1OY71f~) ~SY~~ Fsuria~` ~s'"~hj ril 2c, 195 c t. ~'ie: ce "emete : t. Yierce rlorida S. `019 j{. FUMERAL D1NE 011'S SK.IIATYRE AOORESS 2S DA7E AECD. ~Y LOCAL REG. 26• 11E6t5TMR'S SIGIMTURE . tr a... ~oea Joeeph Yates, h't. rierce 11-2u-56 • An.~a Lee "enison, d. r. ~ ~ f!LED At~Q RECORDEO ' ! ST-lUC1E COUMTY FLA. ~ i ~ ROCER ~OtTRAS : CLERK Ci~CUI? COURT , ' I hereby oertify this to be a true and correct oppy pf t~ye ~~CaFC YEP,'FlED~....~-~-- • ' Ragishart record on file ln ths St. Luc1~ County Heahfi ~ Z ~ msnt at Fort Plero~, flortda. ~T ~ 3 I I 49 AM ~ . , j ~aR11fl9: Not vafid untess ratsed seal of the St. tUCjd ` ~ • , ~ ~ , : ~ ~ .'`i - ~ County Fiealth Department is affixed.) '.~Q~~ .=1 ~ , ~ ~ . ~ i~~nvvc7~70 ~~s+:.• ~ ~ ! 1 ~ ~ ~ • Z,' .t;•,' • 6''y~ _ . ~ ; . ~ ~ ~ 4''~~ N. D. MILLER, M. D. ty iiealth Offic~ d. I ~istrar .,~+~t ~ ' ~ .s, f} ~ = ' : . _ : , 1 ~ I •L ~ (c^" = p~ "~'?,.w~ Sw, ~ . ~S~ y`-` ~ ' , "t,l~ : ~ ~ r, DsN Depvry Local Reciatrar ' ~ ~ „ , , a,, : ;r: .~.1~! ~ ~~a - ; ~!"~j~~ ~ ~1'~•~~i ~ i aoac`~~ ~1~ V~` i -