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HomeMy WebLinkAbout0889 SI'-15.735 ~ ~ , v . 239955 Ro~E~ Q;`a~l~~', ~ `y . C~ERK C~~:cuiT op1~~T ~ ~ RECORD VE~'FIEO `L 239955 - o~~ sc a PN ~ai . TA1• D~- ~TATt iOMD OR M~/?LTfi CERTIFICATE OF DEATH CO~~~ • YURGU OF YITAL RATlfitq fTAT! FIL[ N0. '°a" FLO$IDA O~4 ~A~p S:2TSi azs.: ~~as..z ~ar S L! si~tY[~d ~C[ OI KATM CODi NO. 2- YWAL AtNKMC[(Ilnl~dlir~. •I/i~MN+.w: R~:/~r1dw~~i~iri~ •nd •111 a STATE apyNTy s. ~i.e•a ' ' 1n y~f- GT1I. ~ORN.OR IACATqM t. K KACE Oi DEATM t. dTY. TOMM.OII I.OGTIOM 6 RF510EMCE ~ ¦~n~~t 1NSIOE CtTY UMITSf IMS10E CITY UMITSI l11 e YES " rq ? ra ~p I. NAMf Oi (JJMf I~ ~Mlifd. /is Ihql MIItN) t STREFT AOO~ESS Iq5?ITAL OQ IMSTITUTION ~ A 7' 3. ?u~rt oI i'brt NiIQs Lrf MtE XwN Dq Yse ucusce c~D"'~'n :ROSE F?.ED~ZCn P~~'r..~RSO'.~' ~T" A ril 1 fi . SEX COLOR OR AACE 7. MAUl1E0 Q~MEYE11 MARNKO DATE OF ~UITN ACE /tp/ i l~lOEt 1 TEAt YMOE1 N Mi wt ~~a) r.rr n... r... rr.. ~ i s• Fe;nale 'r~hite .noorm? wvopcco A r. 1 18 p 1~ l~ 1> >a. usuu. «cw~no~ io+.r N.~ y.«~ a.e 10p. KfMOOF WSIIIESSOQ 1110YSTIlY 11. ~IQT1VlACE (Sldt ~?/f1?tl/~ tMtWI) 1 tlI1IIM CF ~T f~DIMI~tf . t c a y~ r- ~vuy .wt N.~?t~ 6k. arw y~ttireA Housewife i~:ew York U.S.A. D1aok l~t ~j, ~ATME11'S NA11E 1~. tqTNE1l'S MMDEN ~u1ME ~rP••t1ti• Alexander Ga er Catherine Ginter IS- MIAS OECEASEO EYE11 W Y. S ARMEO fO11CE51 li. SOCUIL SE(yRlTr NO. 17. IN ~ Ma~TV~ E C. Peterson l l'a r. ~~.lrwl UJ rw. w+ w. ~/rY~ rrwrl • 1~o Unsvailabl A~•« 202 it. 1 h. Street Fun~~~l ll CAYIi N KAT11 [B~fow~IMtt~tyt?fiae??(~).I~).pf(t1.) IKTE11vAl~fTRE[N . d 1 t~ e t e? ~~T t OEATN rAS CAIREO ~T: Ti~ pKET AID DEATM ¦u~t fll• IMMEOMIE GYlE Coron 1ilY'~~i~31$ tA• t~?- 'i °irl°.s. a..jrr.~,.r~.... ouc m c~~ ertensio:l ~I ~ltl? t*• rlk# prr r b~ . I 1 e a w 1 ~t ewu~~l. ~ r~sistt~r at~tty Us ~~/er• pllE TO (c) ~ . ~ •ItAl¦ 7= = - A o u a f- ~ rIlI1T IL Ol1El1 SIGI~ICAMt C0~1fO16 C10MAIM/fK f0 OFATM MJ~ NOf 11[UTW TO M IWrMI ORAlE COIp1110M GIYEM ~1 fMi 1(~) . MIAS AIJTO?SY • ~ERiO1lMEOT t~r d~~ti~ or e~fer• ~ YES ? MO ? .•t ~ m"- ~ ~oe. ocscaue ?ar wuar occua~o. (4wa ~.rrre yq/w~ Pr.t l r Prt 1~ y tu.. ~~J i 7 r ~CCwtNT SuitloE ~wa~GOE ~pes1- ~ ? ? ? ew ef Tu~E oi H~ar red~. Dq. Yt~/ wusr n_ c D. ~ 2O/. YUU11Y OCCYIUEO mt. ~LACE Oi IM/UIIY (t. i~ M 1iMl mJ. CITY. TOIM11. OII IOCATIOM COIINTT STATE MfNKF AT ~ NOT MMIIE ~ ~A./~MI. M?td. ~~tt WI/.. eftJ WOIIK 117 MOIIK ' 1~ft~nd~d fM d~ewwd/rom 19~3 , to ~ 905 ~nd lut w~ hi~ ~li~~ on _gjL 65 DNth oec~rnd ~f a~ on ?A~ d~t~ ~t~td ~bw~; ~nd to tM 6Nt o/ m~ knowNdp, /rom tM uuws ~t~t~d. ?11 lt~~• NOIMiYA[ ~ •r• ts 1~ (~a q tYk) ~oW1E55 Qs. MTE SKMEO ~ . ~~¦P~•~• ~ John D. Bror~~ni.z M.D. Ft. Fierce Fla. 4 12 6 ! •COY~~t~. Z3~. ~u1aY.C~u1~T10M. Z~ OATE T![. MAYEOfCEMETERYORCIIEMATOaIY ZII- IOCATION(G~f/.lMn~.MMl~fp (B'~ff) ~ ~ Rer`.o°v`~a~ -b-b ~ ~ :or~.h Brunsk~ick Ce :ete Ko• BrunsV:ick N.J. • v. s. fei~ z~. su~c~ a~ o~ ~s s~e~u?ruac Yat~9~r~eral Ho:.e xs. a?rc iecca ~r wc~ Rca. tc. Rce~sruus s~eiuruec i R.".1°6e Jose h w. Yates Ft. Pierce, Fla. ~ 4-19-65 Anna Lee Denison d. r. , ~ i hersby osrtify tha to b~ ~ trw ~nd aort~ett oopy of the lotsl ~ . <i rA/ ~ Repim~ra rooord on flk in th~ St. lud~ County Hsihh D~psrf , . _ . ment ~t FoA Pler~, Florlda. ~ ~ (VNaming: Not valid unl~ss ratssd seal of tfie St. t~ud~ t;. i~~ l~ J' ~ F~•~!~ County Health Depa~tmsnt is affi~ced.) ~ ` : ak ~ •~=i,~ . N. D. AAILLER, M. D. - ~ . : : y : : . - , f, Camty Hsaltfi OffioK b Loal Rpistr~r ~ : r ; ~ • ; . ~ . j LJ ; ~ • ~ - ~ . , ~ ' a _ J . 1 al,_,i ` ' ~ ~ ' ? i OrN D~p1Ay toal R~olstrar . - ' 'Oa ~u. s'• 1~~1~~~ . . . . .'.'Ea?~j~t1 t ~.r-- • . i,~ t ~~j''~~/~~1/i/'~~~~t1 ~'flf ' . i.1 ; • ~ ~ . . ' i