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ORANGE COUNTY HEALTH DEPARTMENT
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,t,,;; ` 832 W. Central Blvd. • Postoffice Box 3187 • Tel: 849=3335 • Or1ando, FTorida 32802
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24~Q~~ CERTIFICATE OF DEATH
. Ik~p~M~~1 of Ikal16 ~ed R~b~6l~polre Senke~ tTATE FIL[ HO.
F L O R I D l~l '
IN ~°°~~m1°O REliIiTRAR•s NO. ~ `
~ ~ECEASED-NAMf r~ae r+ow~ i~s~ ~X DA1E Oi DEA1N ~ roNtr, e~r, rta~ ~
~
~ Z~IODORE R. LATWAITTS ~ Male , October 1 2
lACE wr~r~. N16~0. ~W\K~N ~MOI~M~ AGE-ut~ w~en wot~ ~ ow~ OA1E OF ~1R1H ino~M. w~. COUNTr Of OEATH
nc. ~ sr~c~n ~ wna•~ ~n~+s~ ros. wn wov.~ YN. tfI! 1
. White s. s. s, ~ M 11 1 2 Or
Crt1l, TOwN. W tOCA?~ON Of OEA ww~ cm ~w~ NOSMAI OR 011KR NST -N ~w w~ ~w une~, o.•t s+rer uo ~.~r~n ~
srecN~ •es oa no
~ n Orlando ~ea r~ Florida Hos ital
S1ATE OF ~1liM ~ n ro~ n~ u.s w~r~ qi1ZEN OF wllA~ COUMiI~ ~ MARRIEO. FIFVER MAR~IED, SUtVINNG 5?OUSE ~ w vrw~. are wieew wre ~
cow~. ~ wpOwED. OIVWCEO ~ v~c~. ~
New York • USA Maxried Dorot Reichert
SOCIAI SECUR1Ttl NUANER USUAt OCN?AilOH ~o.ve ~r.o a wwc op.t awwo ros~ a 1(Mp pf N/SNESS OR iHDUST[1/ `
woM++O urf. Mw u~tn~1p 1
102-18-6$ Methods De t. Dn lo ee Pi er Aircraft Com
tES10ENCE-Si~tf COUM~ CRT, TONR1. OR IOCATION M~ STtEET ANC NUM~E
` rsrear• qs w wo~
Florida St. Lucie Ft. Pierce no ~a 2 St. Marka Road
fAiHER-Nw~+E rns+ rwae us~ MOiMER-MAIDEN NM1E r~sr .uepe ua~
~s John Iatwaitis u te Balnie
~ INtORMAN)-N4ME nuKn+G ~DDRESS umn o~ ~.ce. .a., cm~ w ro•.,., ir~a. r,r~
Mrs. Dorot Latwaitis ~n 2 St. Marks Road Ft. Pierce Florida
?A~t 1 pEAiN WAS UUSEO {Y (ENiER prHY Oldf CA~/SE PfR !M~ i01 (e), AI. AI'b (~A ur u~' ~•TM
' Wa@O~~R C~Y1t
ST. LUCiE CO TY FLA.
i ,e~ Cardio respiratory arrest pocrA ~o e~s
. ? • N VO~o
' COMDIt10NS. 11 ~~R, „ RCCOFV ~~~.I IC '
~ VMI(M O~r~ ~O ~e~ Brain stem c m ressi ll
rr101~t! CAYSI ~ol, ~*O, W~S ~ COwHOVl~+C! W:
' fr~t~wo twj uMo~t- ~ f ~ ~ 1~~ .
Secondary to massive subarachnoid hemorrhage
?A~~ N. OiMER SIGNMICANT ~ONp1t1pNS: ~~n~s edan~vnMO w a•m ~ui ra~ ~eu~ro w e~use arv[N m ran i ro~ A~~~ ~ rES ~~~t n¦o~wos ta+-
~ns o~ ..o~ uw~eo ~M aaaur~wo e~vu
W Ot~~M
es Yes
tn~boM,j ~tCGroFNi. SUIC~DE A t rd.rw, p~t, rt~~ i NOUR HOW INIUR~ OCCUR~EO ~ ewn~ wrwe p~w~un ~r r~n ~ o~ r~n N, ~nr ~
~ MOMiObE; Ol UWEIfR1Ylu~EO
• ~ ~M
' 7N 7k M. ?N
IH1UR~ Ai WORK KACE Of NIURY ~t wort. r~~r, sr~[n, ~KtW~,
LOCADON ~ sn[er o~ ~.r.e. .ro., cm o~ ~o..., si~a ~
~ spe~~ •es o~ No~ ow~c~ ~e.,lK, tl?N~N1
10~ 7~! ~ 1~1~
CEtIMKAiION- ra+~~ w~ ~tu ra+a w+r *u~ ~~+0 ui~ f~r wr/wt~ ow ~ pO/WC NOt v~[rr~N! Ol~iM OCCYt~ED u~t hK~, o.~ w~I
~ .mNOm m~
' ~N~SK~~N: ~t. 4, 1972 T~ Oct. 7, 1972 p~t, g' 1972 ~
didiiot
tq oecus~o ..o+ • fD - tic f 1~1. !M q.M ro na e.usew~ s~.ae. i
CEtiaKwT~Or~-MEOKJ~~ Ex~??~ut+ER OR COROr+ER: o.. rM~ ..s~i w.we »ow a a.m rwe oecea.n wws ~n.cw oe~o j
t~arn~arqw p nM ~p07 wp/O~ M! MrlS1~G~rpM, tia rr p~~aqN. • Q?~ ~l~t NOy~
Ol~~M OCCY~~tD ON M( O~~[ ~MO 01R b ~M! C~tISE~iI 51~~lD. '
)t~ M. Ml
CERttf~ER-~+~ME mre o~ n~rn S~GN E oteae o~ nnr UA S O M. • ~
Robert H. Shear M. D. i~'~~
' ~"~3~"~ran "e Avenue Winte'r`"~a"r~ Florida 3~~ sr~rt t,.
' , ~UR1Al. CREMATIpN. ~fMpVAi EMIEiERn OR CREMATOR~-NAMf IOCATION C~~ p~o`+N fun f.
~sncw.~
Burial t~~. Hillcrest Cemete :a St. Lucie Co. Florida ~
OAiE ~rp~tN, O~t, nui fUNERAI MOME-HAME AND IDORESS ~ ft~tet Oa ~.r.0. NO., em p~ tOrN, ft~rt, 7~~ 1
~ Oct 11 1 F+uieral Ho e 1 N. th Street Ft. Pierce, Florida
u+`E u ~srue r . DA/E ~KEt1l[O ~1 tOC~1 R[61S1U~
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~ ' CERTIFIED OOPY
I hereby certify the above to be a true and correct copy of the Local Regi~tr~r~s
record on file in the Orange County Health Departaent, Orlando,=~Fl~vf;lda.
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Health Officer and Locsl Registrj •
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NARWING: Kot valid unleas raised seal of the Ora~~;.~P,~~~:,,, •
County Health Department is affixed. - +
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