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R~OCER PqIT~
t~E4~t CzRC{117 COYRT
AE~ORD YfRc~1ED~~
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240591
~ I hereby ce~tify this M be a true a~d correct copy of the local
Regist~ar's record on file in the Marsin- County Ft¢aith Depart-
ment at ~tuart, Florida.
(1Afarning: hot valid untess raise~ seal of the Martin
County Heahh Department ic affixed•~
'i N. D. MIiLER, M. O.
; County Heshh Officer b Loca~ Re~istra?
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~ o~t~ Deputy locsi Registra ~ t,~b )
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, . ° R 207 17fi2
BOOK PAGE
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