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HomeMy WebLinkAbout0259 ~ . ~ . ~ . _ , ' . _ _ . . . . •~i/~~~ ~ ~ . ~ ~ ? ~ C 3 t ~ f . ~~~~r _ _ . . . _ _ . _ _ ; . . . , . . ~ ~ - ~ ~ ~ ` - ~ _ ~ ~ ~~RT1FtCAT~ ~O.F DEATH ' ' ~ De~:~ew~:/fie.tii'.d Rebl,+hfN+w&..inu. . . ~ ' ~rwTt~~1?I~t NO. ~ ~xveaN a~. ~iu.m . . _ . ; L O 1! i D A . • Tr~E, o~ ?bMt iN ~.r.w~a....~.M ' lttMA1NMT tNK ` ~[Ol4TAAl1 ~ MO. ; S[E ~~OOI F0~ DKE ~ . ~~ur. . . . ~ OA . . ~ ? .~a.s ~ -:R" ' ~ I'i~ ~BMICH~ ~ ~ ' z: Mnl , June 2 - 1 ucE wr+.: neow....u.~c.N.»~, ~ wde..,uN?:. , i a~le oF MRn+.~,.e~. .,t. cau+tr.a.aEiaM - . ~tt. ~ Yft~n ~ ~ ~ ~ ~ - iNwl~r ~RY!> rp~, .~yM' OOiI~; . rM; ~ _~fMt ~ ~ . . ~ , . . . . ~ , ~ ' ~2'lif'ie. s.. 8 . si ' : .j"18.x'r :1 ' 1.8 ~ p~l.~ ~1l8t?~1", -~O O~ cm. tOwN. Ot tOCA .~~4 cwr ~ . _ - cn het rmN s~-~nim n~o M}~w~, • y, wca. ~t~ p Nq . . , Boca Raton - ~ ~ ~ Yes.~' : „ ~ 1~G1 `-4~ dvsnue : ~ STAtE Of ~iN ~ r_ ifer N~ r s:~.; w~tw~e Ci ~MilA1 COI~i!!1t . : MAl~D. f~YL#~ i1'OtISE r» vnwt: OM,'r~~+ ~Miri! ~ , • ' ooww~ ~ ' MfIDO'WlO. t sit~v t ° ' ; , - - - YMMI M~~OlMp ~ ~ . ~ . ~ . . . . r . _ ` ~iacii~'red Sdwaic~~ . ~ - ~ ~~o u.~... soc~~ sECU~m ~ aoax~eow ~ati. R.,e o..~o.. eo~. a.~ ••oa o.. uo+o cx ~~~or~ ~ousn~r~ - . OCCIM~lO M . . . . ' Wd~[~M6 IIM.'tVlN.M altNO~l ' ' ' ' - - ~ . ~ : . . . . , . . , ' . ~ ~ ~ 1MinM!Q~. 6M ..we..urw« ~r 19f7-?G^~9~• . ?a. dCC~lulf'iBIIt'i . . ~ Q~'4H~ ri!O~ $i ~ Degt• , ' ~is~•••. RESWENCE-SiA1E . CQIM~1r . ; CRY. [S>wN. t3RlOCA1fON rM}M t~h F~a . . . ~ ~ ' : . . . : - ~ - " IfMC Rf O~~t14 : ~ . . . . - . ~wFlorida ;..~'al~ Beach t~.~o.as xat4n , ~ . ~4a , . , 5~ 1Q~" "~Aveaue - ~ ~ . fATHER-N.wE ~ np;1 . . : ~ ~ i.wpt _ _ . : ' . .T~ . ~a,. . . - . . . ~s ' :RObBx~t ~~'t'~CCQr~Ck a • ~ _ - - . : ~ -we,~r . _ . ,~u~~l.+c~:~oD~ESS .n~. w,...e: .w:: cn. a. w~+: u.,,n,, n.~.. - ~ . ~~.Mrs. winif3ced~~~IoCa~ick ~ `~555 N~t ~~~?$nue. Se~ca. ..Ratan, ;Fl~ii: ~.3~3 _ ' , PART 1 -0[AIM:W/1; ~AIi~O SY - ' ~ ' ~ENifR C~ITY QIJE CAUSf'-rER lt~ ~OR (~6y ANp .(ij~- . : OMitR ~AIN ~ il 'MMYM ~ . ~ . _ - . . . . . ' ~ ~ `'I, . . ~ . ~ . _ . . _ . . ~ w . . : . . . . ~ . Cowo~nOHS.Jl~iR, . - 1l~~~~.._~~`.~": ~ ~ . WMICM G~YI ~Il1 W - " ' ~r ~ ~ il.~~•i~i ~ - ~ . irrfD~?t! .t~Yf! l01 p ~ A.~ p: . - . - ~ : . ~ ~ . S~~nN6 iw1 YrDN . . - ~ . . . . . . . - . . , inMC c~uu ~~s~ . ~c '~~t . • . ' , ' ~ . ?wR~. tl. OTNER SIGN1fKMr1 ~QNDl71F~^r5: ~ co.iano:a ~tdww~un~+c'w oun~ w~ .wr nurte. ~.o c.nu cnn+ ...-r.n ~ ao~ ~ AYfCM'Sr. ~:~l. rES wen- r~we~MO~ to~r . ~ ~ _ . • . . ~ . . , - - ~ . . . . . . - . . ~ - • ~ t~lt 4~ iq~~.. 3~MMY. t» O!*lWININ6 CAYft~. . . r'.'_ . . . . . - . ~ ~ ~ . _ . . . . ~ ~ . . . . . M~PM r . . - . ~ ~ ' ~ 1~'~~Q 1* ~ . . ~ . ' ~ 1~.~~ I IrONT1(, Ow1; n.~ ~ ~ . MOW IN~VRY OCCUlREO ~ e:m~ watu~f ns a~u~ +a ~ut.i Oe ~i~r ~i. nM. i. ~ ' . . •IqMICtDE: OR AIED ~ . . , . . . . . . . . . . 1~ : . M ]d~ ~ . . ' , ~ - . ~Fl1NR~ A[ ~MCtifC ltACE Of Rilt~f.wT'war, rur; srin, r~c+~».. . IOCATION _ rs~ei ow'~.r.o. ..o., cwrt o~ for.+ uea'r. . - - . 1 ~~lCIR O~ MQI ' ORK! ~cpff.,lK. t1IlC~It t. ~ . . " . . . . ~ ' . ~ . ' . . ' : . . . . - ~ _ , w.. . . . . . . ' ~ . . ' . . . . . . " , . . CERT~ICATIQ/i.- +~+4i . eif. .7~u . rOnwr e~~ ~ rtu aeN ufY Lw.rrwlw[f ~tn't OM ~ MY/oq wOf r~ryr Mt DfATM OCCVMfO .at.a~[ 1L[!; pN~q~-~ . ~ . /N~SICIAM: . . tO ~ ~ . . ~ ~ . rdatr _ O~s - R~M W07 ~RH Ot~M " ~ ~ • . OA1f. ~NO. ~O Mf KfT . . . . ~ ~tVtr~WfQ iw - • O~"r~ a~pp~~ qK . tta oecuseo ~.~A~ ~ ~ ~~i~ ~Gf 2I~T ~ ~'L. Q rr~ D~C~ _ = ' l.~_ ,o ~~s~ u.~e: CEt?1fKJ?TION-MED~CA4,E7t~AM~ER ORtO[CiNER a+ rut t~s~s a• ne • ~.ove os oe.n. r~e oxeoa~+ ...s .~o«au.Keo oe~a. ~ ~ - ` ~ ' eurr+~t.ow W us lOn~ wwofo~*Mt~wrlinwt~ow. n+ rr~pWWu. . . ~ ~ ~ ~ - ' ~ i+d~lw , wv . . v[wf . ~ ~w.n . ~ ~ ~ " ~Dt~M OCfVM~D O~.1M! PI1R ~w0 W! ~O fik G~11Sl~S~ St~tEO . . . ~ . . ~ . ~ ' . . . . . ~ . ~ . . ~ r.:. _ ~ tL . . r" . . : : ~ . M l71 • . . . ~ . ~ . ;i . . , CERTtf1ER.-N4ME ~me Ot r~u.~i ~ . . ~ SKsNA ~ . ' ~ ~ / ~ _ ~ M . ow~te c~' OAiE D~.~o.+n., oa~.rw~ ~ , . r Ri har 3 `Buker ~ ~ k ~ tiulNG wD[1RESS-CflffER . si n oR'~, ,.o c~n o~ +v.~ ~ ~wh • 2 E. Palme~ta ~ar Rd Boca~Raton Flor a: W!U?t. CRfMAJ10N. ~EteOVAt . RY OR T. -NnMf tOUT10N ~ c~n or ~o.+N ir.n ~ ~ sreta+t~ . . t4 moval' ~?.Rivereide Cemete I~onroe Co~. Ne~ York ' DATE - rra.~w, e?r, n.e~ WNERAI MWitE=NAME A/m ADORfSS p~ a.r.~. .a_, cm a w.ru sr~n, :w~ ` ~ . raee~ 1 : ra• ~ H . ~o~ca Ra~on, Fla. 33~32 ~.,v. s. sb i2 iw6Ut tMLCTOt- . eOC~t is~las ' Rev.147fl ~ _ , _ . _ , , ' i.. ; • 7 ~ , : ~II. ; . ~ a ~ ` ~ HLREBY ~F~~ ~ I~o T~ ~.i3~VE _ J:;i; A. Tr~L''E. ~'.PiD t~ F~'~ ~r' "Tlfi+. ~ S" R~^~RD ~N - ~ I;~, r3 :HY; ~ ir'g ~ ~ ; 1•.~, ~ _ ~ ~ - ~ - ,z ' :{"tot valici unlea~+ t1~e ae~` fr'~.h~ P.~e~~ ~y.Nealth ~ ~ ~'~partrr~ent - is a.ff ixed } ~ ~z~` . - ' s ~ . . - - - . . . . - ~ J~ ~ . . . ~ June 5 1570 • . ~ Local•~egi ' ' . - ` ~ . i~l1T'?~Ll Of ~~it~~ ;~t.& ~~~L~C' ~ ~ '.•;e-st F~alm ~e :ch, Florida • ~