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Home My WebLink About1516 .~%t C~: i~INi IN ~~w~nuo ~i • REGI6TRAR'S NO re Rrn~nkNl iNK J[CEw1t0-N~M[ r•~~~ •'°OU ~•s~ Sft DAIE 01 O(~tn ~ yo..~~, a,., .t.~ ~ kf ht~;100[ t0l ~s~~~~~~ , CAROLINE~ELIZAIIETH BAIRD DAY ~ female ~ Januar 5, 1971 RACE ~M1~~. Nl4M. ~r1~K~M ~«ouw. AGE-l~f~ u..a~ ~ r~~~ uwo~~ ~ o.t CAIE OF ~IRTH ~rWAw. 0~~. COUNIY Of OEAIM nc. i s• at~ ~~~o.e.89.~u ..os. w,~ »a+~~ •u~ ~ , wfii~e ~ Oct 9 1881 Broward ~rtY, IOwN, OR IOCAl10N Of OEA/H ws.o+ ua ~~+~~ti HOS~I1Al OR OiMFR INSIUUiiON-d~ME ~u »o~ u~~u c~.~ imu .w ..~..u~ ~ incu~ o~ »o Pom ano Beach es 2720 NE 12th Street Stw1E W~~RiM ~ w~o~ u+ ~ s.., M~r( CIiUEN Of wnAi COUNiR~ wuRt~EO, rrEvE~ ~?~~~EO, SuRVIVt~G SIOUSE ~ w~rw, ant ..~~se« .~w ~ cou~nn v$pl q ~W1oC~OW@Q 's.u~. ~ ~f~u~ uf~ol~+tf ~ ~~1~ f .~e~: ai~i.uo SECUnTY NU+~?ER USUAI OCCU?~110N ;avt awo o~ Wwc oo«~ au~~~+o +ot~ w KWD OF WSNESS OR 1HGUSTtr I~.IJ Ol~M p~ly~(~ ~~It. ~rIM U ~!t ~~O 1 N<u~~lD ~r+ ` ~~~~~~~~~«~.~M „ 275 20 3650 record librarian hospital 62~Q ~~iei~tt ~~~oq .o..~~s o.. RESiOEr+CE-51~1E COUNTr C11r, fOwti, OR lOCnt10N ~+sw~ un ~...~n S~tEEt ANO NUM~E~ t ' . ~ vuu. •ti o~ .~o ~ ~~T ~w Florida Broward ~u Pom ano Beach es 2720 NE 12th Street fwtnER-N~.wE r~~s~ ..wou usr ~?OInER-wu~OfN ?+~w~E W~~ John A Lamb Elizabeth Neff INfO~wNi-M~f lrukwG wOGtESS ~una o~ ~ r s. ao . un o~ ror~, tir~n. tu~ 44118 . 1~~342? S anqler kc3 Cieveland Hgts Oh~o .~HJa~~~ n.i~.c. ?ART 1. pEATN WAS UUSEO ~Y (ENiE! OMIr ONE CAUSE ~ER tINF fOR (oL (AL AND (a)I tlt.uw O»St~ ~+o Ot•rw ~r,uoun uust a~ arteriosclerotic heart disease 15 years - , . • ~uoue e ~~M~~~~~~s. diabetes mellitus 10 years rMKw G~v! ~~S! 10 ! (0~ ~r.~oun t~wi w+. ~ p~~ r0. oa ~s ~ Cn~a~out.~tt 0~- f~.nMe iwe u..oe.- ~n..c c.ust ?.u kl ~I?t~ Y. OiMER SK.N~IKwnT CO+~WTIOr~S: ca+anws eo.aa~wuw ~o eewm wr .w~ aune ro uw~ awer w. ~.n ~ w~ AY101Sr If 1ES +e~t ~~MO~MGS co..- 1~~ «~1 O~Ot~ M~ ~?~\r~MIMG C~Ylf i~ n~ ~w ~ pwpoW~~ wCUOEnT, SuKiDE OR • 1! 1 rOMiM, pAt~ ~iu ~ NOU! MOW IN1V~1f OCCURREO ~~Mtt~ ~NK 4~ IN~y~1 IM ~a~~ 1 p~ ~~ar u, aer ~ Npp~y~1C~p(; pR Ur~pEf[W~NfD . !0~ ~M !M. M. 7M ' INIIM~ AT wORK ?IACE OF WJUR~ .r ww.e. raw. araa. ~~c*oa, ~ IOCAi10N ~ snett w a.r.~. Mo., em o~ ~o~?r, sr.te ~ ~ i?[an nf o~ No ~ owKe kna.. ac ~ veun ~ . ~ ~ ty ~~..0 uf~ Lr ~/r!~ ~i~t Ow I~ Cb: D+~iA~ mt~DE~TM OCN~~EO lw! ?uCf, O'. ~t ~ CEtTIf1UT~W1- +o..r~ w. rw ~ ..o..a o~~ .,a~ i rp+tw O~r ~e.a '~OOr .nt~ M~m. ~~wpy~~ o.se. .po. ro+.e fef• i •M131C1aw: TO ~ ~ n. w e.ieo o~ Se t 1 63 Jan 5 71 l~,~ Jan 4 71 did ,,,8:30aM o;'.~."°;.;;';;.,; i ~ CEtiNK~TWt~-ME~tCw: Ex~NER OR COROriER o•. r+E ~.s~s o~ *~e wow q o~.a *¦e oa~uMr .~s r~o..ou..ceo oe.o es.,.~...f~a. a n.t wo, .»o: o~ •.e ....es~c.,~o.~. ~w c•~+,o.+. .a+rM w. •w ror~ _ oi•~. occu~eeo w q~e o•n .»o oui ro*»e u~~s~ s~•Tio. Zts M t~ M CERTIFlER-nM~E n.n o~ •o..n ; 51G?+ eE oeo~~e w~n~ OA SiGNED ~•o..+~. o.• e.e Paul A Des Jean 'r,~~ .aK .U.:,~ Jan 5 1971 . MA4WG ADORESS-CEtf~ffER :*~ef~ o~ ~ ~ o .w. 27 SE 24th avenue Po*~~ano Beach ~'Zorida tp ~URIAI. CtEMATqN. REMO'/A~ ~Cf+METfRY OR ~~7EMAi0it-r~,?w~f ~IOG?7~ON us* o~ qrr aurt ~ vea.r ~ :..removal I;,. Calvary Cemetery Cleveland Ohio DATE r.o.nw, o.r, .e~~ WNERAI NOME-N4ME ~NO ~G~af55 srun o~ ~ r o o t:r~ o~ *urw. sr.~t. n~ ~ Jan 6 1971 `n.FRED HUtTER FL'~iERAL HO.tE 6301 TafL Street riollvwaaci ~ ~ ~,1 • 5. s612 ft~1ER~j,?O~RECTOR-!SIG?v~lUAf _ REG'~i:i~?R-S:GH~T~aE. ~r ~ ~ ,~„~t O~TE aKfNtD lOCwl ~^G~N~~¦ ~/RQV.I970 ' is. :-~-s/' , ~ ' ~1,~~..._ 1 r~~ia ~ / ,l/ IA ~-C~C ~i G~ . i ; CERTIFIED COFY i ~ I hereb~"~certify the above to be a true and correct copy of the Local ~ Reg~st'rar'$ ~ecord on file in the Broward County Health Department at ~ Pdrt Laudefd~.I.~g', Florida. ~ ~ - ' , - . '(~afr~iirig~ •''r ~N t'~lid unless raised seal of the Broward County Health '~,ae~ Diepa~tment is affixed.) J ~ L ~ r~ l L ~'1 Ly, ~ • . , ~ , _ ,'Jli : - y Couat Health 0 icer and Loca~.3egistrar ,Y. ~_S Y ~ ~ ~ ~ ~~~~"i ~ ~ Depu Local ~egistra : ~ ~ F tEC ~!+f LEi~Ra~O 5~ LUC~~ :,~SJM Y F A. ~ P0,%• ~ }!'~A$ PLEASE RETURN TO: CtE~:s. . ';:~1~' :CL~RT ~ . nff`~:.; r:-: •f~~ ~ Clyde W. Manspeaker, Esquire ~ WECK & STOI3E , P. A. ~ 11 ~ Oe f l 2641 East Atlantic Boulevard ~ Post Office Box 2066 ~ ~ Pompano Beach, Florida 33061 ~r~1,~ _ , ~42-oaio 'J t j ~ i ~~t~~ ~JQ ~A~E~~~~ r . ~:_s:r ac:~. , ~.~r. . . . _ ' ' s a ~ ~ iy r ~ .,.~~-..+:~7 ~S ~ ~s'ct+-'.'~"~ ~+~es"~~ =},''a ~~;•K~., `~-'~~~~~cs^..~n°"s.~...r'~-'~-~<"''~=4 . _ _ . ~ ~ ~x~""'~'.: _ . .