Loading...
HomeMy WebLinkAbout1930 _ ~ ~ - - ~ F~lEO A~C ~tECORQE , • Ik--- ST. lUCtf ~ ~U1~ZY F~~. ~ 242924 ; ROGcn ~OI,RA~ l. ST-2(~.?3S ClE4K C<<~~Ui~ CDU.R~ Rf~ORD ~lE~1, ~E~ ~ . ~ ~4 ~ ~b'~ ~ - '~42924 ; Nov. 30 S~t- CERTIFlCAi'a OF DEATH ~ DepA~ew1 ~ Ika1~L aw~ Re1w611WUee $e~rkw RATi IlL[ N0. n~.~o~v o~ ?~,.LT~~ F L O R 1 D A Tr7E. O~ ItINT IN w'~~~Ri1~'~O pEG16TNAR•S NO. 35~ , ~iGIdRNINT INK ~~~_NAME ~w~ ~,a~,~ u~~ ~x DwTE Of OE~TM ~•o.~w, ~ ~ YI tt17c~i00t i0i ~ °S~~ ~ ~'OEL RFY~OLD~ '?!AL ~A j . R~CE v.~n, .~NO..rrt~.. w.... wGE-u~r •c~. ~.e.. .;wt. ~ o.. ~ DwTE 01 ~.lTh ~~.o.s~. ws. COIN+TV Of OfnM j 6602~ .K. `.o.. . a,. , .o..~ ~ ~ T~fHITE s. 86 w ~ 's~ ~~1u .22 1884 T ; 'it, TOMM. Ol t TWN OEAiM ..w~ cm ..~.n hOShTM Oi OSnfl riSi~TYT~OH- wp r. ~rt.~~. an itit~ w.w.N~ ~ i f~~tur p~ rp ' r ? A. ~S ~7~ 3017 SL~l~IS~' BLVD. _s SiwTE OF WiN ~r wo~ ~-w•-• w+w GT12EM Oi WNAT CO~~.ii~ wWLF~. nErFt ru~RiED. ISW~~VNG SIOUif ~r o~w. M~ w~wM wrl cow~n~ ~ WrpOwEO. PvOiCEO ~ wc~. ' : .~i«..a ~ NEy~r YORI ~A . ,_'~iID01K ED ~n . ~u Na.x~ ~ivl0. Y Ol~b • SOCW SECW~IY MIWE~ USVK OCCWwTfON ~u.. .-o u.~o.. ~w. ~..~..r. .w~ o. cr+o a wsw[u o~ waanr cccw~es w ~or~o wr, e~e. r uwis ~ It . . .,..w. o.L. ~r ~h. ~ 1 ~I~ ~ c~ wror tESWF?~CE-SiAfE COUN~Y IOitr. TOwt+. Oli tOGTiOn "'we C++r .~.w~ STeEEI wN0 ~aYr~E . ~~LfCMI t~~ q Mp Ih W . T I 1M ' i~1 14 f IATNE~-N~Mf /MY aww~ uu ~+OiMEi-MA:OEN NAYE rrat r~w~ wr . If T i ~I~ INfORMMri-NAME ;+N4Wi AOG4E55 ~YU~~ q a~.~. w0., CI~ o~ pr.. M~V. tr~ 33450 . u. ~ :n 9n ~*F .F F ~ rw~t L ....a,.~,:i OEwTn WwS CwuSED ~r~ ~fi+ff~ Q~..r O~vE i~utE rf~ i~vE s0~ NL f~l ~ k p NA'~~r1 Qry~t ~w~ N~Iw rr~..M 4wf~ i a t ,~A wYGw ~ . . (Or~~t~Owf. ~M~, • ' w~(~ G~t~ ~iH q ~~w~~~~t! (~Yi~ IM. M q. p U~(O~HO~MK~ O~~ ' \~~t~MO Yw~IL . ~TU~O C~ON Y~t ~ I ~l~ ~ ?l1RT Y. OTMEq SiGNIfKAMi CONp1i1pNS: cow.aows tOw~wyt..w q~a.w »t woT ~tur~s ro twu a~w ....n ~ w V ~ES r~~e n.+~~wos co.« ~ ' IA\ ~01 LN~~~ Iw M~l~rww0 4YM ~ i a ~e•+w ~ :?••MM~1 KUOENT. ~OE A IA / t1~ • ~ .,wu~~~ f ~+Or+:+Of Oa 1M0lifwwEO ~ rw~.. w~, rw e.~4i ~ MOW ~NIYlr OCCYR4E0 ~w~ rwr p~rn~ w rlu+ ~ p r.n i ~ ~ i ~ IK ~7a- Ir.l1t~ i } tHNl~~ Ai WORK Iu[f O~ wnAr.. wr. ~~r~,, ..ao... i IOCwAON ~ fnut p i~.~. ro.. 4n M M~~+. Y~w ~ ~ ~~I~(~A q ~IOI pN~('j Yp..IK. 1 VK~ 1 ~ 7M I2M ~7R ~ CfliY1GT10N- Nt ~ ~~Owrw O~t ' r~u ~ uW ust Yr ~.~/M~ YM O~+ ~ W/MO wM ~M~/ M OtnM OCCYYEO M~v[l.O.. M IM13KIU~: rO ~O+TM WT I~Y ~~p~1 Yp~ M~Iw. IIw011~~ ~ NY. ~i+O. q 1W M1T ~ •mwo ny a ~~w~.uou. aw ri. e~ce.t~o r¦or ;7:f '2+: f P~. ,tN K ~o re u~rsua~ s~.ru. ~ CESTYKATiOe~-irEp+Cwl EltwiwwE~ M COR0.vE~: a+..a us~s w r.~ .p,,. p. W.u. o.~ wcex...u no.~an~c+~ ~w + ~~u~w~nOr~ O~ U! W~~ ~w~/01 M w~l3/KN~~Or. w~t W++qn~ , rOrR~ M~ ryY qy~ ; a w~ ouvw~ w~w ~.n ..r w~ a r uYww r.aa. 1• ~ P x~ rn AUGU T ~ ~ 2: 2 ~ p. i 1. M CEiTYIE~-NAME mn o. nwn 'wt E ' ~ec.ea w mu ~OATE SK'~NEO ~w~~. ~~r. ~W ~ ' E. P. DEFRIEST JR. CORO\ERrn 1 . j' ~n,_ tS' /o ' MwRwG ~OO~ESS-CE~?s~Er s~ne. a...o. ..o. cm a a.. . s..q :r j ~ * • * - P . F A 4 O ~ w~w. uEw~tqn, ~Erov~? tEar oa crFw+~.roor-w•.~[ ?ounon cn. w.o.~. w.. ' RE~tOVAL PETERSBL~tG CE~SETERY ~~w P TE 'R \ W ~~i ~ r..TA G. 10 i97i~ ri.~FORT P EI RCE 1f06 ST.~~1+~~ST. ~~F'T p PIERCE FLORIDA 33450 ~ ~ y~ 5~ /61Z f{AL K~~~~lA iEv: ' R-SK.ty~TUtf WTE ~FG11I(O ~OCY ~(61S1W ~ R.y.i9ro ~.r.i . - ~ ~ti ~ E. _ J~ (~w Au st Q7 1 ~ ~ ~ 1 hereby aerfify fhis to be e true and aorrsct oopy aF fhe Lonl ~ Registirsrs t~eaord on fik in ths Sf. Lucis Counry Heihfi Dop~erl~ - ; msnt ~t Fort Pbra~. Florida. u : ! ~ (Wuning: Not valid unlsu nised seal of tfis St, L.ud~ ~ ~ ~Y , ~ `~t ~ r-~:. 'r. ~ County Health Deputment is affixed.) ~`s,~;,.. . :f~ ; : ~ ' . l~,,g, - ~ ' ,.r~ ? ~ ~ N. D. MlLLER, M. D. " ~s~~ ~ , ~ ~ " ~ Coun Fiealth Offiar b Loal R~gtstru . ~ ~ ` !4.. • , . ` ~ ; ~ ~ _ f~a~ •r ' ' . , ~ ~ / ' ~ • ; r y ` ~ ~ o.~. o.~? ~ R.o~m~. . ..tr 1 d 1y`'~~Lw;•Y`'L ; _ ~ • ~ 1 ' , ~ - 3~ ~ n~'~' ~ ; - ~ - ''-~,,,,,,,,,l~ri . ? OU~. 2O0 ~~~E ~ ~O ~ - ~ ~ - ~ ~~Y^ , ~ ~ s~-3 -4 rA; ~k'. y i ~-r . ' `C~~,q"':T~~ Y , . .c~.`~`~;~ ~ ~r ~;?`=r~_ . ° ~ : = . x~'-~;`'~.~'_~?~~ ~ _ _ - -