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Home My WebLink About4199 r 1,ED A110 REC ADEO - - - - ~ aoQER P4~7RAf u 244403 c~t~K cjacu~t cou~t ~ Rf.tORO VERiFlED ~ ~ ? ~33 rM ~7Z . 244403 i ' tn~: s._- nwTC BOARD OF NGLT1i CERTIFICATE OF DEATH L~ eo~es a ¦URGU OF VIT/1L fTATIYTIC~ tTATt FIL[ NO. 1•s•~ ~•e- FL08IDA , ord ¦h~n BIRTH NO. RE61iTRAR'f NO. ZO prep~~l~ L YWwI 11[NO[Nttl~~w./rr~tliwt fli~w.war~ t~r~rNN.+M~:r:w) aa~eut~d 1. Kl1tt O~ ~[ATN C~i •wl •ill ~M~ a STATE C0IJMTV St. Lucie 66-025 Florida St. Lucie ' pTr. TOMIM.OR IOC~TION e. ~s rucc as ourn e. urr. rowM. o~ ~ouT~ a Rcs~oc~ 1~ •~O~\t INSIOE C1TY UYITSI qKtOE CITII LIMITSf r,l.. Fort Pierce resDX Mo0 Fort Pierce - Rural res0 NolCl I. NAME OF ( ~Mpiht. WM f~b ) tEM6TM Oi STREET ADOwESS ON A FARMt ~ r~~ or~~ei~a ~emoria~ 2 ~~a .R.F.D. 2 Box 160 "a0 ~u..c or n.r iuw~ LYf . DATE x..u na Y~.• ~ceuste - ~ ~~1rss r s~~ EVt.LYN OPHA JGNc oE"T" ~ ~ S. S[X COIOw OA ~ACE 7. MARRIEO ~p IEY[R YA~~D WTE OF WITN . ~GE /l~ KO/ i UIOEII l t4R YMOG M I~i u Ivt SirNNi1 Y..r. ow. Y.w Xf.. ~ s s. F`e White .noowcn ? avo~ceo Ka 2 191? 4 y1~1~1~ IOs-USW1lOCCU?ATq~(Qiutiwl~/ontMt IOe.K1NOO~WSUiE.55011W0UST~Y 11. WITNiL~CE(9dtR~nM~nsW~) 12-CR~tEwCf~Mi00tM1~TT •ftb ~~r- Iniy~wtNwlbl~k.~+4?~~) Florist Desi er StanWOa3 IoWa (T.S.A. ~~Nk l~Y 1 iA7M[A'114MC 1{. MOTNER'S MAIOEM MAME _ s,....,s.~ lhomas Graham 6ertha Frahm ~S. w~s occ[wsco cvEe w u. s ~~rio soeccs? socu~ sccuR~n No. i7. w s s~awniwc ~e ,jOR@S ~r.........n...~ w....w....w...r...~..? No 26 -12-246 A~~ c~ouse Rd. R.c.ll. 2 23ox Fu11~f ~1 1~. CAYK N~[ATN (S~f[~ p[I pt tqN yt?1~~t/b (1). ~a/ (tl.] IKTE4YAL ~E7W[El1 ?ART L OEATII M1?S GUSED ~Y: ~T A~ ~ATM a,..~s.. W~~a,,,~ ~ i~~ Generalized Carcinoma ' 2~'~os. _ ¦wt ti~• tN e.r- c~r~~.a. Ca. of breast 18 !'~os. ! .?e~ ea• r~c~ we .~~a ~ I• e• 1 iqt~I t1t rwln- ; ~ r~sistr~r f~is/ nrae Juf. ~ TO ([l ~ . ~itDi¦ _ j O ~AAT IL O'f/Q S~C1/1CYR COMdf1011S CpR~U{lf~li i0 04?M ~IR NDT AFl?liY TO T141LRYYMI 015EASE COI~IT~0116fYU ~ rMi 1(t) . MAS AUTOrSY t LOY~• •f- F ?ERiO1lME0/ t~t d~at? ~ Y(S? Mp? ~ •r s~tor• t I06. ocsuisc Now uuuRr occw~o. (~rn s.rvr./r.fivr h. ~.n !r P..~ U yY~. u.) p ~ •akfwj ~ µ'CIOENT SU1C10E MOMKIDE ~ •~~~i- u ? ? ? ~ ew •t T~rtE Oi Ilwr Xw~. MI. Yre ~.a~. iwu+~r n. ~ ~ ~ ~~11. MIJU111/OCCURIIEO Nit. ?IACE OF NUU11~ (t. iw M ~tMrt ywt. 2% Ct7r. TOIKN. OII LOGTIOM OOUNTt STATE ~ w~wc ~T ~ NOT MNRE ~ N?.. J.rr«r..r.re. Nk~ wy., dr.) MOIIK AT NOIIK ~ 21. !~ff~nd~d NN d~ewNd Irom ~9Sa . fo ~ 7.~~7 ~6~ •nd /ut ww h~T ~/i.~ on ~ Dwth occurr~d ~t ~ A M m on tM d~t~ ~f~td ~60~~; ~nd to th~ b~st d m) l~nowNd{~. Aom fA~ uuws ~t~t~d. ?11 it~~• 72a t101u1TYR[ (Dr~?a~?t4li) ?20. ~nDRESS 71[. WTES~GNED ~ t• 1• ' ~ ~..~~.c. a H.B. Goo xi Jr N.D. rt. pierce Fla. 1 2 6 •eerr ~t~. 27~ sue~. Cur~tp~ 23S oaT[ Zlc. ?U~ME OF CFMETEIIY 011 CIIEYI1TOIlY 23/. ~OUraN (GYI. t~w. ~r naat~/ (8i~) ' Burial~S~~ Dec. 0 1962 Ft.Pierce Cemete Ft. Pierce Florida y /614 21. NIIEIIAL DMECT011'S 51GMATURE ya~gw,~,eral Nome ~TE NECD. I.OC~I NE6. ~EGK7RA11-5 SIGM~TYRE z "••.1°b6 Jose h W. Yates Ft. Pierce,Fla. 1-3-63 Anna Lee ~enison, d.r. - ~ x I her~by aatifj? this to b~ a trw ~nd corroct oopy a~f fFts tasl ' ~ Repittrara rooord on fIk in ths SL tud~ Gounry Hsalti~ Dspetl~ ~ ' ; m~t at foA Piena. fior(da. { . t ~ `~~.N ' " (Watnin~• Not valid unleu ratsed seal of the St. Luc1~ 1- ` ; ~ County Health DepaAment ts ~ffix~d.) ~ t~ ~ ~J• = ~ i . ' J% ; . I `F N. D. MILLE ~ Z?~' ~'a'.-''- ~ i -M \ ~ :t Q~ M. ~ 'l~ t . • ~ ' : " C01Jf1~! ~i~1~1 ~IC1K at ~AC~~ ~~itfK ~~;f_; : \ '~s Y:. ~ .~~ij • ~ / • 1 fJ \ ~ v ~ t a ~1 _ . , x: - , ~ o.puy? Loai R.o~,t?a? ~ , ~ t . ~ . . ; i ~ ~ ' 6 Q YAi' 11'v~? ~ . ~ 6i.UM - ~ ~ h`4 :s " I ~ , : . _ ~ ~ ~ I - ~~°x,~~' s~ ~,_"~'~~T ~ _ _ ~s~a, .x.