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HomeMy WebLinkAbout5031 / - - ` FILEO AN~ RECOROEO-- ~ ` ST.lUC1E COUNTY FIA. ~ RdGEa POITR~S ~ CtERK C~RCU11 COURT RECORO VERiFIEO J~ S 9+~a AM'~3 244994 244994 D~- BTATE BOARD o. M~?~Tx CERTlFiCATE OF DEATH ~ o.~ BUwCwU OF VITAI YTATI~TIC~ iTAT[ Fit[ KO. FLORIDx ' ir4 P:ATH T~O AEGI6TRAR~S NO . o. eflr GOOE t~0. 2. ULWL wCt10[MC[(/M~/w.ria !!•w.M.M~ lr.sw.M.~~r~+wwl ciecut~d 1. ?lAC[ Of Y[ATN ` a Si~:( 1. C01.MT? s~~ .u~ ~~~TY !(o!~ -O~s Florida St. Lucie . o~ Pi.~.a St. Lucie ln y~t- 0. C~n-TOiN.O~IOC~T~OM f. ~S /UCC Gi G'a~iN ~ t. C~Tr.TGNN.O~ IOC~Tqw cS RiLGFwCE .an~~t .~S.:.F t'Y 1:~1TS~ ~NS~ ~T~t l~riTS7 r,,.. Ft. Pierce rE:C~C k,~ i Ft. Pierce .ts ~ w~rE OF l!J M! i~ ~wl~t~t. f~M ~tr[tt ~i4~H) ; 57RLfT ~OOAISS ; sYT~Ta~ Ft. Pierce Mem. Hosp. 1115 S. Ocean Drive ) NAMC O! ILN ?!INlt L~t ~ D+~TC AIMf~ IN~ Yt4 ' Ts~Mp~iwt) DOROTHY C. BETZ TNFebruary.' 22, 1968 ~ S ITY ~ CO1011 OR MC[ ~ YARI1:[J ~ w[ViN M?MR~iDC~ ~ a'TE Oi i.aTN j~ AGE ~I~ ?fV1 ~ W`x~ i~ ~S ~"'1 U 16 ~ 17 O H i fYt C n q) 1/..'y D~w Nw.. M:+. F Cau rnaowco:., xvon~co~ g• J7 y:•' ~ i r la. NSU~I OCC41~T1~1 (CNf t~~f ~jr•Mf 4af SOp ~l~ADOi ~~5~[SSOA :NOv~Twti i ii. i:A2rtAlICE (y~t M/N~Y~ tM.~f~~l Ij PT~t[~ Oi YMl Cqi*A~t ~ v 1 a? y~ f- ~rr~Ri w~d • rwa~1 t~(t, ta+ ~j rdvdl _ .....p~ Home ~4aker Own Home f k~allese , En land .Iat. USA " Dl~tk f~k j~, (ATM(~-S w~Y[ IJ MJTMCn~S MA~OLM w~Y( _ Unobt . ~ Unobt . - K SOCuI S[NMTr Iq IL ~N/Ol~~iwNT f t~Gly~TYA[ AC4~u None ~~n,Zk;~ ~ J.~~~ Ft. Pierce, Florida ~ • M~n~e~t 1~.CAYttO/OUTN~G~fIr~~I/~~e[u yuLv/yi.:yb~i.~.t~ci . ` InT[A~t.i[Twit+~ /~RT a O[~TM M~S CAI,SCO ~Y~ 7 ~ ~,7 ~f ~ ~ oys ~~J OCwiM ~ 3~r~etor ~t/vC--~i ~~_J/~I' (t'j/`/,/lli ~:.r._ - . c r~ 7~~ ~rwtoyTt C~wu J- ~ ' c n • e ~ r - J . ; ~ 1 - tifle~t• Co:~rw..'/a¦r. J/•-~' "(..~G-~.'• ! 4 . •itA lA• Du[ TO l~1 _L_-~ . Y'~11A /Kt I~!(-' ~ I 1 • C • ] ~'Olf f~tlN ~ 77/ ~ . ~ ~ta.~~/ f4 r~~tr- ~ ~ L • ~ G I ~ ~ ~ L ~/'~CC~~--~ ?~Rt~te~r IIu, nus~ fut. Ol,[ TO (ll~y ~t" / z ~_J_.::. ~ ~1tAls 7] W~S~~T~~KY . G IA11T H Ot11d~ 51LMf1CM1 ~OwDtT1DwS C0~I71~ W jL D"J N tJf Mi RC~/lRD i0 7w[ Ra :l.~L A541( CO~D~tIM GIYIw .w IYl 1(~) Aou~• •f- ~ / ~ ?1Rf~11nF~0~1 t~r d~~tl~ ~ ~ • 11[S~ hUl.a O~ Of~01• ~ f'~'~W~~ 1 ' ~ j{H ~ j(ID. OCSC~:LE tiJ'w :w:~ql pCC~~nCJ (lwr~r ~rart ~/~wjrr~ iw P?f I r P~rt 1I ~/~t~ f~.) . ¦~1{~ws •w) ~ A~C~u(MT wK~a MOYIC:OC .,.o•.~- ~ ~ ? p V . J p( TIME Qf I~~Y• XM~a. WI. Z~fM ~ 11• V iwl~11Y w. ~ y. . _ i 2J~ uwu~r occu~~co ~ 20r r.•c[ os ~ti.~~r ir. s.~n s. wr.r a,.u. 2'J! CfT~. ?CNM. 011 IOC~TqN cO~~Tr sz~rc Nn~LC AT WT MNHE N~A. ~fM?. ulllf. LJ.[f (t~.l ~ :wO~K ~ ~T M011K ~ 21. 1 ~tund~d ~A~ d~e~~~W /rom ~ . ro __?r- ~ - - _ (jnd 1~~~ ~~.`e~ m ~1..~ on ~ ~ r/ ~ ':l . D~~tA ocwn~d ~t ~ n ~ ~ m on tA~ d~t~ ~~.teJ ~Do.~: ~nd ~y-rM 6~st o/ mr inorAdj~. Irom tA~ uu~~a aur~d Ail It~~• jj~ NCN~ITYR jLr Nt~ia 2=' aDONES ~t. WT[~GtiEO:i . % ` ~ ~ _ / . ~ i'~'l.,li ~o ~-~'j~~~.~=~ ~i ~ ~ C ' ~ ` co~pI~N i L l ?ce~r~t~. 2~_6 ~~~i a(r?npw ~p p~T[ iDc ~.~to~:i~i:cpro~:ec~.:"vAY i23~ ~U~~qn,Cr~.naw.r~w~ry~ iS~ru ' au:.;s. cpraJ~ti Buria~ ~2-29~68 ! Hillcrest ?~ie:?.Gd^s. ~ Ft. Pierce Florida ~ Y. ~014 j f}.~ D~ CG301~ SS~Ghj~ u~~L ~Y pp~ 55 ~7 t~ 25 L~Ti ~iW ~Y ~AC~I pEG ~[GSTR~I1 S S.4 ~(~Ty~~ _ Q~. 1'~. i / 7V1 i~l. /~11 .7t., ~ ~ Aer.1J66 ~~.~i?~~•~!` ~ Ft.~'~ezce,Fla: ~ :~-b- L- ~ r~ . 1 haraby oactify this to be a trus and comect oopy c~f tfie Loml Regiatrers reoord at f(le in ths St. Luci~ Counry Ho~h}~ pepa~t ,..,t~ ment at Fort Piercs. Flortda. • ~4 / i ~ . (Waming: t~tot vaJid untess raised seal of the St. Luda . ~ County Health Depa~tment is affixed.) - ~ : , ~ _ * ~ L ~ ' ~ r~~c~,'!~' T'~, _ .1•.i,.~•- N. D. MILLER, AA. D. r County Fbalth Offic~ b lxal Rmpistru ~ ~ . • ' /lY ~ ~ I y ~ . ~ ! , j: r` ~'t, • --t~~ T i~ 'S. ! v~ _ ' ~t a7Jj ~1 ~ ~f ~~j ~ f*~ On'i+~ Deputy i~ocal Reoist.ar ~ ~t~ ~ : . ~ • - • ar 1 ~ f'• ~ i s~,209 ~~2024 . - ~ ~ ~ - .....~"F,c.~,~.ii~~ ~ ..r K' - -f` T'r ~i.. . ' : ~ ~ .~.r-~:_.c~~r-c-S..~':: ~ ~