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HomeMy WebLinkAbout1108 N ' CERTIFICATE OF DEATH De~.n~...~ ~1 Ik.ld R.i.6~kur~.~ rrwrs ~a. ~ ~~.~w ~ ~ F L O A•I D A ~ . t~?E. Q~ ~bNi IN ~~~wr~~s.wwv 11(OISTIIAi!'• NO. NlMAMM~ INK ~~w~-h~~ r~d~ .Ma~ ~a ~ E7! OATE OfwM ~.o.rr. ~~u ~ SEf Nr10M fM ' RETHA GAl~I.S ~ FSMALB , MARCH 6, 1971 fwCE •n.w. ..~a~o. .w~•cu. .w..¦, wGE -..a~ u.o~~ ~.iu wa~ D/?1E p Mtta ~ rOMw. M~, COllRY OE OEA1N ~ IK t WC~I~ ~ 4~uN~t ~~f~b ~ ~pf~ M~i ~11q u~ ~tY ~ ~ 60-187 • ~G~ 33 k • MARCH 19 193 PALM BEACH ~ G111r, TOwN. O! lOCwt~ON Of 11Tw w?w cw~ iw.n NOSMfM O! Of11Et NST ~ a.o~ an.~~. ~.~.e s~A~r ..o .wrrt~ ~ Q~ . snrN. a .w e . ~ S N A ~ 0 STAl'B HOSPITAL ± STA1E Oi MtM ~ r ro~ w r t~, r~~~ A1lIQ/ d W~~A~ COIMit~ MAt~lfp. N[VEf INI1Ai1ED. SYlYIY G ypus[ ~ N~u~. atit rneer ra~e ~ cow~ ~ ~MIDOWEO. ~ wan ~ . S01Tf8 CAROLINA , U.S.A. N MI~~D „ CHARLES GAMBLB .~e.. ac..w --i-- - ~ ,,.w u a.~. SOCI~i SKUMTY NIM~Et USU~I OCMwT~O~+ ~a.e c«~ a won oaw waro .os~ w K~+O Of MiSNKS O~ KOIRiRt x:~ueo w .a~aoa uw, e.e« N~enns ~ ~r U[~OBTAINAnIB ~a, HOUSSi1IFS ~s ~erotrce ~lq~f .a~.ao. itswEna-sua counn cm. rowN_ oe ~ourqH «sw an ~~,cn sreE[T ~u+c i ~a FLORIUA iw ST. LUCIB . FORY PIBRCE ~~u ~~YLS p~ ~M 2807 SHERADON BLVD, fA~!-NAME ..~oo~~ uft MOTI~~-N~DfN N~M.~ .~rU aawe We ~s DAVIS NC GILL u ELIZABETH EpPS ~ 1?~O~Iw?Nt-?~~w~E wt~wG w00~Ei5 jtlOm ~snetro+~.re .w. c.n w.o.». s,.a. rv~ C e recor a Of , ~n CAROLS L. BORBONUS ~n A. G. HOLLEY STATE HOSPITAL r C. Borbonus ! ~ OEwn~ wnS UuSEO ~r. ~E?+rEt Ortr O~+E C~?uSt rEt ir+E ?or lo!. rol ~w ky, ` ~w.~ww cwu ~te.wr own •.w w~m • Pi1Ll~pNARY TUBERCIlLOSIS FAR ADVANCED ACTIVE CAVITARY 2-3 Years . ~ co¦~uo«s. ~r ..o, - tMl(M O~~ ~1s~ p ~~nfM~t! C~Y1~ 10~' OY~ ~O. W 41 ~ CO~+ff011~ ! O+ a•uwo ~¦e YM~lF K lnN6 C~Yb t~ft ' kl ?wt? ¦ Oi~(~ S~G+~r+C~t~et CO~+O(!~O?+S co.~anw.s <o.awv~~•.e ro ee.n. w..w~ Muno w u~se o~.e~ .u. ~~e~ M ~ES .e~~ ~~we~..~s eo.~- ~.es w~ ./w~, u~r~ sena.u~wo u~rse IA ¦R/ O~ N~1M ~w ~E: ~TEWMED ~~OM . Or~, rlNi qQW INI~I~~ ~CCU[ff~ ~l~nF~ wNt N~wi11f~ ~w r~~t ~ M~?~1 a. w~r ~ ~ ~ ~ M ~ IN~![r A1 w0~ Iu?CE Of INJUtr .i .o+e. ••~•..•s~rn, r.n ,n. lOC~110n ~ s»en o~ ~ ~.e 11RG~/~ t!f M+O~ Ow~C! MK...lK ~ fRC~n 1 'W . C.n W tQrw, if~R : ~ ~ • C~IRCwT~ON- ..w.w o.. nu .o..*. o.. .eu ..o wr sw. ~~u um o.. J4~iao w~ ++e,. ne oAn~ oetumo u n.e n,.n. a+ +~e ' twtiKwa: ~O ' .a.n~ w. nu ~t~. .ne~ w~a ,wor. ~ w+e. ~.o. ~o we yft n. ~z~.uo •.o.. , 19~ 1 MARCH 4 ~„~MARCN 6, 1971 NARCN 6, 1971 DID NOT ~~.1:00 a. o M: w`n"i:;, o' C~/~CAT~ON-MEWCAt 4XAAlINER Of CO~OMEf o-+ r~e us.s ~ n~ .w~r o: ae.r.. r¦e eeceoe.n .a ?wMOiw.uo w•e tWUM~~~d+0~ M WO~ ue/W n! ra.esr~G+TnM. u. p~M4~. ..Orrw W. Np,i~ • M~4 OCtV~Mp OM M W~w0 OY! ~O f1Y U.VY~L SLRO . - ~ \ µ M. CBT1f1Et-NAME ~~*N o~ r~wn ~ . ~ eauee ownne 51GNED ~ra.w~. or...~.~~ ra. BRQCE COHINOLE D. ~ u.-~ -~_%~,,k ~--t »•,•.,.,.s - Z-.,._,~ ~ NARCH 10. 1971 ry ~~P ••O BOR 3084 ~m ~ ` FLO1tIUA 31~460 i101+. ~r~O~lwl Ot tCt'Y-~tA1NE cOCwi101+ c.n o~ ~D...1 s~.n ~ ~ YA~~ ~ Fa~ ,;~R~E F/~~.dR DATE ..~W.. ~a,. ~ , uYt. o~ Mo.. ~n ~w. . it ~ ~11 ~ ~ ~ v. 5, s512 f pl~[(~ - . u w rto ~r i Rtv. Iy70 ~ !w I t6i ~ ~ ' ~ 1' ~ • 1 1 ~ ' 1: 1 ~ ~ • • ~ ~ _ • r ~ . ~ 1. - ~ s • ~ • - : ' • ~ :z48511 F~LED 4M~ N.ECBADEL ST.I,UvI~ GpuM1Y'fCA. r~.__ l`~ . ~ r ' 'iRT r'~~ ~ ~ S ' " ~ - - ,FF$11 iG a2.AH '~3 a~~j'K ir1.L 1'~~[ i~o~ '~tf r - - - _ r_. ' _ _ : _ _-_r . - . ~