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HomeMy WebLinkAbout0201 _ ~f ~ ~ . - - ~~?O~ ; ~~n.. N- iTAT~ - nAD OR HGL_„ . C~.. i 1FICf~?'i i. OF Dtk~. ~ CO~~s • YURGU O/ VIT/1L fTATIQTiC~ STATi Filt NO. l•a•l FLORIDA O~d •A~n BIRTN NO_ - R[618TRAR•C NO. ~ prep~~l~ 1. rU1t[ O/ 0~11TN GODt NO. t usYAl Rtf1O[NCt(~a.~4wdwr. l/:..~+... sr:wrW..W:..:..) •I~Ctlt~d OOUN7Y 5?ATE COlIMT11 _ ..a ."1 St. Iucie 66-U25 Florida St. Lucie D~ ~l~e~~ iw *~f- 0. ~~Tr. TOMM,OIl1ACATqM c. ~S ?LACE Oi DEATN c. GTY. TOM~N.011 LOCATpM e. K RES~DEMCE ¦t~~~t IhS~DE CITY UMITSi - IMSIOE j~ITY LIYIYSf e~~.. Ft. 1'ierce YES[~I ?ap Ft. Pierce ,~s Mo I. NAYE OF ~ (JJ MI h ~N~if~1. /iN Wttf ~IIIIM) STREET AOO~ESS NOS~iT~I OA ' WSTITUTION ~erce ise~o: ial. uos ital 2905 Sunrise Bl~ d. 3. NAM~ O? F4rt allr/1t LW DATE 11(NN Dq Yt~/ ~K pEATM ~:~:rch 1, 1966 - S. SEX COlO~ O~ RACE 7- y~R1ED NEYE~ MARIIIED ~ MI1TN AGE IIw Kd~ ~~R 1 TEY yupE: ta NK. ~ fYllirfl/q) X..r~ D~r~ Rwn ~ . /frw e• t ' C Mnoorrcn ? avaicw Au . 1 18 0 ,.~1~1 ~ la. USUµ «CY?~~ (Q~ ti~ ~JorrR Iwt IOD_ KWOOF ~iJS1Nt55011 ~MOUSTRY 11.~ ~t11TNKACE (Stdt ~?hrtl/~ ar~b/) 12. Gl~tL10f nY1T (70Y 7m •fL~ p~r- fsriy~wtywrlie/h/r.ar~l/r~NrNl . ¦~w~wt ~ i~;.4ji~i~ j1$k 11~lk ~Ot 11 iATMEII'S MAME- 1~. ~10TNE1l'S MAWEN NAME . . •f e~..r~e.* •r T . ;~.ILBr't~I) EDITH ~ZL ~ . 1S. MAS OECEASfD EMEII 1M Y. A AIIrED iO11CES1 16_ SOCtAI SEpiIl1TY NO. 17. IMiO f i10MATYR[ ~ry • D. COO~C 17w. r. ~r akrwl U! N~ w~ Mr~ rnir~ . ~ no:~e A~~~~ 2 0 Sunrise 31vd.-r^t.Pierce R~a~r~l 1~. CAYf[ 0? O[ATN (Swld NIl ~ nwe p[r fiwepr p). (0). ~a! (c).] . I~fTE11VAl ~ETwEEN AS~~lte~ ~~~TL OEATNMASCAt15[D~r: OMSETAMODEATN ¦u~t fll• IMYEDt~TE CAYSC . C 1"i311 Yrs. t~• .e~r- . tftie~N C~atWNU.1/a~r. p~ Tp ~ ~it\ t\• pK r~K 1 • • ~ 1 ~Eest sok li)• r~aistr~r +t~tiy t4 r~4r- 04'E TO (c) •1Nlo 7~ 7fi~/ uue fwt. . O ?MT K O~IfA SIG1i1C4iR OOMOfilOt6 CAMfRI~Vf~1G TO OEATN MR IDT REIAiED 70 iN[ Ti1~lYML OIYAY COI~ITDM GIIR11 p~ ?YT 1(u . wA5 AUTOtSY lwr• r[' ~ K~OnuEW - c.~ a..oa s e t i~ estinal obstruction due Lo adt~esions vcsp wfd ~ •r t~r• ~ IA.. ~ ~ t0a. ocsueuc How ~ruuRr oeeue~o. (E.ta ¦.rw~ yiwjv~ tn pwt P~.~ lt y~rs. na ' ••ki°a •p~ ~ ~cciarr wK~oc wo~K~oc • ' wtso•.t- v ? O ? ~I ~s p~. TIwE Of Ilwr Af~wt~. Dq. Ye~r •a7• ~ uuu~r n. E p ! o a. f = 2QI. tlUUR~ OCCUIUIED IQr. ?LACE Of utJU11Y (t. is N dwrt lo~[, 2% CITY. TOMfN. On LOGT~OH OOYN7r STATE ~ wNac ~T ~ uor wH~tc ~ haen..~,~u. oefcs OtN-. su.) M~WIK AT YYORK 21. ! ~ft~nd~d tM d~cN~~d /rom ~~~-O~ . to •ndla~t a~~ A~~ ~/i?~ on ~ . W~tA occurr~d at ~ p m on rM d•t~ ~r•r.d •bo.•; •rtd fo tM b..t o/ o~~ tm.N.dt•. 1~om tA~ uuws ~t~t~d. ?11 is~~s =ts. sICMAiYw[ (DryruwtLk) 7?A. ADWtESS - ?1t. a?TESKMtO ~ •r• te 1• a..vi.e. ~ ~ielvin 'holkowsit~ ~~i.'J. 802 7th. St., F~,. Pierce 3-2-6b •Cta~~t~. 23r- MrY. QEr~nOR Z1A. OATE 23c. NANE Oi CEYETERI/ OR CREMATOAY 2~/. LOGTION (GV/. lMri~. tMt~f~) ($~ft) ~ RErOV4?(S 1 ~ . Buria~ hillcrest :•:e:n. Garde s rt.Picrce, rlorida s. t ei a zt. ru~~ oac o~ ~s s~e~?T~~c YATi~4~;.~l:.iL h0: ~ ts. wre uw. ~r ?nc~ Rca te. aceaTiuR•s sw~TU~c ~ "••.1°6e Jack J. ;~ore Ft.rierce, :la. 3- - 66 ivina iee ::e:~ison, d.r. r FIlEO AMO RECONOEO ST. LUCIE COUMTY fLA. ~ ROGEi~ rrITRAS - CIERK Ci~?GUIT COURT c~ aECO~~ v~a~~iEO~ ~ t~eoet~? c.rHfy thi~ to t~ . r~,,. and comea copy cf fhe lao.! ~ 10 11 Sl 11f~'7~ ..;•~.~f:-_:- Regtttrars reoord on file In th~ St. Wcls Coumy KoaFth Q~ti . `._'''~~:+i~t•~'r . tnerd d Fort Pi~nos, fbricje. z; ; ~ ~ , ' (Wamuq• Not valid unlsss ni~ed ssel of tfie 9~ Ltxio ~ ~ ~ t ~ , . ; counry Hsshh oepsrtment f~ afftxada - 0o i ` •,•e ~ . i 9 _'~,~t _ ~ N. D. MILL6t, All Q -~'4~~; ~ . y ; Cots~ty H~atth Offlorr ~ Loca1 ~ x ~ . , ~ . r r t ~j ; t' ~ w* -Y} ~ ~ d ~ - ''~'•~~~t f -.k~ • . . ~ 4~ D~p{Ar LOO~1 itapFinar .•~-~~x~,.'~ ' ~ . 1'; ~`'i . ~~/~.~h~ rr . BOOK 2~~ PACE 2O1 ~ ~ s< ~ A~ .;~r~ ~ ~ ~~a ~