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HomeMy WebLinkAbout0257 - ~ - lOOi 9 33~ ~ ~ ~J~~.~ y- ~ ALACHUA COUNTY HEALTH DEPARTMENT 91d 8. W. FOURTH AVENUE "~~oO~~ ; GAINESVILLE. FLORIDA 32601 f Walter E. Murphree, M.D. ~ X TELEPMONH l70-6l21 P. O. BOX 1327 DIREGTOR CERTIFICATE OF DEATH DeNrt~ewl of Ile~lt4 ~d Re~b~iflallre Set.ice~ fTATt /ILt NO. on~ oF f~a~ni F L O R I D A RtO1STRAl1•• No. ?r?E. O~ ~l11iT IN °~~~~R•~~;~ ?ttMA/iNT INR ~Ew~_N~ ~~a~ r~oae usr SEX OATE Of DEAM t rOMlr, 0~~, ~e~~ ~ SfE MIMI00[ t0~ 11KTp(i10~ ~ $ t 1. ~ACE .w~e. .wow. .,.~nc.w u.s...., wGE-us~ ww~ ~ n~~ woe~ ~ wr OATE Of pRiM ~no.wM. ~r. COUNfv OF OEAM ~1C. 1 YlCIA ~ 4~TM~/ / ifl~~f / YOl. M~i NOM~ rN. AI1~ 1 I199 • s• ~ ~ - ~ ch CTt, TOMM. O! lOGT10N Oi OEATN ws~a cm u.na MOSMAI O~ 011~t NST ION-NAME ~a ww w tnw~. cn[ srnt~ uo uur~t~ ~ sncu. ~es o~ uo i~ f R d 26 n I- S1ATE Of MRM ~ r rot w u s~.. Nuu GT1ZfN OF W11AT COIMJiRY AIARlIEO. NEVE~ MARMED. SUtVIVlIG S~OUSE ~ r.rre. cae r?oeM wire r . caw.n ~ wIDOwEO. 01~?0lCEO ~ srecr~ ~ - # Harold e Aust en ~ uw.. nsoe~te t It1d~gllg • u ..nn oecuseo SECUR~i~t M/wvEt USU~I OCCt!?wilON ~un ~..o os rwa oo«e ou~uw ros~ or Kl1D OF MlS1NE55 OR 1?~USTttf t~+tD Y p~M - 265 58 ?823 ~ :.~,~,,,.w.., one ~t ,y q~. B fl ~es:oe»u w~wt ws~oe cm urtts STREEt NUM~ER .=.~~s.o.+. ~ypEH~-SfwTE CWt~R~ Crt~, TO+wN, OR IOCAiION ~y~,~r res w No~ ' ~ ~N ~N ~k IN. ~M 4 Geor venue fATME!-w~ME .~n~ ..ioo~[ ' ust MOTMER-MAIDfH MAMf ~ust .uoa[ us* ~s u Ro ?hiel INfOW~NT-rr~uwf r+u?~twG ADGRfSS is~ut~ w~.r.o. .~o, cm w ror.., si.a. tr~ ~n v Pierce F orida 33450 urwi~w k ?~Ri 1 pEAM WAS UUSE~ ~T. (ENiEf Onl~ OnE UUSE IEf l1NE IO! ~errrttM OMSet ~w oe~*M } ~ r.~eOUR C~uS! ! sT_ ~uciE couNTr Fu ; ~ aocE~ ~o~Ta~s G a f . As, ~ , S~043 RfCGaO YERIFIED coMO~noNS, n ..n. ~M~cw e~•e ust ~o Ib) IratOl~T! C~VSf ~ol, py~ IO. W~f ~ COMSlOIIfK!•W " S1~t~MG tw! VMOI~• ~nre c.v~e a.si kl ~ ?AtT r OtMER S1GNIiICwNt CONWT~OMS: ca.ana+s cdawuru.e w oe.w w~ .ar ~eu~fo w uuse wrew w rur ~ a~ ~ YES we~e ~iwo~«as eae- ~ns w~o~ ~ on N areuu.wa e.wi H~ IA ~~~y1~~ GoEa?. AM~oE Ot Dw ~.o..rw, w~,.tu ~ IIOUt MOW INJUtY OCCU~[ED ~~wn~ a?~ur w~w~ro iw ru* ~ w~ui inr ~ ~ : O~ I/OE/EUWNED ~ Acc ident ~.8 :40 A M~ one c r Automobi le ceident ~ iM11l~r AT w0~ HACE Of NlU~tl wore. r.~., sneE~, r.n.,n. LO~wi1d+ ~ ieen a .w., c~n o~ ~o.M, tr.n ~ ~ IfMC~I~ tt1 W MOI OAKt MOG.,lK 1S~lCUi1 ~ N o Stt 26 on I• ~t CE~tIfIGT10N- ,.o~+r« w, nu roww~ o•~ •eu uo us* s.. MW/N~~ .?~n ou ~ ao/ae w~ •a.r nr Ot~iM OCtutteo n~e ruc~. w w~e t twrSK~~M: ra+m wr ~eu woi a~ni ~wou~~ wa. uo. a Me nt~ } ~~m..oto rw TO or r~ e.or~toGe, ew 2 }I~ - wcuuo rw+ T1~ tlc 71~. tb M~o nu c.uu~s? snRO. CEt~IFKATIOM-MEDKwt El[AwkE! O~ CO~ONER a+ ~.u u~s a ne wu~ a oe.m ~¦e oecew..~ ..s ?w.~w..ceo oe~o ~ ~ IWY~lO~~ O~ ~ WDf ~MO/O~ fl~ WvE1tIWf~OM. IM O~IM~OM. o YW~IN O~~ 1~~~n~f MOYf w.•w occw~w w wr n.w oue ro m[ uvs+~s, s~.no v' (E~ A. M~ JUIIe 30 17 / 1 v' A M n. ' ' ' ~ CERTIfIfR-NAME ~mt w~~u.n - S~GH~ ~ ~u d rnu OATE SK,NEO ~..w~a, wr, nu~ Walter E Nu hree N D r~ _ ~ 7-/- ~ ~ ~ w~RING AOO~f55-CEfIYEt sirn o~ .w an a.o~.. su» t~. 8 1 2 ~1 4th Avenue Ga nesville Florida 32601 WR1Al. ClEMI?TqN. REMOVAI fMEiE~T OR ClfMl?TORT-HA11+E lOCwiION un w ww.. u•tt ~ vfun ~ H. ori 1 Cem ri~ Ft Pierce Florida D~TE ~..o.nw. w.. ~ W~E~At MWrE-~Nj?Mf ANO ~ODRFSS ~ ~uur o~ ~.r.~. no., cm o~ ~orw, u•n. tu ~ ~ ne O H.~ ~ 404 N in St Gainesville Fla. 32601 ~ S.1612 f~ ~~T~- i ~ REdSiRAR OwtE ~t ~rlO ~ lOCwt fEGi t ~ ~ ~ Rev.1~?TO ?A ~ ~q~a~~i,utr~ ~ ~ 3 7a tY i . J' ' ti;~.•'''- ~f : ~ J • •3'. : I NEItggy CEI~I~'Y ~ ABOVE ~~E A TRUE AND EXACT (~OPY OF THE DEATN ; CERTIFICATE Iti~ 1HiSt ~IEE. ` o- k 212 F,~~ 257 =-~'t ' '3= 80~JK ~ • t ~ ~ : : yy~i~ - i ~~y•ti~ ~~~~~~~'~1~. . / ~ . y / ` i ~ ~ - - Ir[yrtle Trovell, Deputy Regiatrar ~.C-c~-L . , ~ L•11. ! ,l' (DA - • - - ~ - _ _ _