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Home My WebLink About2842 - CERTIFICATE OF DEATH 7 3 6~ 71~o1~~e~a~1~ ~1~ R~~.?~N~ilatlrf ClfvlClt tTATE F~L~ N0. w~~~~~~-.,~T~~ • FLORIDA - IYtE. Ot ~tlNf fM ~M~`~R~~"~° ~ ?EtMAHtN~ INK REGISTRAR•s NO. , . SE( tUMD100[ (0~ ~GEASED-wu~t~ - . np~ . . , .~,'yp~~ . . _ ` a.u SEX . . DwiE Oi OEAin ~•o~t», e.~. ~i.~ ~ i asnua~ws AAAOI,D J. CRg~ON t I~S~le ~ i tACE vrwu, weaw....u.c... wo~•~, ~GE-~.s~ v»o~. ~ o.. DwiE W t~RM ~.rn.n., oo. CdJ~+Tr Of DE~ia fK. ~ f~tCM~ I ~ ~ulrp~s ~ rlw~» rpy_ Mtf ~OUas rM. ~ ~ ~ i~lhite 6 s. s. ~ Oct. 1 1 ~ Broward ,10MIN. OR lOG?iION Of OE~TN ~•.see c~r ~~.ws MOSNTAI OR OTNER NSTiTUi10N-NM~f poe n. e~ar~, c..e snte~ w.o Mu.u:~ ~ / C! ~ sreun ~es a wo n Fort Iauderdale Yes Aol~ross Hospital + St~TE OF WRfr~ . u~o~ v i..., M...r pntEN Of w+u?i cOe~riTRr autnEO, r+EVEe MUlbED, iSURV1vt~1(', SipugE ~rue. a~.e w.ro~r wrt ~ s' can.m ~ MIIOOwEO.OMORCEO ~ uecr~ ~ ~ ~~~ti • Ohio • II.S.A. Me~rried n- A es Kray~nik t w~,.: oece.ue ~ oF wsr~ss ae naousrer u.eo u~.a~ SOC~wt SEtunTr NW~?eEt • uSUAI OtCWwrqN ~ave ~..o o~ .roe~ oaa ou.rw ..oa a pt(V~!!D NI ratM6lMf. MM p\lMt01 ~ . 281-0 4184 Electrician ~x. mical ~lS:DluC~ ~tWt! ~ •o,.iis~o.~, RESIDENCE-STAiE CpVtfM Glr, IOMM, Ot IOCAl10N M~ ~a* ao~ws STtEET ANC NUM~ER ~uuu. ns o~ wo ~a Florida ~n Bx~wgl~d i« I~bu~t I.aude~c`da18 Yes 21 E 1 t fATME!-N1Mf nalt r1001! lwfi MOiMER-MAIOEH NAME ~uSt r~pp! uft - i~ ~s Hartin Cr~edon . Stella Driscoll INfORMANt-NAME MAiING wOGtESS ~s~ne~ ot u.o.i.o., cm o~ ro.~+, sia?e, tri Mrs. A es Creedon 21 N E C ?wct OEAM WAS GUSEO i1': ([NTEt ONIr ONf C~1/Sf !ER !WE fOt ~o~ (Aj AHp fc)) ~mre[w oNSt~ ~..s ae.m p. wua.n uu . p.~/~ ~ (Oj ~ ~V / j~~v ~ ~.~i ~ ! / . • M!lOYt~K 01: ciF c u~ r • f coMS~nows, u ~ S ~ C ~ OCER ?8~ta~ ~ ~S? ww~c¦ o•.e use ~o (61 Z ~rrlO~~t! t~uS! ~e~, ~ yp. « • gpy~~! O~~ s*~~~MG TMt u.+oee• - myo c~~se a.sr . RlCORp Y~R?FI~Q (c) '~r'~~~ v ?ARi OMER S~Ge11iKANt G0r101110N5: tw~aoo~+f cowrwun~w w ot~tM wr Nor Ku~ts w ?~n~ ~~L ~ 0151 S rn o~..os co..- n s w«o~ ~o v. otnuu..wc c.rsc ?iN p_ I 2 i, u ~ ~ 70. ACGDfNT. StMWE OA NRlll! 1rOMtN, yr, ~eu ~ IIOUR ?~pW INIU~Y OCCUtREO ~ t~+n~ wnMt or ~wwn n~ r~i p~ ?V r ~ ~M • oR urr~crtw~r~o rn ~ 7M !k- M. 7'tl. IWUlY AT wORK ?IACE OF wJURV.~ .o,.e. sr~cr, r.cexr, IOCwT10N ~ snen w a.r.s. .q.. an oe ro~N, sr.~e ~ ~ l~~l4rt riSM.~01 pqK! ~IOG.,lK. 11~lC~nl . ~.1.. 701. ~01. !y ~ ~ ~ CERT1f1CAT10N- ra.rr o~• ~ea~ ~ ra+w wr ~w .?w ua~ aw.r w.riwae un~e o.~ _~~o ~t~r ~.t DE~1ti OCCIiNEO t. o+ o~~ ~N~fK~wrt: q TD rp+~ w? iEU soo~ • .m. ~ ~m..oeo rwe ' ~ ~ ~ / 111? ~»oue~ ~ o.~e, a..o. ~o a~e ~es+ na etcc.uo .~o.. c a ~'~u 2U~1 flc xr 1t~. tle • M~o m['l1Lx~i~ sr.•ta CERTYICAT1pN-MEpKAt Etw~+uNER OR CO~ER o« rwi ~.i~s o• ne wq~~ p q.n~ ~we oec~a..r wy no.qv..ceo oewo ~ t~arwanOr~ p Mt ?~Dr ~..O:oa r~ w.~s+K.rw).~. pr~epe., rpaM O~r r~n! Of~~M OCCUl~tD ON ME O~tl ~++D 011t p Mf CwYSt~L St~tlO. CERTIFIER-HAME ~nn o~ reMV•i M?~ ~ ~ M SIGNATURE otWte c~'yru DATE ll~tfD t , o.r, reui fA RO~Q 7)~ . W t ~ V i 2k. 02 ~p ~'jd 'j MAIWG ADDRESS-Cfftlf~ER s*nr. o~ ~ ~.o ..o. un q io.~» u.rt • i~r ~ ~ 4 . ~ tUtu?t, CREW~T~rf, REMpvwt CEMETERY OR CREwu~ipRr-wu+f lOCA1tON ~~n p~ io++,. s~.n 7-, ~ snc.n, ; :a Creaation BroWard Cre~:atori ~k. - OwTE e w..:M, v... FUNERwI HOME-nAMf ~HO xODRESS ~ suiu o~ ~.r.e. ..o., un o~ rowM, s~w~e, tn ~ - :u Aug. 28 1970 Eaird_Case 4 N. Federa3. H. Ft. I,auderdale Florida ~ J~ y• 5• 161'1 fWFR~t 0~6R~..5K~Ai(J~f ~G~STRAt_~NAf,~[ ' ~IIw:E lf~vEO ~t IOCAIl lEG~SiRA~ ° : . ~ ~ i G l A ~ ~ • / } ~ .C~,J~ ~ / C~~~t.C:iLI. /U' _ ~~'4~'^ Z ~ ZK Gw h L ~ ~ COk CD It! 71i: ~;:ii.i~~ F~cCbn"G$ ~--•--j. - . Qf BR~ - , 8f?a/( • ~ CERTIFIED COPY ;T,A : N-~' '`j - ' ' F I~ E R ~ ~ ~ <<y I hereby certify thc above to be a true arid correct copy of the 'Loca~ Regietrar'c record on file in the Brovard County.Health Department at Fort I,auderdale, Florida. . , . . ~ ; ~ • ~ ' . . Q7 - ~ 1 (NA~n':.ng: Not va~id unless rafecd seal of the Brovard County Health ~ ' . .vapartment is affixed.) . ~ ~ ~ ; ' ~ ~ ~ ~ , , ' . . L4%~Gc~~~''~~•~C~'. ?"r ~ 'A~Z.LLJ ~ ~ N u. . 1. 1). ~ 4/ K • County Hcalth Offica~" And Local itegistrar ~ a$ . ~ ~ ~ v . ~ • . . .g ~ ~ ; ~ - (71.~'~~~~ ~.P . ~ ~ 4 i . W ~ ' ~ i p~ ' ~ ' Deputy l.ocal ~ce~ictrar b~t+~ f'~Cf~!7~~ i . r _ - _ ~ yr~"':'r.~ s.~ _ t _ x w ~ " - . .