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HomeMy WebLinkAbout0553 . 252364 ' ~ . _ ~ - . _ - - ~ , SAIS s.- ~,?T~ .o,?RO oF HEwc.~,~e CERTIFICATE OF pEATH ; co~es • YYRiAU OR VITAL iTATICTIC~ iCTATi FiL[ N0. , lea~l FLO$IDA otd ~Aen BIRTH NO. REGISTRAR'S NO. prope~lr : esseut~d 1. KAC< O~ KATN GODE ti0. t YfYAt ~MO[NCt(I~Vnsir.rdl:w. ll:++:~s..w lw.~~.W.n.M.~..:w) . i •nd •111 ~ ~M~ S`t Lucie ~ ~A~ ' ~NTM ~ e D• ~l~e~A • lq p~~- C177/.70MN.011lOCATqM t. K?IACE Oi O[ATM t_ QTIf. TOYIM.OR IACAT1pN t. IS RES~DENCE . •~Aiwe tlcStpE CITY tIMITSt IMS~DE CITY LIYITSI r~~.. Ft. Pierce .ES No0 FL e o ida ~s ?.o MAME Oi (l~ M! iq ~NN)Ih1. /w W/d ~/htL) 1. STREET AODItESS MOSMT4l OR '"n'T°?'°" D 0 A l~t Pierce ~!e:n o :~~~Csxt Pktirv. 3. wwrc e? ti.,e xifft. l...r w7e xwN o.~ r.o °T%~ - ROB~.FtT BOUP.KE ZEMIh'A o TN dul 2:, t 967 S. 5[X ~ 00[Olt OR JIAtE 7. YARRIED IiNEYE1111A1I11[D OATE Of WTII ~t~f0ist~7~ ~y^ty~ p~ ~~i~'NS. t c• M. C8u. rnnawcop awrecco DeC. 4 191$ 51 ~.~1a1r la. ySyAlp«y~ATqM(C'vetial~/rpttht 106.KU~0OiWSWESSORY~WSTRY Il. ~tlliWUCE(3~ft~r/MtywlMW/) i. aT~uxocww?raou~.r~r? r1tA y~r- Irruy yr~r~i~~h(r.m~i/utuN) .•.•p~ ~terviewer Fla. State :Vew Haven, Conn. U.S.A. Dl~ek lek ~j, FATNEII'S N~ME MC7MER3 MAlDEM MAwE " ~~r•;•~s•~ FSrank Zemina ada Bourke t ib. socui sccuR~Tr ~o. !7. u~row f fIGMAT4RE .d16sa j 01,0-09-5729 r:rs P.obert Ze.:~ina Rt.2, Box 37?9-60 Ft.Pierce,Fla. ? ~t e~~u os oewrM (s.ia ..tr ..e nw. yr. t„r l~? c.?. le~..¦~ itiTCnvru s¢rwee~ ! Puner~l ~ d 1 t t o• ~A~T L Of ATX M~S CAUSEO ~Y; . C~"laC efi i~e $t OKSET AMD OEIITM ~Y~t ~llf ~ WMEOIATE CAYSE t\• Hf- ~~r1~.~. c",v;..,,;~..,, o„E To ce~ Ventricular Fibrillation •1[A th• r~ir~ ~qt ~u~ q 1 e e~ 1 ~Nrt t~tist `i). T~ r es 1 s t ~~r fI'~fial r rx led. 04E ~TO (c) _~~7S~~.Ck _ Sty_.i+,LR+~ti~~~_~ d i p O ?MT 11. OiKA SINii1GMI (ANOITIOwS Cp.'Tb1JiYrG t0 DUTM q/f MDT R[??i[D 70 TN[ 7[~YYML pSEAY Cpipi1p11 GIYCA M?YT 1(~) . WA S AUTOISY ~ Rours af- ` tERiO1tME ~ t c.r a.ace ~ rES ? No or a.ror• _ ~ 1 ~ ~~p~~~~YOCCURAEO (~+~IOaMy?t~/njV/iuPtlf/MPMfI/~Jilta/s) ¦~klwa ~ ~ICt~G(MT SUKIDE NOMICIOE - . ' ~'~perl- W ? ? , or ~ ~ IOt T~w[ Oi Il~ar Mo~A. LMr. ) i~r . ~ 2:~.~g. 7-23-b7 ' o ?a-.. W ~ 20/. uUU11Y OCCUN~EO ~t. ?UCE Oi uuURY (t. a v Jwt y~r, 7II/. qT11.70tMt1_ OII IOCATION ODYNTT 57ATE xMwE AT n Iq7 NnHIE /M~. ~M/. Yr[H. c/ict 6f//_. d:.) INONK AT WORK - 2I. ! ~tt~ndd eM d~~wd /rom y~ ~ . to _ ~ •ndl~it wr di.~ on ~ D~~th ocw~r~d ~e ~pProx. :4V~~_ m on tb~ d~r~ it~t~d ~bw~; ~nd to tA~ Mat o/ m~ ~norl~d~~. lrom tM uus~s ~ut~d. •)1 1N~~_ jj~ sICNATYRt • (lNptt N fDte) ?2G ADp1tESS ??t. WTE SWKD •r• to D• ~o„~.~. . K.artin G. Gould, N.D. Fort Pierce, Fla. ?1+ Jttl. 67 ~ •c eut~t~. ~~i~l. UEr~iqM. j3A p~TE 23r ?uYE OF CEM[TER~ OR CRCYAT011Y 23/. IOCATqN (CYI. fNrw. M nsRf/) (St~ftl ara~? l+yr~,pl ~L -26-b Hillcrest ~!em. Ga?~s. Ft. °ierce,Fla. Y, g, jAl Z j{, NhErtnL DmFGTOrt -5 SKNATWIE 40DrtESS ~ th ~ 25. D4TE P[CO_ ~1f LOC4l REG. Zi. ItF6~STM11'S 51GNATYRE a.~.,~as ap6r I„ Eyrd Ft,?-ierce,F'la. 7-21a-67 An.~a Lee venison, d.r. 25~64 s~.`iua~ E . - ~ CIERI~ CNtC~f17 OOIMT ~ ~ ~ : RECOROYEAif1E~.,....,.~,.,,. >i`~, a:<<,~,.' ; ~ he~eb'Y ~fY thb to bs a tnr~ and oo~rrocf ooryy eF !ho l+o~! '-~~~e :;.~'t%~~ Rogtstrars r+eoord on file In th~ St. Lucb p~, , ',,~-~t"_•;r`~i~. i ~ P,~, F~. ~ ~ II 1! i~ ~t!'~~ ~ ~~Y~~~~;''~ :~~1 i (Waming• Not valid unlsss raisec! aool of the St. Lucf~ f..'+~'--,~'~ i ~ ~ounty Heehh Oeputrrrant b aff~x~,) ~~-s~s ' .--~F~F,;~ ye - ~ r,, s? `L .s~ Y. . ~ d ~ . 'i"~ . _ ..T ~'~sr. - . _ AI. D AAILL6t, A+~ Q . j_ • t;~~ : • ~ . tlwlt~ O~h~t i ~,rat :i~ ' ; ~ - ~~,J 1 t i I ~-~G - ~ ~ . . ~ ~ ~ 3 O`.~t - r~~i`~~' ~y bal Roplstr~t ~ , ; ~ iS~ . ~ 1 ~ $~213 ~ 5~~2 . _rt~ ~ . 1