HomeMy WebLinkAbout2570 _ - - - - _ - - ' .
. CERTIFICATE OF DEATH
, a~.~.~.~ .t t~~ ..a R.a.~u~.~n~ s~..~. F L O R I D A ~ ~TATR FIL! NO.
avwoiv oF •.n~
ri?E, OR ?tlM IN ~"'~'~f°, ° RCOISTIlAR•s NO.
~tRMAN[M INK SEX OATE Oi OEAM ~•oM*w, ~tu ~
fEf M4M100[ FOt ~~-~lNy( nnt r~oxe i~s~
'~1tl"101~ ~ Edooard T. ~orker Male , March 29 1 2
RACE .re. waw. uuMCU~ ~rerw, AGE-us~ w.ee~ ~ n.~ v.oe~ ~ e~. OA1f OF ~iRTM ~roww, wr. COUNTII Of OfwTN ~
nc_ ~ snan ~ wrrs.• ~ nus r..os. wn wows r.~. i,,` ~ ~
~ White ~ ~ .March 1,189 Indian 81ver
/ A~ UIr, tO~MJ, OR IOCATION O~ wM ~wsim tm tr~ts MOS/tTAI OR O R NSI~TUT _ ~a wf n~ em~ee, cM snen uo nu..u~ ~ ~y.~a, ~
V ~ c ~
T s.ecr..es o. »o
Vero Beach h yes ,~Indiam 81ver Memorial Hospital r-°.
S/ATE pi tIRM ~ n»o~ a~ u.s.~.. .ur~ pTIZEN Oi w~iAT COWiTRY MARtlEO. WEYER fMR4ED. SURVNHG 5~01lSE ~ r~.ue. 6ne r~~eM 1~r~r~ ~
n•~~ Ne~ York USA ~
' „°O~°axr~`ec1'"`~~ Aru~a Wiachert
l~ +waww~ SOCu?L SECURITr MJWER USUAI OCCV~Ai~ON ~am c.n a w~c ewe oun+w .ova
u.~w a wsr+cu ae wouste,r o
OCCVMt~ M . W4M0 ~Ml. Mw If ~lMte ~ j
~:.120-14-0950-A Fireman-8etired City -Fire Department ~
~0i1l~"• RESIDENCE-SiAfE COUNTt dtY, TONN, OR IOCATION ~w~ Cwr ur~n STREET ANp N1W{[
~wu.. ns w w
~..Florida ,„Zndian•Riv ' Vero Beach No 66o-1$th. Place V
fATNER-HAME ~µ{t ~pp« . u3f MOi1iER-MAIDfN HAME ~NSt
ri00U yyt
Thomas Corkery ~atherine Donnely
~NFOWMii-trawE wulu~G ~DOtESS ~smn w~.~i. ..o.. cm a~o.o. u.n. i+~ ~2[1 Q
Mrs. Anna Corker ,n 6C0-15th. Place, oero ~each Florida
?ART 1. OEA1M WIIS 11: [ENTE • OPIE GUSE ?Et LNf fOt hl (b1. ~NO k u?wa~r?r v. ~vu
wr u se ~ ammr oMi~t .~.e ea.~
N! ` • .;~iy?„L C.~-~.~~it'wr...~ 1'~-'
M , .
COMNt~OM1 M uw, ~ ~ ~
rw~c« a~~~ use w J M ~
~ ~ 3
~~rtM~if C~Yf! W. ~ ~ q. Ow1lOV! [ O~_
3I~fINO T~1~ YM~l~-
~nMO C~tll! 4~1/
_ -
OTMER SICNMIC/WT CONOit10NS: .cadnws cawmin~..o q s~~n, ~w „o~ Kw.ie q uVSe u.e. n. ~an ~ w M710K~ ~f rE5 ~.eee rr..s~ras co-
~ns a..o~ f~~l~lD ~w qt~uu.~roG 4L'
p O/~1M
pn~a~ ~+.No ~n.
I • Iqrlll0i: Ot 17W~iEtY1NEp A ~ ra.r., w~, •u~~ NOW INJVlY OCCURRED ~ tMlt r?Tltl p~M~Vn ~w ~w~t ~ W ~u1 rtfr 1
j ~tlccident ~~Saxch 25 1~7 2 a M. Fell in kitchen
I 1 WU[Y At wORK RACE Of NAJl11 n wor. .~u. snen, ~.e~w.. lOCw110N ~ sreen w~.r.~. w., em o~ ~m~n.. u.n ~
1f1lCM~ Af O~ MOI pA1(( M~G.,lK. 1~IKV~1
! r?o F;or.?e Vero Beach, Florida GGO 15th Place
~ CER~~ICATIOW- tlAw Ms tW rOMw~ a. •eu ~u~0 ust Lr wr/w~ u~+! Or~ ~ Mo/~Yr~ ~q~+ tMt O[AM OCtvn[o .i fwe ~1wCe. W M[
~wtSK~wn: TD .a.f,. wr au 1vOfure~ eurM. ~wwi wn...o, w na
~~tn,+0[O nM 1 ~ '~4~ I ' W rr [uOVatOGt, v
t~a au.tee ~wr ~ • tn. ~ ' Zi Jk. t~~. }t~ i 1 jA ~~o n.e tu~sem s~.•e
CER/iKAT10N-MEDKwI E1cAMWER OR GORONER: a+ ~we ua~a a ne ~wu~ a r.n. .we oenoew~ ~.s ?~a.ou.+uo oe.e
tlYM~bOM W M! WO~ ~'O/W M M~1t1Gwf~OM. M r~ W~+W~+. O~~ tt~~ MOY~
OI~A OCCYM[o OM M M~f ,u+0 OK M m[ 4VSl~fl i•~~tp. µi _ ~ L ~
~ R
CERME!-trAMf ~+rrt o~ r~a.n eeene a+mt O~TE ED ~w.+u+, n••, •w,
n. E H R ve • J 1 „M
~~~-"R~~rt' Breez ~wa Buildin ~m Q~ Ve o Beach Florida 7~~2 60 J
~VRUI. CRfMAT~Oti. REMOYAI ERY OR CREMAiOR~-NM~F IOC~riOH - ai. w p~..: uni
~ fMGMr ~
=N Buria N? H~]
l~~st r`em.Gard_ e~. ~k Ft. Pierce. Florida
OATE ~.,pNrw, y, au~ iVNERAI MOME-N.~Mf a~lp ~ppR(SS ~ s*~en o~ ~.r.s. .+o.. ur. a ro...., sr.n, :~r ~ ~ O - .
2M 7f~ ~ . ~ ~ .
Y• s• ~612 f(MQ - RE{r~ST A?URE OAiF FCE~iED i IOCAt [G~S fA!
R.y. ~9~0 1550 a~ 3 1
-
~ "I hereby certify the above to be a true and correct copy
~ of the Local Registrar's record an file in the Indian ~
~
~ River County Health Department at Vero Beach, Florida."
~
i ;
This is not valid unless the raised seal of the zndian r^'Arm
Z_ ~r,o~_
Rivgx'~ity Health Department is affixed.
V,~ t t, _ - n
- ~ c - r
' " ~ l V ~ ; , V _
.v ~ I ~ ' ~ ~ ~
_a
~ ~ ~ . \ _ ~ ~p ~ i c:
' ~ ~ . • W+~/ a ~ s
t~`,", County Health D~iz. Local Registxar ;"'rm,
~ ~7' • „ s~v
~
.
~ ~ ~
. . ~ .
~ ~C.U~ ~0/j~Q ~ 1
-
~'s~~''~~ Deputy Regzstrar
~ ~ ~ ~o~~ 214 ~ac~ 2568
~ r ~ ~
.