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Home My WebLink About1966 I DADE COUNTY ~ • DEPARTMENT OF PUBLIO HEALTB t~d0 M. W. ~OURT[tNTM tTRtST M~~TON S. Sws~ww, wo, MrM. r . GIA~CTOR , ~ . . ~ . D~IAMI~ FLORIDA 93155 ~ . ~ ;:;•'~",=-~c ' - _~~~iIS TO BE A TR~1S COPY OF TEiS LOC„AL R!lGIS?RAR' S R'BCORD O~ DBl?TH . ; ~ •,~''i~;_.• . c~ . tjr - • - ~ r;,;'~: ~i~ ~ _ . ~•n:.s valid ualess the rais~ seal U'1'Y I~GSSTRAR J the Bureau of Vital Statistics VITI~L R~CO~iDS I1NIT ~'.~i "1'~~..;; ~ affixed. ) DiA~ CWNTY HB~L~i D~s'~AR'1!lENT t~ ` _ MIAMI, FLORIDi~'1 j , ~ ~ r I - " CERTIFICATE OF DEATH '9k~...~~m~n~ d Iteald~ ar Re{~+Wluauve Srrrkzs fTATE FIL[ NO. i~vs~xr ~~i:n~ F L O R I D A ra.~s+aaa~*.~ras REGIbTRAR•5 NO. DKE~SFD -NAMf ~'~St . r'pOU ~~5~ ~X ~ DATE OF DEATH ~ ~owiw, 0~~, rut ~ _ , K a ~femele ~Novernber 5 1 72 . vsCE .~,~e. ~ecw. •••eeKU. ~r.ou», ~GE-us~ ww~~ ~.e.~ u!we~ ~ o.. _ OAtE OF ~lRTM inO~rN. e~r. COIiNTY Of OfAIH , e.ea~, ~ ~~fMO~~ ..ws, .ws w~s ~ows yM. ~fA~ 1 w . Jen 8 1899 Dade ~ ~ ci~r. TO~ a~bioui~or+ oF ocu,*H ~ ws~ee an ~r~a MpSMTAI OR OiHER IiSTliUT1O~~-NAME 1N M~t tM EI~W~. L1vF SI~FI ..b ..,w~e~ ~ S~fCN~ ~!1 O~ NO , • ~.~es 5521 N E.Mian~i Court _ ' ; s?~TE OF ~itM ~ u~o~ u+ ~ s... ~.r~ ClifZft~! OF wMAt COIM Y MARtlED. NEVER MARMfO. SURVIVNG SrOUSE I~~ 1YM~. G~~ W1~M wrt ~ ~ . caw+n. ~ w100WED. DIVORtE~ ~ snc+r ~ j ~M~nn~~ot~ + widowed - - U,S.A. ~CC ~~l SECUMiY NUMlER USUAI OCCU?ATION ~a+e awo Or ~+o~a pp.t ow~.w ~+os~ W KYiD Of WSM/ESS OR INOUSiRY ~ ~IUK ll/(. [V1M II ~~il~[O 1 . , 264-50-4684 Li n e P actical Nurse 5elf Employed ; iES~DE:~Cf-Sr~ttE CWNtY Clitl. TOWN. OR ~O~AT~ ~r~n StRfET wND NU'r~ER _ vtun .u w ~.o ~ # ~a ~k Mi m I~u es ~~.5521 N.E.Mia~i Court F a T r:t R--NAM! . rqpt i~s~ MOiIiER-MA70fN NAME ~~~sr rrppte t~st t ~s B n m' Bomstad Hett Howman ~ ~ NFp~~Nt-N,M~E MA1pdG ApGRE55 ISItlEi p[ ~ f D. MO . fH~ M:Owrt+, Sl~tt. !NI ! - ~:M e e M 6i11 b50 East 60 Street Hialeah florida ~ ~ Pn41 I ~rr~ot~ra n.re r~~ I OEATH WAS CAUSfO !Y: (fNiff ONIY ONf UllSE IER lNE fOR (o~: tbl. ~~'~O (tl, {!t'1.FlN ONl~7 ~ND Dl~~H F - i ~ i - ~..~o~.n cwsi Lu~ I to~ lci4~t~-('j ~ ~ • ~-C NSFOYEr~C! O~. ~ [O~aD„~~OMS. ti aNt. A („"~,.t~'~-t.•~ ~ ( V c c.vt ~~at To ~ (bl ~t - ~.[G~~!F C~YS! la., ~ py~ 70. O~ ~S ~ fOMS[Ol:( ~ 5'~~~wG TM~ yNOt~- ~ J_/~ , . . ,~.G ~~JSt l~lt ~ w ~ ~"~R.(~ • (C~ ~ i ~ _ ~~a? ! OiHER SIGNIfICIWT CONW~IONS ~a+p~~a+s ca++wuuac ~o oe•m w~ .~o~ ~tureo ro c~ust w+eN ~....n ~~o~ TAUTO?S~ If 11E5 we~e ~~ro~NCS co..- IctlS d~01 Ypi~tO 1N Oltf\r:H~nG f~uSt , OI D[41M `1? Ih II _ '~_t-cyl~~. ~CCWEHT, SU~CiDE-OR~ ~ Dw ~-w1UR~i..w». wr, .e.u NOUR ?10W tNIURr OCCUR~ED ~ t~rn ~..iun o. s.uo~. ..~r ~ o~ ner ,~r.. ra ~ ._M~.GtE. OR W~DFiEWWEO x: h~ :`r~ ~ ?Or - 7k M 7Y I : rr )UR r AT WORK ?IACE Of ~MR1~~ wpr~, r~~+, Snttt, /K*0~~, ~OCATIQN ~ S:~l~+ o~ ~ o. No , Urt w to~rw, s~•tt i , ' ~ SrE~~r. r[S Of ~vOt IdIK! NDG.fK ~S?KI/~/ . ~ ?C. 7M ~ ~ t ~Et*:r~C~T~ON- .o..rti W/ tl~~ D~~ ~E~t US~ f?~' w!f ~t~vf ON ~~DIO MOI v~Ew TM! DfA1N OCCUl~ED ?1 M! ~uCf. ON 7MF ~M~S~C:AN T~ YOM/M D~• 1!V i{~1 ~ff(\ q~TM / iwp{1~~ A OAi(. ANO. 10 iM( ~fl~ . }Ie . M *o n~t uult~si ir•~!o ~ . .rtF..~eo rwi ~o y ' 71~ S ~ ~ ]t~ / ~ 7 s' ~ it~ ~~~Z • 7 _ d C ~ os rr c..owitoct, o~e 1 :tCf~t40~~~~~ .1 I ~ ERic~~Ui~ON-MEDKAt EXAMWEt OR CORONEt~. o.~ ~~e ~~s~s w rne ~wv~ o. oe.rn r*~e oecea..~ +~s ~~O»WroClC Dl~D I t~a..~r•r.~ra O~ n4 qG~ ~~O/W tw! wrf3~K.~'~Or~, n~ r~ O~wK~.~, rM+lr W~ rf~~ MOU• ~ :E~'^ :~`C~.~~lOOM fM! 04T( ~MO OtR ~O tM C~VS!•S~ 1~~!!D M?» M ~ ~E~n~iEV-ruuvf ;nn or n~..n - - SIGNw _ ' 4 o<nru DATE SIGNED ~ *w. .r. rwi s : pr,James farrelliM.D. ~ ' ~ ~ ~l~ / L' ' , j MnIttNG ~DORESS-CERi1f1ER ~ sri[[t o~ ~.r.y ti w ww.. u~tt • t : st / ~ i oURial. CREMAt1pN. ~EMOVAI CfMEiERY OR CREMATORr-NAN.[ LOCwT1pM un o~ w+n+ sun • i s•[~_~rr i € B~~ ~~~hPrn Meg.park North Miami floride _ perF „~o,aM, w~, rtui FUt~ERwl NOAtf-+vAMf AND AODRESS ~ srnn o~ o«o., urr w~o~.w, s~.~e, ~n ~ _ 1325 W.49 St. Hialeah F~a. • t ' N a~/ l~ DnfE fE ~ ~I~~ lOryCnl R IlAI f ~ c,~NERI~t b - IWE ~ RE -S Rf ~ ! ~ c a _ _ i 4 . F ~ ~ 2~94~5 ~ i ~ 4 - o ~~o - c. ci it t . , ~ ~ ' ' J ~ p N ~c~~~ ~ BooK 216 ~A~F1967' ~ _ ~y~o - ~ Co R w ~~1t~ ~ ~ _ - ~ ~ , ~ u."~nT""~iZi~ ~t~~' ~Y~F~'~a-.~. ~f~G { R `rt?~ - . ~ -3 lm.w,iK-~r ~'.i• :~e'