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HomeMy WebLinkAbout2720 ~ ~l 260419 ~ ~ i j ~ CE~RTIFIGATE OF DEATH . ~ewr~.~~ of Ik.l~6 awd R~b~l.~~~irfive ~et~'ices BTATE fILC FiO. ~u~?<w?a~r~a:~in~ FLORIDA iY?~, OR ?tiNl iN NEGISTRAR•S NO. S9S ' SEF `14r9100[ f01 OECEASEO-NAMf ~~»t ..+ooal ~•a~ ~ SEi - ~DATE W OEwTH ~•o~tw. 0~~. n~~ i ~T~~ ~ FLAYD COLIN JOH1~SOiv j, :•lale December 15, 1972 _ a t~CE ~..~n. MGq, w¦K.. ~w...., wGE-..t, ~~ou ~•e•~ ~~~ae~ ~ w• D~TE OF NATh ..a.~+, o~~, ,~p~~TY Of DEATN 6602 ~~~yWhite ~,,•'~$b•`.~:~ ~ r ~ ,,bct.l0, 2892,~~ Saint Lucie - Crtn, TOMIM. O~ IOUTIOt~ Of DEA7M ~~aro~ c~n .~..,n HOSMTItt pR O:hEt !`S l7U~lON-t~~E +o~ e~eK~, am »u~~ .~.o ..w~u ~ a.~c~n c...o n Fort Pierce Yes Fort Piexce Memorial Hos_~ital ~ STAtE Of i1RIM ru ~ot w u.f UT12EH OF Whwi COut~::tf ' htntY.FO. ?+EVE4 /awAtlEO. `~S1XvIVNC SIpUSE ~Y~. 4M1~ w~aw ruw ~ towrn ~ ! W WO'xtD ONCRC{O ~ tt+~ i ~ ~ Alabama USA c'~a.rrie~ Annie l~ilson ~~.e.i eace.xs SOCut SECUntY t+ui~ER----~USt1~l OCCU?AiIOK av? awo Or ~ae ow. ow~.w ..os.'w i- ~,.~o. o a.w Rwo a wiwESS o~ ~r~ousrer occwuo r~ .wa~.~e we. ~•w ~n,a~a, ~ w~ „ 266-34-1181 Grove Ocvner Citrus .o.usfw~+. RES1pENCF-S?~Tf COU+~T~ iCtTY. TO~.OR IOCAl~t~ ' w1~a c.n ~r~q~i3T~Ef1 wnD t~Wit~E! - ~ - I ;~:1lCN~ tll O~ wO~i Florida ~ySt. Lucie ~ik FOr~ Pierce .\G i~. Jenkins Road fAiME~-NAME ~~UI r~.~.c! • us~ ~~+~07NEy-Mw~JiN NUNE ~Na~ ..~00.~ usr r Johnson Hoodie Benefiel r ~s Jar,?es ~t. ~rifORM~t~i-?i1wf i!~w4~>+G wDLRESS ~.um. o. a. o..o . o~. w~o..., sr.a. io~ _ Mrs. Flo d Johr.son ~in P. O. Box 581, Ft. Pierce, rl 33450 ?wRi ~ OEAM wwS UUSEO ~r: (Er~iEe CivtY Or.E UuSf rf! i:n~f i0r ;o;. ibw ~'~4~ ~ ~~r~..i,w ows~~ .w p T.. ~i ~...eoun ews~ i ~ / ~ ~ ' lel ~ L ~ ( ~KJLlG/~J/ w..yw~~.c~ u. ..~,c~ a.. ..s~ .o i 2 %L COr~O~t~Ow i ~M- j ~JL~[ -fLN.~~I~ ~~1Y J~4 . ..+m~.re e~~fe ~a~. I ~~o. o. •s . co.ur...e.xe P. ! i st~r~nG u~+01~- ~~~~G C~u3~ ~~f~ t .?AtT B O7 NRK~++~ C `t(N11fk~5 :~~:~ws • ~~,n..c. *o a.tw ~;,r ..o+ u•~o io u.:a •.wn. • ' _-rwUT0?1Y 1f YES ~u~ ~~+a..GS cow- ~ ~ 1_~ ~ yW LW~tO Ir~ 0t1~~r.w~wG 4YSt f ~~BfC _~~'~l~l~~~'4~'~-~~ ~ iL~~ ~ ~~uL~uu7[' -V.ff~l4Tc=1~ iiti f/K/' ih c~.r. i?..bos:Zi Rcc T, w. pAYE Of @:)U~ ~d. w~, u.~ ~ i UR ; MOW/rylU~~ OCCUitE4 '~"r~~ wr~at O~ ..~.W~ w r~~~ ~ O~ r~~t n, ~~W ~ ~~Kw[, Ot WOEif~M D ~ til t ~ 'TO? (79c M :76C INJUfY A1 WOf~C T?tACE Of tr~~t1RV .t .o~.e. sme., c.nq•, ~ lpCAflON : a*a~u o~ ~ r.o . t~n o~ re~.~.. s~•n . ~lnUn ns w w0~ 'OMKI MDG.,~K ~snun~ ~ 7E~ 70~ ~L CfT.7fK.At~ON- +o..~+ o.. .~•i ..e«M o.. r~u ;.w usr a..r w~i..e~ •u+t o~ aw/rr.r~ ..tv+ r.H oEwih OCNnEO .r w~ rua. a. r..e ~MYIKI-N: : rG~iw n.. .w ~ ~oo. .rr~~ a.*w. ~..ou. -fl o.R. .«o. w a.e ~ts* ~ tt(hOfO twt o T~ • ~ OI r~ [MOw~lOGl. OV! . 71~ aeu.s~a ~eo.+ lZ, p '.t? ~tt~ 171 21e 0 M. to nn e.uu~s~ st.r[o. CEtTIFKA'T~ON-ntFD:CAI E~ OR tORfk.ER o.. *..i s.s~s a rn .w:.. a e... i~~t wc~~ ...s •~a.w.-eeo et.o eiuaw.ntr+ d n.t wos .r.ol0~ TM u.r~s+.c.:w-.r, ~r or~...G. ~ w w. .e.~ wOw Of~M O(CV~ltO W M O~~t ~MO DY! t0 ~M[ 4Y:~'S~ ST~t/O . . 1~ + CERT~FiER-N~µf ~~rn w?~w*: ^ ~ ~ S~GNA U' j~- M~~ f o. ~.~,~~DwTE SIW~ED ~~o»t~. o.*t.~rM 2h Melvin Wolkowsky IrID ,b l~4 I~i ~~L 11~~ r~ 12 18 7 2 ~ wtAilWG wDDRESS-CfRTU~c uni. w....c ..o. u.o.... ~T.n nr 7l! ~ ~i1R:Al. (~EMATiQN. iE~4QYAl CEMEiEYY Qp C4EMAiGRY-nt.W.f .IGCATICN O~ ~J+'~. s~+si ,'n`~'~ BuriaZ ;,.~i~to ?ierce Cemetery Fo=t Pierce, Florida ~ - OwTE ~.o~.+~, w•. n•e~~~ FUNEQ~I t+O~tE-he~ ~tJG ~D'ufE15 ~ f*~tu o~ ~•.o. ..o , u~• o~ ~o~.., sr.q i~: ~ Dec.__18~_ 1972 l,s. Yates Funeral Home, Box '777, Ft. ~'lerce, Fl 33450 i61j FUl1E R " REG15T 'r¢GNi(UiF i DAtE l Cf~~ED ~OCY ifG~ST~wll . ~ e.y.~9TC :s. ~ x. %~ti.;~: '~-a~ .~:w ~'~er 19 i - { ~ I hxeby aertify this ta bs a true and aoR+xt oopy af the Loce! ~ Registrers rooord on fiie in ths SL t~ucl~ County Hoakh D~p~R- ; ~ mant at FoA Pieroe, florlda. • , - r (Wuning: Not valid untess roised seai of the St. tude • .'~I _ . : County Fiealth Department is effixed.) " . ~ ~ ~ : . ~ ~ , • , ~ - - - • ` N. D. MlLLER, M. D. . s Coun Heaftfi Offiur dc Loal itoglstr~r z . ~ ~ ~ , ~oss - = : • ~ ~.'-G~ ~ ~i/' . . , ~ _ - . , ~ , ; ~ Dots Osputy l,ocsl itoctlaha~ iLED tHU ~~CORDED . ~ ~ . - ~~~~t` ~ ST.lUC1E C4UNTY FLA. ~ ' . ROGE:. YOITRAS . J ~ ~ ~ . , • CIERr. Ci~~:v~T COURT - RECORD VEF1r'I~~J....~..-~- ~T 3 ia PH'?3 ~ f . . ~ Re: FLOYD COLIN JOHNSON, Deceased - seox 216 ? 27~ ~ ~ F ~r~, : . . 3 . _ . . . . _ _.~_y...._ _ ' ~ ~ j ~ ~r ~ ~ 'S' _ "c ~a~~~'`~"-~~_.~? .,..~T,,.. ~ - II