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HomeMy WebLinkAbout1969 2szs~~ c~E~ci~cwt cowtt r~ DEATH CERTIFICATE R~COR4 YFRtftEO ~ ~ . r TOSY BIALECK ~ +l ~ Ol PI'~'T3 ~ ~y DADE COUNTY " . . DEPARTDdENT OF PUBLiO HEAIlt`H 261644 ~ 1~JO0 N. W. fOURT[[NTM STRit6T MILTON S. SAiLANf, Mp, MPN. ~ " DIRECTOR • • • • MIAMI~ FLORIDA 53125 ~ - • - , ~ 4. ~ _ t ~ It~Y THIS TO BS A TRUE COPY OF THB LOCAL RBGISTRAR'S I~CORD QF DBATH. ~ ,:.;:;~~s . ~ 0 ~~l. ;t.~, r-•' ~ . ~ - ifl~- ~-•-jr`'r~ i ~ 1 . C'~' C% _ ~ ,J~ _ : .$;-r:~:~~s,.~,;f; =fii'ARNItIG: ' . ~ • Not valid unless the raised seal DEPOTY RSGISTRA . :...i lY ~'N~~{~y-'' ~ " ~y~"'~~"' i of the Bureau of Vital Statistics VITAL R'SCORDS UNIT . . - ~ F ....t. - • :'~`ai•~~? :r _ :Y;;~B affixed. ) DIADB COL~ITY HEAL141 DBPARTI~II:NT ~ - MIAMI, FLORIQA ~ . ~3Q° - ~r+frs<.i . ~ `4: . - - , CERTfFiCATE OF DEATH (kp,.rtmcn~ ol Ikah6 awd ReL~bililatire Se~vkes ST'ATE FIL[ NO. _ n~~~+? ar r~alni F L O R I D A 14 2 wv.~ w wr.a n.~sno REGISTRAR•S HO. CECEASED-NAMF ~nst ~~oat t~s~ $fx DATE OF OEATH ~~+ort.., D~r, ~t~~ ~ Toby Bialeck ,female , ;~over~ber 30~ 1972 c~~._E +M~rE, ~FGM, ~WfK~N ~++o~.r+. AGf-c.s~ ~•e•~ unq~ ~ o~~ DAiE Of tiRiH ~wwTw, o•.. ~p~1MTT Oi DE~TH ~ srtur~, nnro~r ~~tus~ roa. w,s ~~s M~ie•ej Dade , white ~ 68 u i .Au . 1 04 TOvVN, OR IOCATION OF DEAIH wiwe c~n ir~n 11Q5?ITAL OR OTMER NSTITUi -NAMF 1~1 NOf ~w frtwt~, G'+! sr~[e~ aw nuwt~ ~ 3~EC~n rt1 Of NO ~siami Beach yes 1200 West Avenue S'A!E OF 61RiH ~ u.~ot ~r~ u.s-~„ ~+~re CITIIEN OF MR1AT COUNTRY MARpED, NEVER MARbED, SURV1YfdC SPOIISE 1+~ r~rE. GnE r~otr~ wrt ~ v cax.rr+i TT ~A W100WED1 ~vtc~n~ p :?ew ~r~{ ~ l1UK 1• w1.~7~~ 11. SG~~. ~l SECUfJTT NUM6Et USUAI OCCU~ATION ~u.e ~r.o or wwc oo«r ow~~c ..osi o? rKWD OF !1/SWESS OR INOUSiRY ~ WWtIlIG UfE. MM 1~ f1n~W 1 1~7known „ house~~ife own home FES~JENCE-S~ATf COUNTY CITY, TOwN, OR IOGTIpN ~~~n SiREET ~NO NUwUER ~~sretn. reS o~ wo~ ,,Florida ,u Dade I~'iami ~each yes 1200 ~lest Avenue f.+incR-N.UVF nyt r~ppt ~ t~s~ MOiHER-MAIOfNNAME ~'t5* r~oou usr Adolph Federgreen ?4011 (Ur:obtainable ) ' NrOiU+~?dt-?'~M~f MAt1NG AOGRESS tsuttt o~ t r.o. .~o . t~n o~ tor.a, sr.n. [r~ _ 1•'elvin Bialeck ,n 5820 S.'vl.90th Ct.tfiami Florida °4~T ~ OfATH WAS UUSEO ~Y~ ENTE~ O/rtY ONf CAUSf IEt tNtE FOR (o. /b). ANp ~ntou.u t u. t u I 1 2 ur.ee~ oNSn .MO oe~n~ y+rEOuR UVf! ~'~~-~./LiG~!4~i'~~.04[/~.iG ~r 1 - ~ • ~Y~ ' ~ k/ . W ~S • o~+StOVIw(t ~I ~onOmO~ S, ~Mt ~F .,s~ ( ~b~ ~sc~U CL. uu_ .eo~.~e uune ~o~, ~ p~ ~o, w ~s . ea+uanr~ee o. - - - ~I ~..i..a rwt uNnt~. . . ~~+G C~YS! ~~37 ~ ~a?? n OTHER SK'sNIfKANT`~pPlplitONS: ewana+s coarn~u~~«~ ro pe~n. w~ M01 ~Ilw~fD i0 UVS! GnFM r..r ~~o~ _-~-~Y ff 1'ES w[re ~~MD~NGS C~f1- - I ` ~ ~ ~ ~ I* S q O „ Dt~ N O!I[~~INING UVS! ~ J~l~ C/LQ~~Ci{.~e- /rl.c"~~`. ~ .Z-- f '=wb~r1 ACC~JENT, SUIC~OE OR ~A f 1HJUR7 : rONiw, D~r, r[an 110l1R HOM~ fNIURY OCCURRED ~~'+T~~ ~~~VM Ot .u~u~~ ~~~T ~ O~ ~~fT u, ~tW ~ --"..M~:`~DE. O~ UNOEiEtMtNED j J' r hJ 7M 1M M 70/ + ; rrilUR~ ~i wOR1C ,/IACE Of iN1URY Mo..e, s~ne~, r.crw•, ~p~~T10N ~~r~en o~ ~ ~.o. wo , un o~ ~owr., sT.n : - :rE.::rr .t5 Or .q~ iqtKE L~OG . ttt , S~tC.~ 1 1'?r 7N p! , ~iRTIftCATlON- •rO~rh w~ rt•e ..OntM o.r ~[u ~uo u~si s~w MW/M~~ •~rv[ i p~p~ro r.0~ v~+ *wt DE~M OCCUttEO ~t n.t ?uct, o.' me rp.rn oa• rt~e ree/ n~r Oe~!rr. sNr51C~~H: TO ( iwOYlt D~R, ~r0, 101ME tlS7 ' ~ ~?RlMDfD M! ( -f t W MT [MOMIIEOGl, DVf ~ ot~E•seo rro~~_ 7 2 ~Jq _j{~ 7 Z 'tir y~ Z 2N ti .~d~M ~o rHt enuuasi s~•*fo. ~ . . ~ rcRTiFIGT1pN-ME01CAt ExAN11NER OR ORaNER~ a. r~i us~s or r~ NpV~ 0~ p~~~h ~ IME OKfOfM( MAS ~~OMOVMClO Dl~D v•*pa Or nH WO~ ~wO/O~ ~wE wv[S~Ki~tq~a. ~r~ r~ O?w+p.. rOHM O~t •t~~ ~u~ , E~ N OCCL'~tf0 G+ 1MF O~TF wM0 OY( 10 TNf UYSE~S~ S~~RD <?a - M~ 7}~ I Q I/ ~T Q- M. CEP!~f!ER-NAME ~nre w raNn SIGNATURE ~i oj,Flj~p~ rrt~t ;DATE SlCsNED erd+ . 0~~.?tw~1 ~ Eddie G.Canto i;.D. i,~ / ~ y Na~ttNG w00RE55-CERRfKR ~~Cl^v~y o~ ~ ~o jr iar sr.n ':r .~.erid'~an Ave. am~ Beach Florida ~ e kle.l. CREMAIIpN. RfMpVAI GEMEiERY OR CREMATORY-NMAE IOCAi1pN an o~ tpv.w s~~r~ Burial H~ Mount Sinai Cemetery 2« Dade County Florida ::wfE ~,r»nw w~, r[~n fUNERwI HOME-?U~wE ~ND ADDtESS ~ a~ntt o~ ~.r.o. ..o , cm o~ ro~N, s*•r~, i~r r Dec. 3 1 g72 ;5.. Gordon Fur.eral Horr.e 7~ 0 S.W.12th Ave.r.iami Flor~ da ,~urt OR-SrGN~ ~p,,, REG~S o~n ~eccrv[o ~r iotu ncis~w ~ iSS ~V/L JN ~ r______ _ , • MYERS, KAP~AN, PORTER, ~EVINSON 6 KENIN `-'~F ~~7 1961 ORiCKEII E7cECU7iVE TOWER, t428 BRICKEI! AVENUE. M~4M1, FLORIDA 3313~ ~Jr1~ P~GE ~ ` _ ~ ~xs t : - - ~ ~ ~ r'~T__~^~, _m ~ «--r , . :~"-kaa~. '-~"6~