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Home My WebLink About0096 - - - • ~ ~ DADE COUNTY / i~~~S8 - v~ki~ DEPARTMENT OF PU~~3LIC HF•ALTH MILTON S. SASLAW, MO. MPM. ~ ~ 18'SO N. W. FOURTEENTH STRHET DIREGTOR I ~ ~ MIAMI~ FLORIDA 53125 ~ ~ , ~ . ; • - D"~3' ;-r:,, - 1" - r~` ~ IS TO BE A TRUE COPY OF THE IACAL REGISTRAR'S RECORD OF DEATH. - . . '.{r~~ ~ • • r~~. ~ - 'f1., w`i ~ y~.~ . ~ r~~..: ^ ~ • ~ . G : i r~3~ ' valid unless the raised-seal ~ DEPUTY REGISTRA ' ° _"~4~~' ~`•~he Bureau of Vital Statistics VITAL ItEC~7RDS UNIT r3 i• Y~=~'~~~+' - DADE COUNTY HFALTH DEPARTI~NT • ~ ` af f ixed . ) - ' t ' :.~~b''~~ MIAMI , FLORIDA tke~ ? ~ ~~i ~+'s t~d'R' , ~ j . ' CERTIFICATE OF DEATH i'-.E,.:=~,~:.u~ ol Il~altti and ~2e6~E.i~ilalivc ~rrice. BTATE FIL6 NO. iw.~.u?~~~~~a~.m FLOAIDA J~r~ '~~'`Ow'R"~~'~~' REGISTRAR•S NO. % . ' c'S°D--w.wE r,~~e ..~oo.e .•s• ~SEx tOwiE Of OE~T~~ n.., .t.~. HARRY H IvAGI~1ER ! AL1LE ,1A~U~R1 14, 1973 . _ -17 ~ . . ~_.,e ~ecro, ..e~ c... v.o~..a, , ~GE-i.si o»oe¦ ~ :u~oe~ ~ _ ~ OwTF OF l~G~~~ c.., ' CCUNfY :3F AFai~. } i , ~,~r..o•. ~t.~s. ..os w.s ~ »o;,n ,.w •ua ~ , ,.`tLTE 77 s~ ~Oct 26, L~S95 UALE : ~ ~.N, OR IOC~.i{ON Of DEATM! ~ ~?~oe im ur~n 'tF1p5PfiAI OR OTHEA WSTITU^GN - NMtE ~ ~oi r~r»u . .nei• ~~•n ..u+~e~ • ~ ~ Srtt~~~ .!t Oe rW ~ . ' ~ ~ VETERA?3S AD~tII~IS'I'RATIOI~ lIOSPITAL i:\~SI YE~ , r. ~ ~ 1- - - - - - - - , -1 - ~ a rtin . n .,,r v s . ~CITIZEN OF WNAT CO•~NTRY ; w~RR~EU, r~E~EF r+t~RRiED. 'SCRV:vwG S~OUSf ~~~e. c~•e ...~oe.. .+.re , ' - . „ .c~_ r:• i w~i:nwEO DNORCED v~cn, ~ i 1 1 '.''i~co:~sin U.S.A. ~~a MARRI~U ~~~i~Io~~ I.cn:ilir.l~~BT' _ ~ ~ , ~f CU4~•1~ NJNSE4 j USWI OCNVATlON :G.rt a~«~ or ~.on ~C,.+~ ;,o~•tir. r••st o~ , K~Np Of WSIIiFSS OR tNOUS1RY +~Olt~wG l~~E. F.F-. It'~tEC ~ ~ i ~ ~ _ OL-3334 4,~ SttT1p ~H Shi Buildir. ~i5 ~~g2~ - - P__ g-- - E _E - Sfp~f jCOUNTr ICITY, TOWN OR IOCAT~(;N ~ ~~SWe [ n:~r~TS ?SISEH AKC NL'MlER ~ ; ` i`'•""• ! 744 ALTI:RA STREET I~LORIDA ~~~s SAIIIT LUCIE I~k FT. PIERCE ! •-~.e•rf nt~ .~~oote ~~S! MCfMER-MtID(N N46tt nti* ~~~[+o.f i~1~ f Unobtainable ` Unobtainable s ."`-~Nr_""""` I~1f o f rom i~~~~ AOGRESS +snee~ oe o o~ ~o--.. s~.~e, t~•~ t ~ ~,~±'~?LFS W. ANDERSON VA Records `,n VAH 1201 NW 16th Street, ~fiami, Fla. 33125 ~ ' _ _ _ - - - • •~I~Ol~r~it ~r. E v~l ~ CFw1M Ww5 CAUSED ~Y !Ettffp ON(Y ONf ~AUSf oEP tlNf iQR ~o), ;b). ~tND ;r:: ~enrt[n owytt ano ot~rN • '~"~°'•TFZ•"" fILEC Ali~ RECOttDED i s ~o~ BRO\CHO P~E(3~:ONIA ST. LUCIE G~)UNTY FLA. ~ i V! , O~ ~l ~ LOr~Sf[+VF~+;1 C ' ~ ' ~ CIE~R Cc~~UIT CO~Ul1T I # acrpp~ YfR~FtED~~ ' rse rc j (b) _ IC~ 4 .t~'~tF : v5! .7e. 1 D~t 10 G~ ~5 ~ CJ••~[OV[r+CF O~ ~ V ; • J~+DF¦ : :;sF ? a~ ia ~0 35 a~ ~73 fi <<; OT~ifR ;if,r~~F~L~NT COIvD~T~CAtS C~DinC++i CG~+i~~~uFvG •O Dl~~ wr .+or nu•ro rn c.ox c~r[w ~....rr ~~a~ ~ rE5 ~rtee n..aiwos cora ~ . ~ ~ t!S C~ ~+0~ ' S+DiRF4 ~M ~tTl~r~v~+~G C~ul! ~ O~ O[~!M 1'E'S i tw ~ . ~CC~Df':T. 51,YiDE OR OATE Of MIUR~ ,..a.~~, wr. .e.~: T-MOIiR . HOW IN1UR`I OfCURRED ~ tr.rt~ ...~~n cr :..:un ~v ..~r . pe ~.rT u. ~rer ~ ':.E OA cKGt?EiMiNED ~ I ~ 701 I 7C~ Nt ~ Me t _ ' ?1 N^viK ' PUCE OF W1URY ~i ho..[. r.~+. sretet. r.oc~r, ~ i0UT1pN s•¦ee~ o~ ~ r o. , c~n oe ro~+, s+•re : ~ ~ . .:s c~ r..,r ~nr~qe ~.oa..e•c ~YFGn1 ~ ~ ~m ?~v r ~ _=°~r..-aTipN- +c+-w o.• •t•~ ~ +C«n~ c~. .F.¦ '~~o ~S! S•w ..:..lwt~ ~u.t oti ao~wo-~+e~.~,er r~.t~DE~rM OCCJiltD ?r rne ruce. O.. r~µ <ri -r.~~ r.• ! ~oo. .rri~ ce,.w , ~ ~ D~if. ~r~D. TO M! /f51 ~ *~t Jan 5 1973 TO Jan 14 1973 ~ Jan 14 1973 ! 3:OOA o~ ~ ~ , . , . ..i~~ ..c,.. - - - ~ i21~.------~ - ;lfi- - 71---- ' Ir M ~o rwe uuse.sr sureo. ~."..y Ct~-4tEDy~: EEAw~INER OR CORONER~-.. r..e ~.us w•~c ~cor o• w.r. r~e oeceoe~+ ...s ~.~.wr~cio c~•o nt 'rN WDr o~ :,.e ,..,~ts:r.•~a.., ~ . e.:.,,~... .,o..r.. o.. .e.. .~e~~ a.tn a. n.t ~•~e u+o oue rc *~e uusr•si s••>w .'M M ~ " , - ,:r~t_. -~,r~n ~ - - gKr~!.TURF • j~j~ et a nrie --'DATE SIGNED ~..a»r.. e.r ~e~u _ , ~ •~Q / Q .r~ _ /~..~/~i_ rk 1-15-73 ~ • . •.:i ~.P." RT: •nte' o~ ~ •.o c:.r cr .o..., ~y,~ ~r:. ~ :::iL~~N ~~1II3ISTRATIOt: HOSPITAL, 1 O1 ~tti 16th Street, ~liami, Flarida 3312~ - ~RFMI1TiON. AEtiv~YAl CfMETER~ OR CRFMATORY-N~Mf ~ itOC~TtGN ur~ ce ~o..•. s+•n ~ / r=~ :ezraval Valhalla Cemetary t:ilwaukee wisconsin s~~, ~ - - 1- - - ' ,..o..-~. o.~. +t.~~ fUNERA! NOwtE-~~~~vf ~~~D ADURfSS smn o~ ~ r a ~o .'~s. o~ row~. s~~~e. t~r ~ I/I6 973 ,H Bess t~emorial Mortuaries Inc. I900 1:. ~J.36th Street Miami Fla. e~ n TURE REG~Si S.Gr ~ ~ OAIE ¦fCF~~f6 t`I ~OCM R[G~STl~~ ~ ~ , ~ _ L 1~ = E E; -~r ! .--.1 e~- d~ ' . . . • _ . _ a,~; . ~ - goaK218 ~ 96 - ~ - - s~ ~ ~C ~sg ~ = ~ . ~ ~ s~~ ~x~~ ~..~=4'~_..~. _ _ .