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HomeMy WebLinkAbout1421 i~6~~ ic: ~ ~ ~ . • . _ ~ ~1 t~~. 0~- ~TAT[ ~owRO or NtALT11 CERTIFlCATE OF DEATH` ^ ; ~o,., . iu~uu oR v~Twt ~rwin*nca s~rwT~ FIL[ NO. 1•s•~ *•a- FLOSIDA ord •A~w e1R7 NO. Rt61LT11AR•~ NO. ~ pr~p~~l~ 1. KAC~ 0/ ~fATN GOD[ NO. L YWAL RiM~[pCit~aNfw~ealW.t llivw~t.w: t~.M~~Iw~~i+:r:w.) es~C~t~A ~ ~M~ STATE C0~111Tr ~ •nd •t11 b~ ~l~e~~ - i• ~~f- CITI. TONK.OII IOCATIDII t. K?I~CE Oi OEATM C. C~TY. TOY1M, 01l lOG1TqM t. K RESiDENCE . •~~~~t IMSIOE CITr UMITSI INSIDE CITY IIMITs/ YES ND ? 1fES NO tll~. I. NAME OF (1JN! b~M/1ld./bt Wqf ~/6Wl STIIEET AOOIIESS NOS?ITAL OA IpSTITtIT10N Nwut o/ FMrf MffYe Lw wiE afwt~ D+f Yra 0 oceuk~ «~"a'•'~ Randall Hance Mears °EATN Se t. 8 t966 . SEX i. OOl01t OIl IIACE W41UE0 ~p KM[R NMR~EO OATE Oi NI17M ~6E (~a ~ra~ i ui.DE~ t ~EAR V~OEa H Mif. Vl 1Yt AKI~q) ~f~r4 DM Awr~ Li~. i e• ,~je White woowco0 p1iW1CED h:a 12 1908 8 i w1 y 10r- IISU1~l OCCU?ATIOM (Oirt t1~/ ~/nMt Mst IOA. KYID Oi WSIME55011 ~MOUSTwY Il. N1ITMKACE (9~tt M IMtM~ lMt~l?/) 1. t~~ 7~ ~w1t OOUKtRY? •ftA ~~r- tsriy~tNw~tlalb/?.~4~d~M ~~p•~~ Checker Tor~ato Packers Crisfield t~d. S. ~4 ~ , ll~ak iwl FATRER'S ~uYE t~. wOTNE1I~S MAMEM 1awE er Lee i:ears Cora Sterlin ~S. w~s acc~sco cvc~ ~ u. s. ruerca ~sr u. socuw sccu~~tr w. i~. w s u?aMn~u Ma~ belle Mears 11~. r. w w~l~w/ l// w~. M w~r Mr~ ~I ~+1 No 221-0 -68 A~~M 21 Elizabeth Ave . ierce a. Fun~r~l i~_ CAYf[ N KATN [i14?~ Mt tNM /t~liwt/~r 1~). sw! l~).) INTf11Ynl ~ETMCPt A 1/~~ t0 t ~AwT l 0[A7N rAi CAYS[O ~Y: OMSET AMO DEATN r•~. w»~~*~ ~~a e t oc ial InfarcLion hrs. t~. cir~e.e. a.~+....q.... 111 ouc ro c+) e I1is 1 Yr. •ft~ l\• r~IN Nrs r4~ q~ 1 e s • 1 ~~af~tr~r d~t4/ t~e ~wle?- ouE to (c) • •ft4fw ~I~ n~K lkt_ O -?AAT 11. Of1Ew S~GI~i1C1Mf OOIIOIIO6 OOMf1M1fMC TO OEATN ~yt MOT IIOATED 10 M ~dM1~Yl 06GY OOIO1110N iIYU M fMi 1(~I . MAS AilTO?SY IIOr?~ F /ERfO11MEDt NT d~~tY s ~ ~p ? , or Nt~r• 1 pESCIIIK IqW IMJUAYOCCURRfD. (ERlO Ad~NI I/l~t?~ 1A P~?1 I M PMl /I1/MM f1-) , ¦~tl~~ ~~7 C ACC~DEMT SYKIOf MOYKIOE - ~•~~~~1- t7 ? ? Q ' ~ m[. 77YE OF N~rr ~/wtl. Dn. Y~r . •-ay' ~ YWllr w. s Y . = 20/. YUY1111 OCCURREO mt. KACE Oi IIUURt (t. b~r ~wt ~At. 2% qTr. TO*N. OII LOGTION OdlNTt 57ATE MNRE AT ~ MDT ~1111f ~ /~M/. tl?td. ~tf OfI/.. tft.l , MOIIK AT MONK ~ 21. !~fNnd~d tM d~rd l~oa~ 1959 . to death •ndb~t w~ h,~ ~li?~ on 9~ - DNth oaeu~nd ~t m on th~ d~t~ ~t~t~d ~bw~: ~nd to fA~ 6Mf oI tn~ Rnonhdl~. /rom rM auw~ ~t~t~d. ~~1 zs... ~t.. s+o?uru~s ~nrwarwk) ~ ~ooscss gp2 'N. 7th. St• 72t. WTE5IGMED s. ~o,,~.s. a Melvin 1~iolkor~s' y.D. Fort Pierce, Florida 9-12-66 •~Oa?~t1. ~~1~ 11AME OF CEYETERY OR CIIEYATq1Y 23~. LOCATION (C~f~. fMrn. M M~f/) ~g~) ~ . ~ 1![rOr~t (3 1 ~ Remova~` Se t. 11 196 Bass~n er Ceaete Okeechobee Co., Fla. v. e. f e i~ t~. ru~c~u E M'S S1f.1tATU1K 1~~~Lh. St 25. G?TE IIECD_ ~r tACAL REC. REGISTMII'S 51GMATYIIE a.".'o6e Milton W. Baird Ft. Pierce, Fla. 9-14-66 Anna Lee Denison, d.r. ' ~ , Fllf pEC4aDE4 - ~T IUCIF LOUNiY ~p~_t. ^~~~`r~AS - ClE~ir C :CU1T COURT `n RfC:-,_ : ~ ~~f,, ,f,~ . ~.u. ~ ~y ~ ~ Nar ~ I s3 PN'Z3 . , : ; ~.1 ~ Repistrsrs noord on fii~ 1M St. tucl~ County H~atth Oeper~ ment at Fort Piarc,e. Flald~. ~ A ~y • ' r . 'r' (Waming: Not vaJid u~lesc raised sea! of the SL Luc1~ 26'76 ~s , `f : : ` County Health ~epartment is affixed.) _ ' r- . N. D. MILLER, M. D. i.. . :y'- County Health Officer b loul Rsgistr~r _ - , , . . ~ •~'-~,....,.zi3 ~ v ON~ [atel Reaian,~r ;.y ~ i• ~`.'~2~0 ~ i~