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HomeMy WebLinkAbout1792 / 1 ' ' ~ ~r ~ - Yr- . ~ ~ . ~ ~ . ~ ~ - ~ - 2S'~844~-~ , CERTIFICATE OF DEATH ~ ~ Dyn~.ew~ .i Ik.ML .d R~L.41ws.e Sn.~.~ RATt ?ILt NO. ~ ~ ~ , ava~on ~ Nrwi..e F L O A I D 1l ' . TY~l. O~ ?~IM IM ~r~w~awnw~ 11[OIRT11A11•a NO. ' 1; , MlMI1111111 IMR _M~ u~~ SEII W?iE p OEwIN ~ ror~.. w~. nu ~ ;i . i~ , 1B~1M~ ~ ~4~ t. M31@ 1 i ,1 ~ ~rw. wMe. utrc~r ~ww AO!-wt wa ~ w~~ wou ~it O~ MtM ~~a~l. Mb COIR811 p OEAM I ne. ~ wtw ~ ~L~t9 ~J9 ~ °un ~.o~, ro ~s .K ` " t . ~ .a~w cs wn et O~ 1~ ~+S ~r rw r e~r~.. ~rw Nrn w wru ~ f! i! ~ 6602 . - mw«s j~,~~ L~~ li ~ F'~• p~~78 h~[.PS H Ft• p.r~VC r'IBOQ~~ H06p~LAi , s r[ a ~+w~ .a . •.w... .w a vnaa aoiwan ww~uppn~co.pnevice .w~[o. s~ ~ ~wwr~.~n, ~ ce~n • ~ Ci3Y~~~wc~~ „ ~ ~1P.Y' ,t t' . wIN NCM~l~ ~i u~w. r M~a ~ 11fU~?! OCCII?wnON ~ aw a~ a.or wr wrw ~w~r a t~0 O~ M~lSS O! ROIKtan ; i ~'•rw~ r ~w uw. ew. r rww ~ t p" 267-22-L504 a~. Qontractrnr ~ '1 . ~fSIDEMC[-fTAI[ COIMfT Gft. TOMM. d IOCAt10M . ~ I VKwt na p n0 ~ FLotida St. Lu~ci,e F't. Piei+oe No ~ar~Ne31 Rd. Rt. 4 55 ! , lATI~t-~MM[ nw ~Y Wt MOt1~~-UMDEMN~IME tiq ~Ml 1W .i , ! 11 ~ r~:~lVl 1~. ' . .~~M wUlwG ~OWESS ~wa a ari. wo., cwr o ~o.~. w*. rr~ . ~h i~layrc~B Seamble~c 106 Maple Av~e. , Ft. Piei~oe Flor~da 33450 : i ' ~ Mt ~ oe~UN wws Wn[o w. (tNrtr a+tr a+r uus[ rta ?~+f ro~ 1~11~1 M~ kA ..~n.»~w n..: ~ i K ~ ~ ~ ~ . , ~ NI i; ~ : . ~ ~ ~ 3 I, ~ - [OYN~IOM1. M ~M i ' S ; _..~......,...a ~ a? ~ ~W M~4 t~tN 1~1. M q. O~ • tOwNOMK~ Os t• p~nw~ rq ~wN~ ~ inw~ ta~N uN ~ i ; • ~ , ~ ( f~EKAN~ ~111~1~ ~N CW~YM~ 10 M~~ NR MO~ ~lY~ 10 iNIM ~NIM N/Y1 M11ps1 r YfS ~IMMMO~ COM• ~N~ p ~O1 M NV~1 ~MYMwMO CMIl~ A. I1~. F , ~ q~ oe wDltt~r~t0 ~.ow~~. au~ MOW IN11M'I OCCIN~EO ~ e.w~ ~.?wr a.~wn w~ r.~r ~ w ar w..u ! ' ~ ~ 7~ 7w. 11t. M. M/ i ~ 1tU11lt At WOIR ~or. ~N+. ~~n, ~.PO~~. IOCATION ~ s~ea O~ lr). ~n., Cw' e~ ~O~M. Iu~ ~ ~~M[M~ ~f~ O~ MOl OMKt rMvtK. 1M~Cw1 ( ! ~ ~ ~ : . tEt~iKwt~ON- owr ~w .a.~ w ?(N ~M Wt Y~ M~/~M YM OM ~ w/w ra w~ w qa~w Oeewr? u re run. a. ~r ~ i ~eww~ ~.r nu ~or~ r+u war. ~~ow~ ~ww. w. ~o w rf~ ' ! ' .~'s~:'. R»~. ~.e j~. 1 25 73i° 9 5 73 9 5 73 did ,~/•~~,~Kro:;~ ,a ; ~ . n. Md~N~ ~W~ m m n~. n. , ' } CHtAKJ?iqN-MEO~CJ~I WwrH : er wy w.s a w ~ow a w.w~ ww wc~w.w w weroi~.cw ~w i f I I~Y~M~wO~ p A! W~~ ~M/M 1~1! MIt~1~M~10M. M~ pw1O~. M~ R~~ ~OM «.w~ oaw~w a. ~ Mw .rr ~w a.~e c.w~w~ n~~~- M 9 5 73 ± ~ (,(~j~~NMlf IAN M M~1~1 ~ MON p IA~ /~*L M~.AYI ~ ~ Willia m I~ Me r I~L A FA r 1 ~ ~ ~ NM~1 p 1~.~. MO. C q// P~l! N ~ ~ ~ • »~i ~ ~~~~ordl 7 St. ' ; . a ~ ~ CKMi1IlON. ~MOVAI fMEtfn O~ CJEMMIOtY-N4Mf ~OCATIOI~ On O~ f~M ~ 3 i FLo~iBa ` + ~ Burial ~w. Nill,crest Mexrori,al v. • € . ; , . ~ wNf.At MoMe-?uMF Auo ~ooRtss ~ utl.. o~ .u.. cw~ a. ro... a.s. ,n ~ . _ Sept. ~,`~19~ HQ~ 901 N. 7th St P' e ~ ~ r. s. ~61Z -srewrwc . w ~e... ioc...eoa.w - . _ . ~~r. illo - a. Dtember 10 1973 J s ; ~ p~ JRi?ED v`~ t c~LEO AvC ~U1~ii'( fl~?- A~' S~. tUC1E ~ • ; I h~rby awfffy thk to b~ ~ trw Md e~on+~ct Qopy of fhs Loe~! ~e'' F::;1~T ~~URT , ~ - ; Rs~latr~~s noord on fii~ IA th~ St. Ludt Gounty HMlth O~pwF arf~Pg `~s, ~~'`g,...~..~, ~ • j m~nt ~t fat Pierc~. Flo~ld~. • ~ , ~ . _ (Warnirp: Not valid u~?{~s niad ssal of ths St. luci~ ~ 2 56 PM ;~`~,.-Y"r'?'.~, - ~ _ County Fieshh Ospa~tment is aKix~d.) ~ r; f, Y - ; . . v ~ . 3 N. D. MIIIER, M. D. 26'~844 ~ ~ ` ~ . . _ ~ Health Officer d lou! istrar ~ , ~ ' _ ~~~jJd~'~~izo= ~ . ~ : ~ ~ • ~ 5 . , ~i~; ;,1~~.~~ - - . 0~1~ OM~+~?? Loai Raoi.h~r . w , ~ , , - i _ • ~ E:"~ ~ - _ : _ ~