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HomeMy WebLinkAbout2326 . _ ' - - - ~ ~'~8~~b y - - - _ . , . r Ts~. rrwTa ww~o or Mrw~t~ CERTIFtCATE OF' DEATH • ~u~cwv or vnwL rrwrunnu - rrwTi ?iu Na r~e- FLORIDA •rd .k:w gIR1N NO. ' RE61iT1~A11'i Ho. 499 ~r~~~rlf •a~t~t~~ 1. ILAt~ 0I K~TM COD[ NO. Z. YtY~~ IRf1OtMt[I~M~I~rdl:.r U+rw.~ R~rw~.N...r~...:..) "DY"" Sailat Lucie 66-025 sT•rc FloY'lda °0°"TM Sa1Y1t Lua1e N ~I~e~~ I~ 'ye~. ij dTr.TO~~LMIOC~TIW~ t. 4 K~CE O~ Of~TN l. OTf.TOr11.011 tOCAT1DM t. K R(S~O(~CE ~ •~~~~t uWOE GrtY l~r~TS? MS~Ot C~T? l~ri?Si r.~.. Fort Pierce .E:pg bp Fort Pierce n, p ~ur[ OI ~M b~M)ild. /iM reraf Mpw) ST1U[T I10M~tSS ~ r~*~ 1401 South 33rd Street Ft. Pierce Nemorial Rosp. a. w~rc ~r ri.r ~ru~rr lvf 1. 0+~7E ~vw~ n.i Ye.. nK«pr.n CFIARLFS CARROLL SHANK ~?TN November 12 ~ 1969 ux ~ OplO~ O~ YC~ 7. r4lAKO ~ KK11 M41U~[0 aTE Of M11TM ~CE IIw /wI r~~ ~ T W Y~ofJ 7~ Mi M. Cau. ."oo.cc aro.cco Pril 2q, iq22 4~'•r•~'•~ r,d., on. x..~ x:,_ x . t a • ~ 1~ f~ t s ~a. usuu occw•T~ow ~a~.. Nw~ r... ~Oe. Rwo os ww~tu o~ wousrsr ~ 1. w~rww~cc (snh ~+/~4+ arr.~i i. u?WU a~r oa~a» .l t~,~ r- ~~Hy .wt M wtht bk. new y nwM ••••R~ Foreman ~Construction V2rginia U.3.A. ~ ~l~~k ~~t Il f~TN[I1'~ IMYt N. MOTNt~3 w~WLw Iu1ME ~ •s~~••~~•• Unobtaina.ble Anna M. Seal ~s. sotw ftcv~m wa www • t10MATY~[ wtow ~y ~ rl,n~ ~,~„~.L. Zq~.A Ct 1•~~ PiPrce_ F1oTid8 ~ 2 ~"iTS• ~~j•\~jl JL1Gljii~ lYVi YiVKVS• ~/a.~ ~ - . ~ hw~t~l 1{. CwYSt N K~TN (E+Ia wl~wtnw/r.6v~v 1~). (S/. ~N `).j + 1~T[~Y~i KTrtCtw r• e s•• r~~~ i oc~tw r.s c~usco r?: • ' owscr awo ourM . a t t t• n"r[°utc t"vs[ ~y a?• -e.?_ . r ~ .ia~~~~~• G,trtw.~/•¦~, a+c To p) i r~4~ ws .iK.i V ~ . 1 • a • I .swe r~e l ~ ~ Q -~T ' ' r~~i~tr~r +t~I Mt ¦~/er- • p O~T TO (r) ~ ~lt~lw 7f Z ft++N «~x l~M. _ ' . ~~vt t- ~ 1MT M. Oi[qw SK~ItMt C.O~O~i~0~6 Wn~n1RK W OUtw MR MOr II~U~~[s 10 M 1U~wY OeS4f[ CO~dnOM CwO~ M IY~ 1(a1 . w~S ~UTOKY . - a.. ...t. ?cRSO~wco. 3 ~ ra a .~o O •r 1~f~r• _ ~n~w~ m. ocsGn~cMO~rrvu~roCCURAEU. ENa~Nwi - •~k~y ~w~ ~ AGC10lMT wK~ot ~iuo[ ~ N~+M~ 1~ PWt /w A?t 7l yY~~ qJ /f •~s~~- u ~ ~ ? Jt m[ TW[ Q( IIMI ~/Af~. p/. YfI " ~1 MJUI~f O A. . Y I IO/. M~NA~ OCCYRII[O ~r. K~t( os wu~r i~. u~ r~t a~~. m/ G/TI. 10'~'M. OR IOGilW~ Cn11NTr ST~Y[ ' MMRC ~ ROT RM'l[ ~ ~I• p~ttf. ~tl Oft/.. lfl.~ ' • bORK AT ~IORR ~ / ~tI~M~ JM r~ewa~Alsom ~1 ~ • , fo _L~ •nd b~~ wr A~ ~fi?~ en . D~~tA oeev~e~d N ~~7 _ m on tM d~f~ ~f~f~d ~bor~: ~nI fe tM b~t'oI Anp ~ns~Nd~~. /rom IM e~u~~~ ~t~t~d. ?11 f t~~• ~~6 Yw~ (urp~r ~.IYG) ^ 22: •Dp1ESS~1 jjt. y1 S~Gw D •r• t• 1• ~ /!i~li\ ~('n(~/~} / e~~~l~t• a ~~~YJ ~~~Y~'~1L~ ~`s ~ C •t~~f ~N. ~~~t. ~wT~. ~ aT[ ` IJt I~AMC O~ C[rET[I1Y O~ C~CM~Tp11Y 2~J. ~OC~TpII I~I. f~sw. M[M~Y/1 (Sl~ft~ , IlirwKl~ 1 Buria~ 11-1 -69 ~:illcrest ~Iem. Gdns. Ft. Pierce St. Lucie, Fla. . •.s.~eia 2~ u~c~u c o~s n~c ss ZS WT[RtCD.~tlOC4tt[C. I~.I1Ea6TAAA^SS1GItATW[ ~••.,•ss ~~Gl~ ~~~~si~E~c~06 S. lith Aj°~e.-nber 14,196 ~ . . 268~.'~f . Fi~Ee a~~ ~cc~~oEo ~ ST..~UCIE ~~L`M7Y F~a. . ai,Gtt TFAS ~t . r ~ ~:7ii CCL'RT ~ • SF1 . r r^~...~...~ j~il4'., \ r - ! ° ~ : ~I. . ~ ~ hehby ar?tiy thk to b~ a trw ~nd aorrecY aopy of ths t~oc~1"Y ~ ~ 52 i~'1 ReQt~tra/~ n~oord on fil~ tn ~ S~. Lud~ County H~sMh Dsp~t1- . m~nt et foA Pierp. Fbrid~. . . ' ~ _ " ? ,r.. ; . ; (Wsrnirp: Not valid unl~cs r~i~ed seal of ths St. Luci~ r~. - County 'Health Department is affixsd.) j ~ - ~ = . ~j3 % i ~,1"~S ' N. D. MILIER, M. D. ~ Cou Health Officer 6 lotel sgistr~r ~ d _ ~ ~ ~ . e~-. Drtir Os~xM Loul Reoie~.,~r ' 'DOOK~ i'#Ct~7~~~ . . _ _