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HomeMy WebLinkAbout2439 CERTIFICATE OF DEATH ~ ~ ~ ~~w, ~ t111"~M7N (y ~ ~y"/~`„( f L O 8 t D Jl ~TATi IILt' ~~~~r~ M~ - RC~Iii~Al1 ! NO ~ ~_J~F. " ~N~+ OA~E O~A ~ ~Ow~w. ~IM ~ KE;, ~'•Z! : J~ R. Funk , Male S• tember 19 1 ~IbCt .~M~ .w~o. ,.~~«c.~. Mwl.. w0!-w, wse. ~ .~u • , oAn a ~MtM ~.o.+~... cOl~1Tr a OtwM Pt ~ MK~hr ~ M~M~~ ~ tp~{ ~ r0~ Mtl ~IM rM ~tY ~ ~ n•~s ~ Whlt~ s. 1 r s~ ~ O~L. 8 ~ 0 r• ~ . . W l ? ~www c~ ~ru~ d n~ r15 - ~u ..a unw n~n ~ s.ec~+ n~ w .w ~ SL. Pstersbur Y~~ „ St. P~tersbu~rg Gensral Hospital _ S~An a~ZM IM MOI w Y~~., wW WMAT ~~RY M~~~. MflRO~Y, ~f1~VN~'~ ~ IY'1M~. OM ~Y~fM ~W~ 1 CAM~1 W~w~. I VK~~ ~ EstsZla Mart3a~t ~ Kiaaouri . II.S.A. w Marrisd _ - SOCw Sttu~ttr r+?wrte ufu~t OCAMAi10~+ ~ o~.~ a wr eo.+~ ~~~.c .w+ a c~+D Or Miswlls Ot udillltr rOa~O uA. MM M MuM ~ Ys~ ~ssuP~xint,~rdent Ma n U.S. GaRSrruesnt i~r Apt. 305- ~ESIOlNCt-S/4R COIM1111 Clry. tOWN. O~ IOCATfON ~yKwr ~H w wo !'lorida Pin~llas ,k St. Prt~r~bar ~N No ?.~530 80th. S~rest . fwT~W -NAME r~~i raw~ us~ MO?1!~-huDEH ?+~Nt r~ mwe w~ ?s ~?r'r3? Y?unk Lyda Riahardsan 1 -?iAMt MA~ING l100~ESS uwee* w~ r.• uo . cw r+or+~. suw. tD? _ R~twl l_a Funk ~n 5530 8ott?. 3t. No. , f 30'S-H~ $t. Pet~s~'sbur ~a9 ~ •Ri ~ oEw1M ww~ GUSlD tr: ~H+?fi owr UrE GuSf IEa iiwiE rOR hA At +wD 1.H wr. ......•r N ~ ~ ~4~r~- ~,c ~ - (OMN11OM1. 1~ AIIt~ •MKM O~tf fllf ~O f~MMU1 CWN ~M. MM q. O~ ~f ~ COM1lMrK~ O~. ~/AlIMO t~f YM~!{- ~ NWO C~YN ti1tT ?RRI OT1Ea SiGNI~ J! 00110~~ONS: co.o~a..~ cawca:suww v ouw~ wt »of ee~.n~ w c.uu~~ ?.ar ~ A4ROK~ r ti!S .nK Nw~M~~ ca. ~~.~~i~ Y1f~ ~~~/L ~ C~'Q~l~ f~~./ ~4 ~0 ~ or~wtw wyeorra~o tNnr O! I~di ~ rw~~w, w?~, nu ~ MOw tNJY~Y OCCYMEO ~ uwe~ .~MI a wiWn M?~n ~ w~~n u, wr ~ 1~. ~ M. 7Y. N~JIIRr ~i w0e~c NIUt'~ rore. a.r+. unwr. lOG?fl0~+ ~~rw e~ «o . c?* w w.in, a.~ ~ ~ wcMr n~ o~ .w ~ ow~cs we., nc. ~ vaan ~ ~ ~ ~ C~KATIO~N- r0~1w~ s?~ nM rOMM ~ar •W u0 wt a~r w/~ r ~ MloO ~W ~M~/ Mt Oll~tll OCCYrl~ M ~4U. O~. M MItSK1AN: rP~M O+~ wA W~~ N~~. ~wW~~ ~p MA. ~MO. q ~M! MN . .mwa? ~ ~ ~Q ~ ~ 3' tC S % `~J+ ~M. ro w i+~a i w~e !fa wn•sr~ wo.. M !1. tN- CS tM C : w ww wr a w~ .ow a~uw ra au ~~wr.~now w~+e ~oA ~/o~ ~e ~+r~s~w~^a1, r n or~~w. rO~~M w• wa ~ow N+?11~ OCQI~~ OM Mw ~M NR q M~ t~Mw W~lO. t+t M M ~-?NIM[ rnw o~ ~lun rm~ ~.or~r. ~ rw~ ` ~ ~ ~ ~ Pal~ Ir ly_ ~ f ?qK nn a~ ~o~w~ snn ~ var~ ~ Bntial, :.,w M~soarial P~rk CMrts ~ 3t. P+~t~rabur d ` ~ i . ~o' ~~i:-•.~t.~' ~o:~.~:"~e?~ersbnrg. !'l.a. 3~710 f . n~ lOlfriA~ ~ ~ . ^ : . ~ ss ~ ~ssi. res =aa~r~ue ar v~ ~rt~Ma . A ~csur~t~aa corr xc~_ ~ta~r St _ _ _ : . . ~ ..I b~ai~,-~~ tlrt tdta i~ a tru~ aad corr~ct capy of s c*rtificat~ ~ . oa fi~~ •,L~C=,~ii otlic~ of th~ LoCt1 ~egi~i~~ar af Yital SL:Liai! c• of th~ , Pie?e1~~;33o~~nt~ H~lth D~pirtm~nt, 8t. Peterabur~, Florid+i. ...,~a -~:•.-_5~~: ! 41, 1973 D~puty Local Re~iatr r . . ~ i [ i f i E E S ~ Q ~ = r = ; R~.TURN T0: ~ : ~ ~ ~stelle F~~r_~c ~ L~ ' ~ J5?0 ~Ot~ Street I~~rt;~ Apt ?05 B w ~ on ; t. Petersbur;, FZa. ~?70~ ~ ~ . ^ o" i c 9 • 70 i ~J -t - {.~1 i 9 /7 r ~ s ~ ~ROfo a k 220 2435 ~ Q_ . A.,~ RE~j,~ Ft~• $OCK FAC~ r*+ ~ ~e: ~*1 ~ ^ S11. u~,t~ Ou`j~1~5 Rj ~ ~ ~ " . e t ~,.;:~tj C~l! ~ ~ ~ ~~-~r. c ~ C~E~~4~.LF''C . ~ c:~"':,, i QFr4f'~ 04a~~~ W O ~ , r c _ ~ z~~c ~ ~b ~ ~ .,:~v': ; ~ ~ - y m A c7 JJ ~ ~ 2~~ ~ + C ~ ~ C7 -1 L~ 3 ; .~f ~ ~ ~ _ , ; _ _