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HomeMy WebLinkAbout0537 3 ~ CERTIFICATE OF DEATH ~~8 H (arp~e~w~n~ o( 1 kaltA ~nd Re~Labil~~a~~re F L O A I D A s*wT~ ~u No. Ill~'lCM1N fM IMal.lll ~ N Mlr?t ~ ~RY 1~~71~[f N[ti1aTRAR•• NO. K OECE~SEO-~+~wE ~~n~ rwa~ i~f~ SEI GATE AM ~ . . n~ l , Tl~:.~t.~'.A :•;Ai~Gr~H:.'T STE~f/vtT , Female I, December 4• 1973 R~CE •~~n. ..e i~9. ~n1fK~M ~.b,.~. ~cc-~.s~ ~•~w. ~.e.. ~oe. ~ e.. o~~c or ~n~ ~.~o.~.. o,., touwrv a oEwrn ~TC. .l?~C'~~.` 4 ~?1\f~~f~ rOS-TN.~S MOY~S YM ~~~1 ~ jlti w~(1 ~?ugust 13~19Cn Pinellas C1TY. fOyrN. OR IOCATION Oi DfAM ..i~a cur ~run NpSMt/U pR O1NEt HS ION-HUNE ~u .b, ~K e~.~e~. an s.~~r ..,p ~ t?ICN~ ~ft O~ NO a ~ Dunedin Yes N i9ease Hospital ~ STifE O~ NRM ,rot ~ u~~.~ M~re G112EN OF VIIHAT COUNTRI/ MARMED. NEVEt MAfbE- p, -TSURVNNG S~OUSE ~ u rtK. One r~o~r w~rt cawrn. ~ n ~ fMtr. ~ „ ~ , Irsdiana ~ U S A ~~°arr'~° c~e ° ~ Geor e Stewart - - - - - - - - - - - - SO~:'~: SECUtiTV ~+U~WER USUAI OCCWAT~ON ~wn a..o o~ .on oo..t ow~.r: rot~ or ~KWD OF lUSM~ESS OR MDUSTt~ +ronwc .~r~ eve« u urwto ~ 3 -7-5 }-~827 „ ~`.ome Ffaker Own Itome RES+OE?~tE-Sf~fF COUNTr CM, TOWN, Ot IOCATION w~e cm u.utf SifEEi IWO HUM~ER Florida ,a Pinellas Clearkater ~~,,,`~i~o 2766 U.S. #19 North f~tr•Et-.-r~~Wf ~iyt wpp~ t~l~ MOTHER-MA/OfN NAME ~yfT rqplt {~yT . Julius - ?~enz Caroline - Born ~nfOU~~wl--r~~( NuR!t~G ~OGRfSS ~~nen o~ o..o . cm o~ •or~. sr•n. wi ::r. Geor~e Ste~?81~t ~n LOt G5~ Ilaxwell ::obile~ Pk, C1earWater~Fla. 33515 ?A~T ~ ' DEAiH WAS CAUSEO ~Y~ ~FN1FR ONl1' ONf (AVSF KR llt~1E FOt ;oj, (S;, AND (~j~ ~~1vttN p~~ N~ ~p ~.WOUR UuS! - 1 1 ~(~c~ t .~ciil C'.C a C_ L L~ A-~- r ~~4..-!TT a . . . co..uo~~.+« 1 r:~o~.~p: y •~+r. " c~ . .e ¦,se ro iel ' ...eo..re ;.~se ~o.. - - - - - - - - - - - y~~1~w., t..~ ~r~Df~ i Du! ~O. O~ ~[~~..NOWn[t ;I , , ~~~?e~ ~ c--- a,~ dw~ - a a~.o I ?~tt u OTMfR SK,?dNKA?iT COPID1il0?~5 ca+ano~+s ca.+n~uu.w ro o~.n. wr ..oi n,.reo ro c.use cm» r.n ,,a~ MROK~ If ~ES r~e ~~wawo~ co« ~ - ~ ns,a .a~ s~oea~ u. ~enw~rwa uuse _ f ! l O~ ~l~tw i ( _ c{~ , i'-~t~ ~-G ~ Ct• ~ 1~ l~0 ~ t je.ep,piri •c~ipl~it. SU~GOE OR WAlRY ,..p.~n. w~, •[u r MOUR MOW IHIURY OCCURREO ~ tare~ wrwE o~ IMlyf~ IM q~f ~«r.n n, ~r ~ S 110M~`~OE. O! UNOE!ElMINED ISoec•til ~ ~Qo 7Q 2k M 7M u~wtr ~r wpRrt /LACE Oi NJIM~ ~t wOrf. ~•fr, Srpft, ~K7W~, IOCATION ~ sniEr w~.r.o ~o.. c~n o~ ~owa. s.•n ~ ~ ~ i?~un .es o. ..o onKe woc.. ~~c ~ srec~r. ~ ~ 7M !M ~ CEtTYKwi~ON-- ••o.+rw - w. TF~t rOMb o.. .e.e .w us. s..~wn .ua o.. ~ ao1~.~e.~ nK o[~n~ occusto .r ww n~n. o.+ ne ?MrSK~•H~ TO ra+rw o~• ~eu wor .m~ oe.+n. „q,~~~ o~n, u+e. io M wa i .nt..o~c r»• L~ 7 ~f [C4 w r~ twD~lfoOt, oue !4 rt!~.uu ~~u. ~ '71~ / t J 71~ 2 3 7 ZI~ Cl ?1~~: JJt1 M ~o ae Gwf[~S~ st~rw 3 CE1ITY~CAi~ON-MFOCA~ExAHUNfR OR CORONER o.+ ~~e us~s o~ rwt ,.o,N p p,,,, ! rM[ o~ceor..r ..s no~w.Keo o~•o 4 l~~r~++•rA~ d'.q ~OD• •r~O'~]~ rne n~vESr~G•rqa. rr O~s.~p„~ ' rdRM O~t ~ ~l~M GCCU~ffO Jti Mf D~n ~+O Ouf 10 tnf C~uSf Si St~~ID ~ . •f~~ 110Yt i ot~t~q .i~a.i ...n .p.,.. . _ . ____T~.F- n M' j M ~ • _ _ -''':s~~~ y:.t~~t! W . :.E ~C ::I i:~(.'gu .r.. w, wr, tfw:i `-?illiam J. Sradley~ III~_: i. L. ~ n. cL>4 ~F-.._ C+~~j ZM. D. i„1 t ~ ~ ~utRWG ADORESS-CfRliftfR ~i sia~~ w t.o wo, t~n aM rw.. s~, ~ ~ .•,ease ~-:osp~tal ar~d C~.uuc Dunedin Flori~a 52~ ~ ~UR~~I. CREMAT1pN. REMpv~t CE~wFTERr p[ CREw?TOR1I-~uM[ lOCwt10N ar o~ a... si•n ~ snun ~ ~ ,N ;emoval t~~ GrovelaWn Ceinetery t~ ~endleton~ ItZdiana ~ DATE •.~p.~k'd~~R~~~~~ fUNERILL HOME-NAMf AIVO ADORESS ~ snen o~ e.~ o..o, cn. o~ ror.., st•re, t.r ~ ~ ~ ~w • ~ ~ ~:ioss eral ~ome Inc. 132:; .~tain St. Dunedin Fla. 28 ~ ~ IMER j REGISt~AR / A~Uff . ~ ~ ~tE ErvED t~ l / NGt iut ~ ~ 7~ :t~~ ----!`~'-,._•~s' ~ . . ~ TY (~G ~ ~ ~ ? CE~t1'II~.IED COPY `MUST, ~~C -THE F.lSB06SED SBAL OF THE REGISTRAR 0~ VITAL STATIS?ICS . ~ ~ _ . ~ _ i ~ ~~ere~y~cjerti~y,that this ia a true and correct copy of a certificatt :•on~fileF`~i .the office of the Local Regiatrar of Vital Statiatics of th~ _ ~"'~~'•.Pinell$r'Caurity Health Department, St. Peteraburg, Florida. : l,~~'• '3 ~'~~I• 1~„~'~_ ~ ~ ~ DEC~ 6 1973 Deputy Local Regiatr~r ar. ~ f~~ 4UQ ~ ~bUNfiY IL~1. IIC~~?~ 'ra~TRA6 C~~~iK ~i'.C;{IT ~O~RT !1lCGft' VEF~=t~O.,,~„~+ c~ ~°V YiY ~ ~ I~ PH '13 ~:s f = 2'71248 ~ --G-~'~~¢.. ~~'i'~ aC~K ~.1•;~ s•=a "~7 r /Se ~1 4 ~ _ i 3 Y~ ' ~ ~ . ' _ ~ _ _ - ~ - ~ ~ , ~ _ ~ ~^~t.r.. - _ ~ . _