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HomeMy WebLinkAbout0562 '~'a~~' 'r ~ AfG~O p ERIf E9,~,~,~ ~ t~ u I ?M'~3 z~szs~ 2'71264 ~ . . s . . ~ ~ ~ -.~r~ , CERTtFlCATE OF DEATH De~~~twt ~1 Ile~{t~ uJ Re~6ilitalhrc $eniies 1TAT[ Ftl[ NO. misiotv ai ~sw~.rn F L O R I D A Tr?E, OR ?l1NT IN ~'~~~~~0 RCGILTNAR•d HO. ?l\MANtNT INK ~~p_N~E iwst SEf IINIOWO[ FO! SEl[ OA1E OF OEATi ~ rortw. ~~i. ~t~~ ~ ~ EARL FRANK SAMPLE , Male December 8 1973 tACE.n.w. weaw. ~..u~cu~ rw~.., AGE-us~ woe~ ~ n.~ uwe~ ~ s.r OATE Of MtiN ~ro.w. COIlNri Of OfAiN ~K. 1 lMC1h 1 M~1M~t 1 tWf 1 rp~. yy Ipr~; rK ~W / . White 82 ~ . Ma 10 1891 Saint Lucie `j r, 77 C11r. TOWN. O! IOCAT1pN OEAM ~ ~s~e cn ~ww~ 11pSMAt Ot 01Mf~ NSTITUiION- ~ r no~ w e~~, are s*~e~i ..r ~w.r~~ ~ ` arecrr ~es w «o ; Fort Pierce Yes H Easter Manor Nuxsin Home SiATE Of W1M ~ r rot M ~.t.~., GflZB1 Oi w?uT COIlrTl~ w~RtlEG, ?+EVE! wu~R11EO, SURV~vNG S~OIlSE ~r .re, ow~ .urn..w.e ~ cawwr~ MnDOWfO.OnpRCE ~vec~r~ . Kentuck ~ USA N Ma.rrie~ Milda Murphy ~ w¦ea ~ece•~e~ SOCUI SEGl14tr MIWEt U6Wl OCCW~Tqrt ~an a..e a.ro~a ew ~w.a now a ~u~D Of WSlESS OR ~OIJSItIf IMC. Y wM OCCYW~ M ~W[MO LIR, Mw M MMI~ 1 289-OS-5508-A ,a. Steel Worker Steel ..y..»~....o.. lES1DENCE-SiAtE COUN11f UTII. ~OwN. OR IOCAiION r~s~ Cw~ i~n STtEEi ANO NYM~E~ t _ ~ ~srKrr ~tt q i+o ~~w i ~4 Rort Pierce Yes 2615 Sunrise Blvd, ?ATKR-NAME ~Nft ~ rOON ust MOT11E~-MADfN N~MF r~ rOR1 uS* ~s Unavailable Unavailable . ? IHIOfMANT-NAME MAKwG ~DWESS ~snen oa ~.r.~. ~.o., cm w w.n+. sr•u, ir~ Milda M. Sam le ',,,2615 Sunrise Blvd., Ft. Pierce, F1 33450 ; r~rr oEwm wws GusEO ~r: ~ert[e o~r on[ uusE ?Er ir+E ro~ N1~ Al u+o k • A unrew a.u..w waw N. r.ea` ! ' r•, /'l'i~-~-l-~a el.~ o<u ~ 2 <o~.,,,o~,. ~MKw O~~t Ntf t0 I h , ~ lvy / Z ~ O ~ ~~rlM~t[ C~113! ~W. 1 ~ p. q~~~~~~~ p: !*~11M0 ~M/ YM~lF I . {tINO C~YN l~f~ i IA~T II. OiNE4 SKiM/KAMT CONDIiiONS: caw~ao~s cwrr~nw.a q~a.,a~ w~ .q~ ~tuw q cwf~ aM« r~ rur ~ r~ ~~r 1f ~ES rt~t nwe~ras cow~ s ~ns ~ yN~ee u. a~i~r...ww c.p~ q Ol~iM IA H~ - p.~1~ wttiOE ~rw~w, wr, n•~~ MOW iNIU~~ OCCURtEO ~~•m~ wnwe or awn ~w ?u~ i o~ r~n a, /n.. ~ 11DMKIOEi Ol 11lOElE~~~MEA ~ }w 10[. M. IM iNAMT AT WORR ~tACE Of NMY .ow. ~•w. sn[rt. ~r[a~+. lOUt10N ~ fneo o~ u.~. wo.. an w wrr. u~n ~ 1fMPr? Af W MOI OwIQ F~G..IK. 1lIK1I~1 fw 7p. CElTYKwT~ON- ..o.nw w~ nu ..o..w~ e~i ~w w.~ usr a~w ww/«n iu..e w~ ee/w?we~.n~. ~e ot~tM ottueuo •i er ?uce. a. ae i' ~i IM~SKIAN: ~1 ~P~M Mr ~eY ~OM ~?1!~ M~M_ 1 N4. ~+C. b M~[Y F~ ~ ~ ~rtlrW~O t~N " - p rt [rO~nlOGf, pR ~ i !la sta.ue rw. v 'tR 11t l1~. t ro w~t uus~w sr.n~. s CE~T1fICATqN-MEO~CwI Ei~MwER Oe CO~Ot+El: p. nn us~a a ne .ow w ee.r. M~ ~~on.~ ~~s r~oe/o~wrao w~e ' turw~AOw a Me ~00~ u0/W n+ M+esuwrpw. w r. w~+~o... .Oufr w. ~tu wov~ - ~ Ol~s OCLYtltO OM IM M4 ~M~ 011t ~O M 411flW fi~R~. n. ~ rn { CEti~H: t-nNwE rme rn.n ~ S eeuu a r~ne OwTE SK,PifD ~ 7 S i~: § ~w ~ f7~ fl~ v tk i t CERIK f~ • uro q .~o. . ~ cin a _ su~~ i: ~ . ~ f / NM~AI. CtfMAT~OM. Rt~qVAl Fw~ETEtY OR CREruiOR?-HUwE IOUi~ON c~n w~o... s~•n . ~ ~ S~etnr ~ - - ~ti _ o; Removal~-Bur~ial wNE WOO~}lil~l~C Ae~mfe~tery~n o~ ~~i. »o an w ro...., st~ranklin, ~2710 ~ Dec. 8 1973 n.Yates Funeral Home Box y77, Ft. 1'ierce~ F1 33450 Y. S. i612 ~ ~ w-SiG++~runE owie ~[cento ~ow ~~~srw ~ R~r.1970 ?p ~ ~w. ~larQ.~`,r~.~+ 14 I~73 ~ ~ t ~ . • - ~ ~ h«+~Y a~tify tfib ro bo e trw end corncx copy of fh~ Locet , ~ itpistrers reoord on file in tFw St. lucie C~ounry H~elth D~srt- . • ~ ~~K l Y `"J~ ` ' m~nt ~t F'ort Pi~rce. Florida. . ~ (yya~ning: Not v~i~d vnless raised seal of tM St. luci~ - j.'t,t~4 '~a~+~~ 0~'~~- Gounty HqsUh Department is effizod.) _ . ~ ~ ~ :t`- - N. D. MILLER, M. 0. _ : = ~ 1lwith Offiur 6 t Rpi:her ~ ':s~ ~ ;.'~x - ~i ~s t YO ~ :j•~~ ~ . • - a~ ~ ~07 ~~~r73 ~ ~/~^l.i`l\, ~ ~ - ~ ~r (+Of,~~ QrpiSttl/ ~ 222 ~a~:E 5~62 ~ g~ - ~ ~ .ti _ ~ ~ ; - y ~ ~ ~ ss" ~c- - ~ s.- _ ~ ~ ~ . . _ u `i -