Loading...
HomeMy WebLinkAbout1883 ~ ' 2'721'78 ta~~ D~- ~TAT[ eowao o~ Msw~,n~ CERTIFICATE OF DEATH eo~~s • PURGU OF VITAL fTATIfTIC~ RAT[ FIL[ NO. ~•a~t r~~- FLO$IDA erd •A~n BIR7M NO. NE616TRAR•f NO. ~ prep~~l7 1. KAC[ 0/ O[wTN CODt NO. Z- YWAt 11[NO~MC[l~w~rrdl.rr. l/..w.~t.w- s..~~M/.n~/..r:.~) •:~eut~d ~ ~NTM S~ATE A. COUNTY •"d St. Lucie ~-12 Floirida St. Lucie s. ~i.e.e fw A. CITr. TOMN.011 LOCATqN c. K rU?CE Oi OEATN e. QTY. TOMS.011 tACATq11 f. K RESiOENCE •~~~~t ~ IMSti7E CITY IIMIT5/ IN510E CITY IIMIT57 r~~.. Ft. Fierce Ycs~ ~ w0 - .cs0 ~oq( f. N~r( OF (//wN nt Mr~iht. IK Mrsef ~fdur) t. IENGTII OF ~ STIIEET AOORESS MOSi1T4~ O~ OM A FARMT ~sT~T~raN F`t. Pierce N,em. Nospt. ~"b'ar Oleander Ave. ~s0 w NAM[ Of ii?M a(iYtt LMt OATE aI~4 M! Yrtl ~n~«p~W~ Ho~rell Dixon Smith E"TM 6 S- SEX ~ COLOII OII IIACE 7. MA11RrED M[Yt~ MMAIEO ~ DATE Oi NII7M f6E~~1I ~Iw~V D~w Mwn Yi+~. ~ i c• 1'isle Whlte rnoowco O avoacco Sept. 2? ~ 1875 ~3 ~l~lYl~ 1a-uwAlaCV~AT~011fQi~tki~~/sMtl~~t I~.K!NOOiWS~MESSOA~MDUSTAY 11.~111TIV~wCE(Si~ftw/NlyACN~h!) 1 -QIROICi~1N1~U11*~t •1tA ~~r- f~riy~tyr~rtiyfyr.eKwl/?d"vdl ¦•p~o~ t7TOxer Citztis Tenn. U.S.A. 11aek !wk FATNEII'3 wYE 1~. YOTNER'S MA10Et1 MAY( ~~,..~~e.~ Daniel Ellicot S:nith Unavailable - ' IS. M~S OECE~SEO E1fE11 Iil U. S MMED i011CES/ 16. SOCIAL SECYMTY I~D. 17. ~MiOR ~ NYIMTYR[ J~w • Yates 11'r.r~MRrwl 1//M.~w~M~w~/rwrl r4.PiercE Fla. fi0 wta~., lrn~r~l 1~. CAYK ~I O~ATN (6~fs? ~w(/ pt taut yn fiwtlir j03. MI (f).] IIRERVA~ ~Ef~EEN d l e t O f ~~~T L OEATN YAS GUSED ~1~ p,~ ? OMSET AMD DUTN IYMC0I~TE CAUSf ~J1P.1U110~418 ¦Y/~ t~~• ca• e•~- c~n~.s. c..iaa.,.r~..r. ~ To ce~ UrEmia .lce ce. r~ir? ~..e .ut r. 1• e• 1 ~Dase r~aw li). ' t r~ t K~tiy !k rwler• 6 ~y~ 01iE TO (t) Ne^hrosclerosis ~oYr. .r_ . MASAUTO?SY tl tAtO 7= ~ fAIIT H. Of1EA SIGA/1GMT OOr101T10Rf CpfiAl~{JfMG 7p O(ATN ~11f 14f R[UIEC /0 M 1U~IYMI OefFAfE CqpifOM GIY[II M?MT 1(~I IFRFOIIMEDI ! a•r a••cs S $@A111L - rts? wo[~ ~ •r D~tor• 2a t ~OD o[scRi~[NOwuuu~voctu~tuo. (Eare?wwvsN~+J~?~hPrtlaPwllyi~r~N.) ~ ¦aklwj •w7 ~ ~~~p(117 SUICIDE NOMICtOE E t~po~i- v ? ? ? ~ ~oa •f J~ T~rE Oi Hwr XMU. M1. Yt~r - ~ed~. ~ uuu~r a. o D. w. W ~ 20f. uuu~r OCW~REO IDt. ~UCE OF IK1UIIt (t. iw ~r ~rt ~~it, 7D/ CITr_ TOMM. OR IOCAT1pN CdJ1~TY STATE NNKE AT ~ NpT WNiIE ~ I~A• ~M~, ~fRef, ~~[t Of//., NC.) Mq11K AT MpAK " ~ 21. /~ft~nd~d tM d~Nr~ rom , to 9 •ndl~~t sa~ A~~Ii?~ on ~ ~ D~~tA oeeurnd ~t 3~ A•M • m on fM d~t~ ~f~f~d ~Dw~; ~nd fe fA~ A~st o/ m) kno~NdN. 6om ~M uuMS ~bbd. •11 lt~~• HaNATY1K (OqrttMfYlt) 71A AD011[SS I2t. O~TES~GMEO so ~ Fort Pierce, Fla. 6-9- te~pl~te k Russell L. Counts M.D. •Clrf ~t~. ~~,~4 uEM~T1pN, j~. p~TE I3[ N~YE Oi CEMETEIIY OII LREYATOIIt 1J/, lp[AT1pN (GY/, fosw. M~wnlf/) (s'~fe) ~u"~ia~°`"h' 6-i1-59 Hillcrest 7'~em. Gardens Ft. Pierce-St. Lucie- Fla S. /614 j~. FUUERAI WRECTOII ~S S~GMATURE ADW1E55 ?S. WTE 4[CD. ~r LOCAL ~EC. ~E615TM11'S S~GNATIME a.•.l~eb Joseph W. Yates, Ft.l'ierce, Fla. 6-10-59 Anna Lee Benison d.r. ~ 2'721'78 ~ - f ~p AMD ltEG~R0t0 ~ - S~. R46~EA ~0 1RA~~A. ~ ~~~~X ~,:;:.UtT COURT _ af th~ Loc.el RFC'1F( VFf.,~1ED i ~~y a~rt~fy thu to 0o a trw and cor~~ct ooPY 9 3 l~ P~ it~pistra/s reoord on file in tFw St. Luc~e Gamry H~elth D~ert- : i;., ^ nwnt ~t FOA PiNte. Florida. lMI, _ y~%.i, ~ (Warning: Not vM~d unless ra~sed feal ef th~ St. l.ui~ • ~ Counry Heahh Depan~~t n affixed.) . _ ~ - • - . - ~ • _ W _ : _ r,, . _ _ • . ~ N. D. MIIIER. M. O. s ~ 4iai1M OffiCSf 6 LOta~ R~QisTfK . ',i~ ~ 70 • s - : ~ ` J ~ ~ ~ , s.': ~ - y-~ a... . , . ~ p~uey Lot~l R~oistrer . ~ - i~-'.1 0 R ~i~ ~ ~ a~;;~ ~~,~6; CS~J v~ ~ ~ - = _ _ _ _ _ _ ~ _ ~