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HomeMy WebLinkAbout1375 2'73825 ~ . _ _ _ _ . ~ ~ ~ o CERTIFSCAT~ OF CcATH aepaN~rw1 of 1 k~ItL aao RrS..l.~Iitrti~n Jervicer iYATE FILI 1~0. t~~~c::c.v c* ecr~a; 7tt F L O R I D A tvrE, Ot Pa~hT ~N ~`~""~'m°~'~' REGI6TAAR•5 I~O. } i:~fidt$i~t 7.iK ~CE/~SEO-NMtf •~~sT .~a.~ ' i.st ;~Y OATE Of DfwTH ~•o»~», o.r. r~aa ~ 1F Y~'.i:wt f0l '~~R'~ _ ~tiit1 I-. A~D~SO\ ,Female July 3, 1973 7uCE v...re. .~cw. ueuc.,+ ...au... AGE-i.ar ..~:e, s rt.~ e: r ~ OwiE OF L{iTM ~+O~.m, w~, ~COtfNTY Of pEATn - ~sc. ~ srKw~ ~ ( ~~~rwo.. t ~u~~. .os. ' w~a ~wa.a1. ~w ~ . k'hite is: 6~ ` ~.Feb. 5,19C$ St. Luc~ e CITY. iOWN, Oi lOUT10N OF p£~TM ~~:~ae :~n u..rta `MpST~TwI Oa OietER NSTITUipN-NMSC ~r rp ~n,u~. am s~a~r •w ~wuu ~ %~•'7 ,ar~n...uo~.wt ~ ~ Rort Pierce ~ n Yes i,~ Fort Pierce Aier~orial Hospi~ul ~ STATE Of ~:iTN ~ u.oi .w u.s..., r..+~ UTiZ6V Of wwlT COi;KTRY +MAR21~O, t~EVEQ h~wNtEO, ~SUiY1VMKs SIOUS~ ~u r.~~, o~vt ...,u.. .,,r.i ~ 'y ~~"'TM• ~W:AO+.€D. DNppGiD vfc~n~ - _~~..K,.o..,;E , Tndiana , U.S.A. ~~arriec~ John H. Aztderson ~ sa~ ~..Ge~a•r. SOCUI SECU~:TY NUr?Ef ~ USil~l OCCuPwTtC.~ ~ e a.~.a o~ ra. ~..e ~~~~.,w +ou w rKy~p Oi M15M1ESS Ol 11.'DilSTRY cccwn~ .ti ' .o...~.c .~ie. a.~ ~~~~.:o ~ ~ ~ ; 'u"'~'°"~°"' tr ?0E-~7-t~5E3 , Housetvife =~~-u...w. ~ k ~~n Domestic '~"'u'O" cES~EraCE-STwtE COUNir ;Gir, TOWx, OR tOCwS~pn ws+w c~n w:n STtEEi wr10 N~iw:£R ' 1..~~. ~ ~ veun .u a .w ~ Florida f,ySt. Lucie ~,j; Fort Pierce \o ~,s, 1804 So, ; cea.n Drive fwinfi-rl+wf ~~ur .~xu us~ ~tO7Hf2-wulDfrv NAaf ~as~ ..wae ..u x If` „ John Brou~n Unobtair.ablz iNFOW~wNt-n~w: , ,~.t~tt~NG wD~RFSS ~srun u~.r.u. w. un a wv.~, sr.n. ir~ 33450 „~John H. Anderson !„~-1804 So,Ocean Drive,Ft. Pie~ce, Fla. i~7 1. p(AM Wwi U1:SEO lY: :,frv7ER ON:Y ~f ~AUSE iEf :IAE iOR (o~ (b„ .wD ' .rrw..~.:, ' - ~ 1~fiMl/N Ow~11 • ,:.l~~\ ...eo~.n e.+w ~i/`/ ~ ~ r : ~e1 + `i~ar~ ~ ~ L ~ J~I/L~r r~1 ~ l ~ 6~..[l~'w .T. c u~..u.c~ ~ co~o~uo+?. ~r •.n, ( r -f~ ,n ~ / ~ - 'I.~/_ e1~ ~ ,L n.,~y~~ , ~ c,.e ,~s. ~0 r 1b; t7 • G-__I_ '`"yz^""'~ 2 ~ /Y~"~`~" I -L-.:;-~ ,S-_ ..ta..te c. y~M .m, j o~.~ ~o, o. .a . c'o..,~w~~.~ a. f~ l STn.~r~G ~Ml Ot~- ~ ~n»G C~JS! a~3T ' 1 ~ (C) ~ twit u OTnFi S~Gh+fKwtrt CW.D~TiOnS: eo«a.na.s .o.~a.~~+:~w so ~e.r« ~..i .o+ .a.ZO ro e.~s~ ene.. w r•n ~ a~ AuT~~ ~~F YES ~i+t ..w~...es coN- ~ns w ~o~ ~:~~m un.r~~.wo uuse ! i. oe+:. _ pti ~O i ~s: .%•cz~.' wCC•LE\T. Si;.Q~; p:t DATE 11VUZY' .rowrw, wr,n.~~ .Hv^UR ri.~t:~JE. 02 i.NJEi[W~AED ~ ~HOW INIUif OCCUtiED ~ t.rt~~ e..ru4 O~ ~w.u~r ,w rw~r ~ p~ r~u u, rt~r ~ ~;,ec.ryl ( ' ~ ~ 1C6 ~:C<. - u 1:4C ~ ~rth~3'~ wT w~: ?twCE OF w~:;2~.+ ~o..e. r.a... s~uer, ...c;,a,, iOCwti~ ~ snen w~.t.s. r.o.. un O~ ~o~+w, uwn, ~tnun naw ~.o~ ~esnte roa..tx. ~snc.ni ~ 2C. ~20t M2C5 . CiA'1F.~A~ION- .p.tw p~~ ft.~ : .qwn. a~~ ~w us'swr wrlwn un[ pr~ OWJO~L wi0i v~(tI int ~e~~SK~~N: O E ..J..iw G~ T(w~ ~ppr ~~Tl~ Dl~M. ~fw:n p~CbiiFD •i swt i~.K~. G-: !wt •Rt`i3f0 'ni - ~7 T • 1w.'w~l G~s`, u.~. l.f HS[ ~ ~7 -7 ~ . ~ N ~[~.:~'wJ:~GI. Dri 2~a oicf•S!~ ~or J-~-7 !2!S /-:-7~ ??la f-.~?i-~~ ~~711 ' _ Ilt j M. f0 twt U~S[.3+ ST~tiJ LFR!i~+Gtt~x-wsE~Cwi Ex~uunEi OQ CG~OCvF~. o.. *..c ~.;~s o~ ...e wCJ~ O~ O/~T~ I fMt OtCfD[wt r~31~Owpyn~~D CFW ~ ![uiw~l.p.~ p~ ~ ppr ~w.~i0~ in! .ti~Ilir.~rqn, rt p~.w.Cr., ! rpwlM W rt~! p~~ . ae.r« oeeweo o+ e.t G~~( an0 OM A iM C~ul~•S: SiwslD . M ,]2! CEi1T~fIfR-ti~vf mn w •~.rr: - M : ' S~CiI'iAi1i. E Hooshang Kadivar }1.D. 4 ~ «~~ru ~~:F ~ -~~t~, o.~..~.,: z~. , l-:-v~-~r z~: i-~-73 ~ww~::KGwD~aE55-Cf~7~f~F~ 7Q6 ~orth 7t}i:°~Street, : or ~t-PYerce Florida st~i~ 334.~0 zd ~~auu. CREw~aT~p?:. wfr.~OVw? ~CFMFTER~ OR Cw:MATOkY-h.4N~E i10C.~~~Orr C~T p~ iQv~r~ ss,.i ~ s?et~~s. ~ : Resaoval }:.s Oari Hill Cemetery i:., Battle Creek, Mic :ir.an ~+~r!". JwTE „~c.wr«. w~, rur. : fl:nEFwl vJniE-ru~+.: ~~D wDJiiSS snui o~ ~.~.o. .o., btr o~ row«, sun. t~r. 3345C ~k July 6, 1973 ,~,Fort Pierce Fun'1 Home 06 S.4th.St. For~ Pierce,~ia, _ v. S. s612 ?t~iEx/~: ~4oQ-ueruru~E ceG.si -s.:rurutt ~ o.n rccf~v~;, iY ~OG.: LFO:~TUt R~r.I970 n~ ~ .%~~l/,~i!~'!~ , _ ..!i'1.~~ ~s? ~ ~~;^3 . FILEO a~C! ~EGUR~EO \ , ~ i hFr~by ocrtif~j this to bc a true and corteC ca~y of Yrr~ [,o;,at .ST.IU~~r. ~~UtITY FIA. ~0~ • • Rcgistrars record an fila in the 5t. Lucto County H~ti;h Dsp.'stt- ~+~Ci'. :~;~'aA5 \ r'`• ~ .n~nt et Fort P+crco. Flor(d~. CLEF+. C . - COURT ' . , , ~ ~ ~ ~ pcl'~.f[.l'_' . , (Warn;r.g: Not vaiid untess raised seal of the St. tucie c: Counsy ~ Health Department ~s aff~xcd.) f~8 g 5g ~N . • . " t " _ ~ _ . N. D. MIItER; M. D. ''f".:. ty Heaith Officer Locat Rtyistrar ; 1~: p , ~'~~~F ~..~,~:~~5 - 4 ~ 7 ~ ./t d~'x. .LII~ • . , . D~sa DeP~Y laa) Rea~~r.r. ~ _ ~~3 ~i3~