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HomeMy WebLinkAbout1270 ~ r~~1~ •1 CERTlFICATE OF DEATH Urp..+ae«~ d Ik~l~l~ •wi k~.l.~~~„ur~ c•~.: Y. F L O R I D A rT~T~ *~~c ko. ~H~ nn~r ~~r ~n.~ ni ti~c. Ot ?¢INI IN Kd~Y~I~tYR~tVn~1 ~ P.ECi16TNAR~S '!O 1.cNw?MNi tNK C[lEwStO-N4ME r,~tit r.oo~t ~~1~ ~X IOAIE Of GUlrl ~ ~~~t~, ~t~~ ~ 1;[ h.1~101JOt IQt ~zm~aroK , Louise [~larie Gandv : Fe!~ale ~ March 14, 19''3 - ' ___y____ ~ RACt rM~N. MlG\U. ~W~KAM ~..o~.w, ~Gf -~.u ~~^e~ ~~t~~ cwole ~ p.~ OAIf OF ~1kIM ;•o~+rw, O~r, ICOUN~Y O? DEAIH uc. ~ vuu. ~ nu.o.. ~.~.n ~ ..o~. w.i ~wp w •u~ ~ ` ~ White_ _ 6G ,~_I Apr. 13, 1906 I,. Brohard ! CITY. iOVYN. OR IOCAl1ON Oi (~EAIN ~~sw~ cm u..m ?1QSh1Al O! OTN(R Y`S111UIION--/JMtF :u wi an.~~. c~.~ vun ..w wu..u~ ~ C`~ Fort Lauderdale Yes ~ _ •~s 1538 N. F.. 5th Avenuc • - - ' . ~ SI~IE OF ~~R1N ~ u wot ~N u~... .~...e di11fN pi WHA1 COlN~1R~ MA~RIED. NEVER MARR~tD,--- SURVIVINC, SPOUSE ~~~1. one .u~a.. wr? ~ tOw+~a.~ N9DOVYEO, OfVOR~ED ivecr+~ ~ ~s:.: ~ New Jersey , U.S.A. Mnrried n Stc hen J. Gand _~~.z o«~.ue - - - - - - - - -Y - ~~.eu a~~w SECURITY Nti.wBE! USUnI OCCtiPAhUN ,e~re awe o~ ~.~w~ oa+e ou~~.w ru~r o~ RIND Of 6;1SwESi OR It~pUSiRr o:~ uueo w wqcu+G ~~N, he~. v~er~~fo ~ ~t~"~•~~.~~~ ,t 157-28-3293 B Housewife Own Ho:ne ~eti~ce..:e uron >r•~sw~. - - wfmf cm irns STtEET ANU NU~AtER RESiOE?~~E-SMiF COUNTY CIiY, TOwN. OR IOC~iION i vit~•. ~es w .a ~ ,M Florida Broward ,u Fort Lauderdale Yes 1538 N. E. 5th A~•enue ~ iAiHFR-N.I+ME ~~~fl rKO~t W~ M01MEf-M47aEN NAA~f IRf~ r~DW! i~lt 1 ,s Fred Gieseke flnma Schrim~f INfOCM~.Ni-NAML liMRWG ADGRfiS ~sf~t~~ o~ e.~.o. ..o. c:~r w ro+.+, f~.rt. t~~ Mr. Stephen J. Gandy vr 1538 N. E. Sth Ave., Fort Lauderdale Floric?a Pwltt 1. DEAiM WAS CAUSED 6Y FM/ff OtIIY Ut~tE CAUSF /[R U!Jf !GR o', /tt+D (t) ~'~~J""' e••.•t ..i I ! ~ (~l. i ~e?.~Ew o..sn u.rn 1~ - Wreo~.-u ~.-use - ^t fw ~ ' ~a~ ~ :~'~2 ~ ~ :,.~n~~ C~ ~ ~J~ M ~ ~.~-,t_~- } LJ~ Z-N ~ (JNSlWlM:f U1. CONDII~ONS, •~n. M~M1CM G~v! ~1S! t0 (b~ IYY~~I~~~ (~Y3~ 14~. OYI ~O. M~S ~ CONSIOJfMCI O~: f1~t~MG IMt YNp~~• ITING (~YSt l~lt ?~Ri q OTMER S~G1JSfKANi CONa1T:~lJS: ~M+wua.s cOwnN~urq ro ot~~w ~~t aoi Ki~reo t0 e•us~ orvew r.~~ ~ ro, AUIOPSr IF YES ~e~e ~~~o+•~ ss eo..~ ~ ~~u w..o~ S+Dl~ID ~r~ aeee~r~.~.~e uuse o~ ot.~~ ~w ~jp t» p.eb~f ~CCIDENi, SiiGDE O~t t~A~~IKIURY ~.oNfn, w~, ~tu ~ MOt/R HOW INIURY OCCU4RED i[~rt~ w~~~~e o~ ~~~~ir r.n ~ o~ u~i u, atr lqM~G~:: Ot U~9E1ENMll:ED ¢p~c~~rl ~JO <Q~ 7A M !01 INJUtY AT WORK i'L/1CE Of MhlRY •T ~Ore, ~.t., lnttt, ~~C.M~, IOCATION ~ s*att~ ot e ~.o. wo., t~n o~ ro+rw, st.n i I3~fGn ~11 O~ ti0~ O~~Kt uDG.lK. ~S?[Unl }I~ 7Ji ~ CfRi1fIC<.110N- np~tN W~ ~ue I rorm p~~ ~[a~ •~+D teST L`/ ~w: hn O~ i Groiow r.or vn.r ~we DEAIM Ullv~a[v n.~ ?u.ce. cr. mt ~MrSK~•H: ..or.n. o.~ ~~.i ~oo~ ne~ ot.n. ~„~u~~ D~~t. ~n0. W*-F Ks+ 1 ~TfEr:Dft~ TMf C -1 a 10~~ Mar . 14 1973 . r'. `"°"`•'Y'. fl~ DfLM1(D ITOr - 1 I 2 71~ •r»_L_F ~ ~h3 C ~~8 M f0 M! C~:Sl.SI S~~tfD CERiIF~nliOn-MEDi~AL EIAMLN~ p COI.CN~ER O~. iNf ~~1~1 4~ ~Ht w~u+ O~ tt~TM , i~! OKtDlti~ w~5 ~~O*+O+v~~G Gt~D , f~~uw~~'.,~. f,s ~vF t~G. ~..b/o~ tw1 ~r..lStK.~+wrv, ~r. we M« W~, nO.~~M D~~ ~1~~ MOV~ ?h~w oct~~~il~ t~ti r.f o~~E ~~o Gut » rwt Utnc,si Sr.no M t?? ~ 4l CERTiF~FR--tr~MF ~nr~ o~ ?+•wo SKaPtATURE wo~te w tuit -~DATE SlGNiO ~+o~TM. t+~~. ~t•~~ Dr. Luis J. Flias_ AiD ~rn. r-~..'1/~'"~ ~ lik 3-/`f•~,~ _ MARWG ADUCESS-CfQi~ii(c-- u~t~i oe ~.r.o ..o. ° un u r.+.. sr•.c nr - 1946 S'.~ t Fort 7~Lde±'d11~; F1oriAa li1~.+w~, ~REMA7~N, iF/ytOvAi C[METEkY OA CREw~J~70R~-r:an'~ LOCATI~N or. o~ ro... sr.te ~ s?tcn. , Burial ~~?y7estlawn :•'.emorial Gardens t=~ For~Laudarsi~l.s,_£1Qrida . DATE irp~aiH, N~, nu~ fUNEk~I M~~NE- !:AVF AND AD.'.PfSS ~ St~~~r or ~ r.D NO., UT~ O~ iO~N, SI~Tl, I'~ ~ ~ ,y t+:ar. 16, 1973 Y.alis Funeral tiome, 2505 N. Dixie H Ft. I,auderdale, Fla. 'i• S. f612 FU11E?AL.D::.F~T'~i-$:GN4f~/RE is`GIS•.iAK-f.'GNAiURf ~ [w:E iKt~~fO ~i IGCAt RfWS!tA! a~ ..:..Isiv `}5~ (~s(!__ .Vlt~ I.~•~ L 7 l2fe f'~'1~\~.~~_~~ ~ ~~i _ _C` ~i" 1-i J.;~?~l~. a_~ IL ~ ~ ~ CERTIFIF.~J CO~X - ; I hereby certify the above to be A true and correct copy of the Local ' Re~iatrar's record on file in Lhe Bro~rard C~unty_Health Departcent ~t ~ Fort Laudcrdale, Florida. . . " _ ~ ~L ~ : ~e~ (Wurning: 1~ot valid unless raised ceal of the Brokard County }iealth ` • Departaent is affir,ed.) ~ ~y~- ~ ~ - ~ • ~ ' _ - } c / „ [ • ///p ~ ' i . . ' - ' { ~ ~ ~ (,.r , - - ~ /.i(-j~~W?~Ir'/t=.~y:~:~;.'O~,' f ='~c~C.~ I~~ ~ • i . , . _ • ' -~.~J . • ~ L ! y~ ~ ~ ~ . i.-. COUtlty' t7C~~:~. i,Cl ~i i 1CCF F~SI~ LG 1 'E~ ~ . Cu r 1StT'F;I' j A ~f.i:~ - , ~ _/j . ' ~r,. ` ~ ' , ~ ~ ~ ' ~~~G~ ..s~, ~ ` „ • ~';_...c t •~cti, _ ~j• J ~ , ~y, i;- f , , ~ ~~,1,l.~~ -~.sr"`'~ t . _ , ~ , ~~~~/'.~`j~` r t F_- llC~Ut~I I.OCc.~_ tCC~,2E:t2'8I' ~ ` . Il ' y ! , T 2'~'581J ~4 ~r s. Re.~+~K n~K c, • Tamp~. Fla. 33609 ST . ~~~T~j LA. - f ~ . - _ ' • : .:;Jr~ ~ L ~ J = FE81d IL 58 j h'(' 'r` n _ _ ~ E C r 224 PACE ~~67 ~ ~ . ~ _ k~,,,, ~~"~s ~ a , ~ g ~ ~ _ ~ ~ ~ - : s~x ~ ~ - ~ . . - _