Loading...
HomeMy WebLinkAbout1657 i - I ~ CERTtF1CATE OF UEATH Iky..~..r.~ d ff..ld ..J K~I..b~ln•~n. ~...~.~e. Rwri s~u wo - ~~~~r~~r~s.u~?+ FLORIDA w~rs.wuw..wR~ NC61iT11A11 • MO OKt~SlO-- N~w! SEa ~owtt d OEwn. -o-,• (~Klt 2~tanue~~vaquim SILO, ~e June 10, 19'72 , - - - ~ !AC! ••~n w~o? ..~~.t~w ~++ww AOt-~~~~ v~+ef~ ~~u~ ~nM~ W1iE O~ MRI?i •..0~•e~. e.• iC(JUMfY O~ O(I1fH ~EL~It~ , ~ ....,b.. . .o. ~ a.. .~,.~T 1 '~0~ 2 ~ 1918 ~ ~ L , CiT~ rpwN M tOCJ~t~i O~ OE~M`~-J~ ~<n..r'n ~ Al O~OTMH NSiRUiqH-rrw .s..o~« ~noi ~~w 1~~~~ ...c--. j' ..K,.. a ~A CENiER 1_ n BAY N~._~?~ Yea 8AY PINESr FW. _ O - Slwit d MtfN • .oi v ~ . . -~an:er+ a w?~.r cai.+n. - - ~.arto. ?+c~ee rMrED. ~SUlYNNG Sr'OUSf ~ ~~~e .uw. O ca.~ra.. ~ wlO. avWCtO • wcr.. i•{ 1118.i1 FI' O C~E'l1T ~ Portugal ~ U.3.A. L~Sarried-- - - SOCt~t SECtidtr ?atWf~ ~USUM OCMATk'»a ,GM a«~ w~o~ so.~~ nv+~~c .oa~ w~clw0 Or MiSnlSS O~ tNDUSnr ~ ~OK~.O ~M. Mr w Ne~M ~ . . OF30 1~-3400 9ales : ba er _ , _ ":`ire coc~paz~r _ ~ - - - ...~.w c~m .~.~n r3t~tEt •~+O ?~llr~E• tfSt7tr.Ct - St~it FCOUn~r ~R~. 'Ow?a, OR ~OUT~ ` e_ ~ . YH.~~ .~f O~ ~.O i 1 / ) llr~~~? A:~~1• .7C1u4li ,y Florida Pinellae ,,,,St. Peter~burf~ ; Yes ,~1-41 , ?a1M(~ -N.U~F .~n• ~~OM~ ~•V ~ ~D~?rtt-FIP~OEH NAMf .ri~ r~oo,~ y 1L1tOTL'~O ~ d8 s~1Va i1$.I'~8 AIV~B "'M°""'"-'""'` PAUL 1. GIBBS M"•"'o "°`.ess a••• yA HOSpiTAI RECORW L ADMIM. Dl1f. ~Y PINtJt ftn . ?M~ ° DfwM wA3 GUftD {tMiE~ O++i~ irrf UiISf ~!f ~NE fOa ~o~, ~D~ wrO t::; - - _:`.n~ c.sa+ •~.r a.w. . - - - - - ' _ v i „ _ __'-~+i~,.w c.:iu t Carcinorsa of stanach ~ritr. imiltiPle netastasea _ 1_~ ear .o~-ar:r: - =O~~~I~OM1 •M~ , ' ' r~[w 6~~~ uM ~O ~ tLl . _ _ _ _ ' . : r. ~Nl~~f! c~.+~t ~'~J O~ ~f ~ Co.iflOVtK~ M 'f~aS1r0 ~+1 ~wON ~ ~ .~..IO C~N~! ?~1! ! . . . _ _ . r~s~ OtwEe S~G?+YKw+r CO?A[TK,~+S CO~~M~+~ cOMMN~rG ~O Of~fa w~ MOf wuwe :o c.uv u,.e. ..n .o' -TMlTO~S~ ~~i ~ f S ~••o,••.:~ ~..n :v »U~ s.oe~IC o~•u~~ti..~. -~.ar ,:w Yes ~ 'L'ee I~wii~t.? ~C~:~fr7~ Xl1~~ 0~ A'r'~~11~--~o«rw, s.• •tu~ ~qQW IN1Wt OCCYtiEO ~ ~••`~•M O~ ••e, ~OaK:Ol. Cti tME'[WwlO ~ ~ ~ r 1M tuwr ~~T w0~ - T-RACI OE Ml~~ •or. •.a.. ~+~e~ ~.cwn. (p~~.110tv ~ sww* o~ ~ • n ..o . •.n o~ ro... s~.~e .~NC~~ M\ O~ r0. ~O~K~ ?I~i . f~C .VReI'~ r i~1 ~ AT~O~'~- .+D ul~ Lw w/M YM O~ ~ a0~ o~e ..or ..h~ 'w DL~M O((t~~tlL '.1 ~u!~ P~ !r .~0.(ew e.r q.~ , OA~ ~.r ~W ' ' ' - . _ _ I. M W? /fY .~a~ N~~w C~'1 ~r0 ~4 'N f/M ~ ~z t°„ 6-l0 ~z ~`="io=r2 ai~ , a _..~.u~. A~ o~u.uo •~o. . . ~ r ~ M o•.r cwr~~ ~•,~•o CH~KI~T10~+-~CAi fI~+~Rf-~t L~lOe+tt a+ ~ w~i w n.~ wor+ o~ o~.a. i rM «c~e.a .~o~w~ua w.o j +Owrw w. •r.• ~aw.,...sa. a wo. ...~%o~ .w .nt~~c.~o+. n....o... oue. otiwro aw M~+A ...o aue ro~ uvfe:u t•.~o - ~ µ rp - - ~ - - - - ~lTNiE>-IiAME ~nq o~ r~...~. ~ - ~ ~u n.~r b1T'E S~CSt+EO ...o~-~.•~w. •w. ~y - - - - i.-1~'?2--- - - F~1FtII. A. 51i.1 '':A I•I D ~ MMINCi AOf.~t1S-CF~p?~[f U r0 ~~w o~ a~r w•t r~. , tf1 . „n o. b-.. - M~wt C~ew~t~ON. ~~pv,?t j -M~+u[ 10U ~ Hol oke Maesachuaetts ~ ~.n Rempv~_~ rt~ ~w Jsraew Cea~ta - - - . r~ta+~ - p~flt O~ ~ r• MO . UT O~ ~Oru at~~t u? . ' I,~ ~11111 3'~30 -~+9 St. No. ; St peter~burR, G1a. 337? 0 Ju,~e a~ ;i;i'-?i ~ s no~snu .~~y _ ~ ts? ~ ~ ~ ~)1 7~ ~ r~r//!1~ 7~- _ _ ,t. • - 'r.= A C8$~'IF.D GOPY;M?S'~ ~AY T~ ~~5`'D SEAL OF THS RECISTRAR OF VITAL STATIS?IC$ • ~ ~ '~;-~._:.1:.'~~ - a'•: 7 - . ~ ~==1_ ~ Asr~bq ~a~tify that this is a true and correct copy of a certificate a oSn~ file ~~i ~t?e office of ['~e Local Regis[rar of Vital Statiatice of the _ ~ ~r .j~ Pinellaj~~Ounty Nealth Departmen[, St. Petersburg, Florida. 3 • F_ • ~ ~ ~ _..~nv_... - " ~ 1! ~c.' ~ 3 3972 Deputy I.ocal Registrar U ~ ~ f~~ED .:+.:;NG~D ~ gT ~:j : ~!+Tr FLA. ~ P.: _ ; ?RAS l~ ~ _ rOURT ~ ac~^ MaR 5 9 ~3bM'1?~ ! r 2~4 PAGE~V W - 2'76100 - . ~ ~ ~ • r ~ r '~~J~~-n~~{ J f ~ . ~'~''u~F ; Y ~ '.s'~G, 'T ~ ~I : - ~M~d~FR• , ~ ~ ~ 1~ ~ W ~ S 't° - _.~._~_e__ . _ _ . ~ ~`,Y,E' v. _