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HomeMy WebLinkAbout2081 ~ z;sas~~ ~ - - . - - _ _ _ CERTIFICATE OF DEATH - ~ Ikpul.rul I Ir~ItI~ ~wd Rc~1.1LtNl~e Senke~ F L O R I D A • !TwTC FILC HO. . IA\1~lUV l* It~.U]II . ii?E, O! I~INI IN ~"°~~~pO~~O REG167RAR•5 NO. ~[tMAN[Nt IN~[ DtCE~SfD-N4Mt r~~~~ ~ cau ~.f~ S(( !l~~CI;CI id! Sf1 DAIf W DEAiM ~~o..+w, 0•~, ~ ~•s~~~~~k~ Alma t•1, Boe er Female . Februar 3, 1974 tACE ~wq. wI4W. ~~~~K~r w0ur, AGE-Nf1 c+ou ~.t.• v+u~ ~ e~. J O~iF Of ~LLM ...o..r.. u.. CpVlA~ pi OUTN ~ ~K. ~ Vlf1I~~ ~~~M~~t ~r1~~1~ ~J3. J~ 1 W~~~ j I . White 68 u w ~~!arch 18,1905 i,. DeSoto • Giv, 10MM, O~ IOUT~Oa O! DE~IN ~«~.e~ c,~ .~.~n ~ MQS?tiAl O~ O/tiER NS~ITUi1QN-fLtM( ~N Mpt ~r bW~, 4n! ~~NU ~~O Mr~/~ 1 _ aya9 a. ,~A~•. n Arcadia t;o r1~.Pierce ~:ood F'e^~orial Hospital Siwit Oi ~~liN wo~ u+ w.+~ CIi1iEN q wnwT CC'Jr.tlr nrAlth:D. kfvER .~rwtt+ED. TSUlvNNG SqV1E ~Y ~M~. Gn\ YO~r .w~ ~ - car.mi ~w~xwED.D~~O~tCED~vec+~~ , New York ~ U.S.A. h:arried • Charles H. Boeqer .~n o ui.uo ~~u StCV4Tlf M7w~{ER uw.? occwwr,o., .,.e o. .c.a ao»e o~~~w ~oa~ w ctNO Of WSMSS O~ IrDIlSI41I u.~o o~e.+. .o.a.+o un, aa. u.r.,.in ~ ~ occ.,nea 7 A~f ti...uaa.. W.~ q ~7L ~q~ .I~.L~K~ ~IWn =~+'o~~ RES~~EwCE-St~IE CWNt? C~T~, 10vN, O~ tOUitON cn .~.Cn SS~tEI ANO nUMIE~ , ~v~c.~. w w ~..Florida St. Lucie ~~4 Fort Pierce I~..Unkno~m~•.Rout 8ox 3? ?ATnE~-N~IE /~tf~ ~'DOCZ t~)~ MOiN[l-MAh7fNHAMf 1W~ r~WN ' ui~ f ~s Frederic C. '•lier ha it+h?W.e 1-NM~E ;M.A :Ih~ ADGRLSS ~i~.en u~~.~. w. cn• o~ q~+, f~.n, er~ Carole L. Rushino '.~~~?:~^"N ~ec~rd P ~ B Rq 't~R~ iAV L p[AM W~S UVSfD t'I; 'Fr+IER Gv.v O.t C4USF IE~ (wE /Of ow b,.t+~U a ~~~v~~~ ` ( 1 ! ( $ w~~e« u~u~ ~.a ee..w ~eo~.y e.~u - - : ~ 410.~ CO°Q~;ARY OCCLUSION. t4inutes 1 ~ _ . .f • e •.va~Ke o . . (OrO~llOw{ ~M, ~ ~ n, 412.9 ARTERIOSCIEROTIC CAROIOVASCULAR DISEASE. Several Years - ..eo~..e uuse ~w. ew w w.s . eo.sia.7..ce a.. ' le~MO CaV/~ \~t~ ' ~ 309.3 Or~anic Grain Syndro~ne due to Cerebral Ar~erio- ~ ~ <<~ sc erosis. ' /MT O~NER SGNYKAN/ ~QNDIi1QNS: ~~"0'~'019f CCwo~V~~MG q!!~M ~,I~ Me 1t4R~ q 4ulf GMM n~ Iuf ~ NI AUtpSY q tES vt~t ~~»a~.et ee+- ° (~a+a..o~ deeiw o~u~~...»oc•uu ; 440.4 Generalized Arterios~ler~.s~~S 1 ~N ~ O•ot>ei 1 KC~CHJ, 1UKWf q OwiE b~ ~ruuir ,.o~,., o..,•i.¦~ vZ HOW IHRlRt OCNtlEO ~~M~¦ w'~ p~~,v. ,....u ~ o~ ..n mr ~o~.:odt: oa ~menwn.~co r- - ` - ~so.a.M r - . i . . ~ ~ ' ~ 7# .:J~ M ~ 7Y F ~WVtY AT wO~R • E Of s~M~.r .w. uun.-r.ao~.. IOCwTON ~~n~n u u.~. ..o., ua w ro~w. a.n ~ ~ ~ ~ p~a.~ •u o~ .w~. w.Ke ~se..~K- ~s~Km~ s M 7M ' IMf . . S S CEriMKwi~OH- .o-n• ~.r rt.~ .o~+~ p.• .e.. ~.w w. s.~ n,.~..u u~v d. ~ w/w no. .a~. e.e o~.rw oeevute n.e .a.c~. or n~[ q ?wr1K~~n: ~o.n. e•• w wo. •m~ a.w~ rnou~~ o•n. .•w. ro+a ~nr ` n. ;•,.0 8 4 1973 ~O,~ 2 3 1974 ir. 2 3 1974 Di d not n.l 1:30PM O tw1 UuY fl f'~~Ip S r~ ' CEtiilKaiqN-w~fDiCwl Ei/w~!+E~ OR CORO+:LR: o» ..e e.vs e. tie +ov. o. c+.n. o~uw... r.f rw»w..ce~ e~.s ~ ~ ~tuw~•A+ W M q0~ ~+10/O~ 1w~ w~~ft~Wrqw, w~~ CI.~W~+. I rO+M O~t ~OU~ 3 ~ ~ i C~~~w p((Y~~~O O~+ M NR ~rw W q M UV1/~l1 f~~7i. M~ m µ 7T~ CEiTtRU-~+.Vw( inn o~ ~~..n SK.~+w:,;tE ~ ~ q¢ne p um OAIE SK,'+[D ~~o+~w, o.., r~.~~ ~ C. R. Arguelles, M.D. ~/,'d_~_l ~ M.D. 2 3 74 MA!LMIC ADWESS-CLM70i[t s~ ai c..o c.n o~ .o.. s+.~ ~ _ Post'E~~~'ice Box 133 ./Arcadia Florida 33321~~ ~ W~:•l. C~Fw.T~Cr{ R~vwl :E++E::tr pq C:~,.Arpcr-N4vf ~GCw~~N on d q~.. s~.•~ ~7 - if.eun. . . . ~ per~oval T., . GreaL Barrin~toaL".n~s. • - ~ . . D~iE ~+o~• w v..~ lu•aEr~t NO4!-.'I<:•I tND ~DGtESS ~~r.u~ o• o. ur. o~ .o.., u•n, n.~ ~ . Feb 4L19~~ n.P.O~E2't9=~~'<^.~'.v r^.'~. P.O.BOX li:7 ' Arcedia Fla. 3 32I ~ v, S. ~512 ~~~:Ca.V O:R(C.O~-S'G•vwlu~E ~ j` ~ ._G~S?~w~-S~G~+~t~:E a•n ~ue~.eo iucw~ ua~~n,. Rev.:9T0 n?~(%zo , r ~fJ~1i. / C x. .~,C„iQi~ ~ :u , ~ ' • ~ ~ , : ~ . . . . ~ . ~ . ~ cLRrz~~D CdPY ' . ~ I herebY certifp tho above tQ be.a true and correct cony oP the Local Registrar's - record on file in the - Health Denartnent at \ • - - ~~r r_ct 1An ~ ~~~~\y~\ 01"` A• • p E_ ti,~~},, . ` ('~'arning: Not .u~~~ r~l~Sed seAl of the ~'~p_C~ 3; . = Ha~, ~ -~~~i,~Rfi~tit ~~FiXed. ) ; , ~T ..s• t~•~l;~- - ~ . m ~ r' m _ ~?r: ~4 . , ~j;`~f. j ~ ~ ~ ~c-~Co ~ ; ' '':c1' : r i , ~ - sr~r!1;~ . l ~ * : • y L~ ".i},_d~- ~ t'~'• - ~ ~y . 1~ 7 ;~i' r" , ~ <s ~ ~ ~ ~ 7''~ . - 6'~. .i (o~ a,~ W - -~1~ f~ %FN';a~ ~ ~nrM"y.Ya~^aw~ ~.I. Q~ Jti-t2~-. _ Dat~ , .,r" ~ ~e~ut.y 2',oc~l Registrar ~ ~ ~o ~ . ' , 't~ 4;`~. ~ c . an, ~ ~ >v r' - - ir~ t- ~ . • •'r~` y ' , ~ ~ ~ ~ ~ : - : = 224 Fa~E 2Q8~1 ti~:, .f: ~ - - ~ r~s ~ ' ' U ,.~.>s~, ~ ~r ~ y` p, r ~ ~~y. ~ _ ~4~s'~ ' . _ _<a, . > _ e = ~'!c, a = s ~-~~s _