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HomeMy WebLinkAbout2660 _ h,_ • ' ' H / • ~ DADE COUNTY ~2'78$9'~ DEPARTMENT OF PUBLIC HEALTH 1350 N. W. FO[IRTEEN STREET~ ' - MIAMI~ FLORIDA 331~5 _ " . s ~ ~ ~ DEPARTMENT OF HEALTH & REHABIL[TATIVE SERV ICES ~g . `~~"..i `f'? DIVISION OF HEALTH . ' MILTON S. SASI.AW. MD. MrM, DIRECTOR ~ "Z ~g~Y ~~"'~g~j ~4iIg Tp BI3 A T~JE COPY OF THS LOC.~?L REGISTRAR~ S RECORD OF DEA'I'E C T'tl~ c. - ~ , . ; ~ .e ~ . o G• ~ S • F~U'Py RF.C'ISTI2AR . ~ ~ (Not v~~id unless the •raisecl seal a ~ VITAL FECORDS UNIT . `;g_ i-', : o~ tjte ~ureau of Vital Stat~~-~C E~TROEO ~ ~ a' ~ ST. LUCti. ~:ZU!1 Y FIA. MIAMI, FLORIDA ,L: ~~j.3`. $~,,~i,~•~ ROLt; - ~:'~AS \ - • c; ' ,.~rr . , CIE~'.K COURT ~rN~ . - ~ , Y. ~ ~ . • • ~:~`^F." Y~= i: J v~ ~ • • ' ~ I . a~R a ~z ~s PM 1~8ss'7 ^ „ r l . • ' - ~ ' T ~ t ~ CERTIFICA~'E OF DEATH ~,~TE F„~ Ho. ~ ~ n: r,~+m~„t of 1l~al16 and ReIw611ib~lre Serfices F L O R I D A ' ' ~M~th!QV t1Ei~1.711 pEG16TRAR'S NO. ft~+~ O ftlaL R~~ i awa~ SEX DAIE OF OtAiN ~ ro..tN, ow~, rW ~ ~ _~~:'D-riaMf ~ust , ROSE HELEN SEVEL : Fcmale , February 21, 1974 : ~ • ~ r.~ ,r„ rt. ~eaao. u.uKU~ ~~ouN. wGE-~~sr u~~[~ Y^hEf 1 D~~ OATE OF btRTN ~ro+aM. a~T. COUNTY OF dfcA1H - ~ a.s ~ ..W Dade { . - Oct. 27,1895 , I S?'hite ~ 78 s~ • ~ , 1!i'~vN, O~ IOCAiION Of OEATH ~H~ ~'TM ~"~m ~S%tAl Ot OTMFQ MSf1tUT~ON-NMRE 'N ushe~. G~+~ ~tttet uaD ~.u+set ~ ~ ~ ~ srtcu. ~u o~ ~O i ~:iami Beach Yes Miami Heart Institute :s 1_„': GF l~xTH i u wo: u. u.s.~.. Nu.e CITI2EN OF WMAT COtiNiRY M~2 +JED, CNO CED~i S~te~rt ~ SUYVrvWG S.~OUSE i v we~t. e~rt w.w[., ...,+e ~ ' ; tlarry_Sevel ~ , i ; ~ U.S.A. u t~larried _ ~ I ~ ''~n._..llv_2n _a_ . _ - - - . ~ ! ~ ..~ECU1:T1f t~vN.dER UW~I OCC:/?~ifOt~ ~uyY <<NO o~ wwc ooHC o~~'~+c ~sr or KIND OF WSINfSS OR Itv0U51RY ; i~'-" wouaK, u![, tvtw u rmtw ~ tA- _ ± Own Home F ~ ,,~_z8_8950 House k'ife . ~ ~y- u.swec~n ur~n SiREEi IWD tiU~tDER c:_.~Er:Ci-SiAIf COUN71I C3T1?.10vYN.02lOGTtO?a ~ytun res o~ ~+olr F D~de ~k. Miami Beach I,a Yes 100 Lincoln Rd. . Florida ~a. us, , f~ ~t.,E~l-NwlutE ~i~3t ust MOiMER-MAIDiN NM~tF ~ Farbste in ' Fineman a ' Sarah ~ , Israe 1 . MARUiG ADGZF55 ~sr~u~ oa ~~.o...o.. cm o~.ow~, fr•n, tv~ ; r:FO:ww(i-tJMif - ~ . ' t'.arrV Sevel ~n 100 Lincoln Rd.Miami Beach Florida /u..oi~..~r ....i~..~ ~ .'w, t Q~,TH WAS GUSED !Y: (fNTE2 ONtY ONE GUSE ?ER IINE FOR (a), (b), ur0 (d~ ~~twter. o..ser wwo ce.m r - wroun wst , ~ ~CU~G ~~ot.tar~~ ~ NF ~LGZ'IDti11 ~ ~~~o~~b . 1 „ ~ ~ ~n.,n..lOMl. 1/ ~Mt. ' ~~~pr~,o SG,V. O~ti ~ E I~WT ~1S~~.s~C ~ ~ ..,~ti^e..e nse ro ~ Is) ~ ~~e c+us~ ,a. o~i io, w•s . eo«xow..e~ a: .~f~MG ~M~ YMOI~• ~ ~ .L C~YS! 1~11 ~ ~y . AUTOISr IF rE5 Me~E ~~MD~NGS CON• ~ I:a:' ~ OTHEt StGNRKANT CONORIONS: ea+a~bor.s to.nu~ur~.w ro ot.m w+ Noi nurto ~o e~uu ~mw ?u~ ~ im ~~is a^o~ oi of.rn eere~r~n~r.e uuse ! iw Yes ie. 1'es ~ ( ; _ ~ r_ ACf1Cf~.~, LitGDE OR DA E IWU~ ~~+a+tw, o~~, ~ut ~ HWR HOW IN1U4Y OCCURAED ~ ewrtt .urutt Or ~hrv~i ~N r~~~ ~ Ot ?~n aw ~ x' { ~ v~~.~LE. Ot l.a[~fiF4uhED ~ . ~ • •r1 ry M 70d i ~ 7'A ;•~:'.Q ~ ~T WOtK MCF Of IN1UR~ •o..e. r.~.., s~u~i, ~.eroai. lOUT10N ~ su[er o~ ~.r.o. No., un o~ ~or.., sun ~ ~ l.t: n tt3 W NOI OniCt NOG-.!K 1SrK~/11 { r ~ 70~. ~ ~r~*~~iG110N- ..o~Tw o?r n•~ ..onm o•. ~W u•o usf swr ~wvNe~ ~irre on ~ or~,~a+v~c.v me OE~in OCCUR~EO ~r n.e r,wce. o.+ TMe ; i ro..~w o.r .w ~oo. .nt~ ce.ew. iuo~n o.n. ~ o. ro n.e ~es~ ~ ~ . ~n.>'C~~N: ~ O~ M~ [tipr~:t~J~.[. Otf ; ; ~ •rt~wDlD fwf '~I~ Ttl1~ ~ • ~I IQ1 !t~ ~ Z~ ~ 1 t~~ tl. LOP• M- to n~e U-.st~si s~wito. C1[NttD ~~Or fwt 4NtDt.~i w~i I~O~+OVI.ClD Ol~D ,:~T;~~,r,Af10N-MEDiCAI E7(AM1P1~R O~ CORCNER: O.~ i~t ~~sn Or u+! wou~ or ot.r~ ~ptirM D~~ ~t~t wov~ ~ ` ~ ~~~r~.r~~•7M O~ ~~7~ ~vD/O~ fM~ IM1ISIY\i~ON. IN Y~ OIW~~~. M ~ +'~ClUN~~ OM Ml D~T~ AND D:!! ro tw~ C~~st~s~ s~~TeO. M. rn - /~T ~ t SIGNATttrt - - - oEC.tt w rnu DATE 11GNE~D ~A J ~ .^.~i R-N~eE mn o~a ° R~1 ~~`9~ L. ~ ~~l.i{ ~ ~j'` ~ t~ W ~l~~~t ~ l, ] a:.~t • ~ ! V s : ?D O~ CEii~ FR Q ~ S\ ~ ~ o~~ ~C ~CR ~•LO~ ` - ~ ~ /IK~JDt. IN ~ ' IOCATION c~n o~ ~o.rN sun ~ ?~st. CREMAI~ON. QfMOVwI CEMETERY OR CREMATORY-N~ME j Altoona Pa. r + ~ Removal Mt. Sinai Cemetery~ z~~ _ _ - - r,,,.E ;,,p,,,, 9.~, •e•~~ NNERAI HOME-NAME ANO AODRfS) ~ sr~en o~ ~ ~ o. ..o.. ein o~ ro.~. s~u~, t~? ~ . . February /f3,~1974 ,;Riverside Memorial Chapcl 1920 Alton Road Miami Beach, Florida . r , _ _ _ _ OATf C . EQ { IOCAI~ G~I s,.,.o~t tRECj~-~~~ ry~f REGISTR~p +~iu E ~ ~ ~O.~c~r~"lL. c~'• ~ i rE. , ~ -j '9 K t`-' _ ",.~'S, ; „ / ' , T ~ .T . . _ P ~"FT~~'1t~ ~ . . _ ti, - _ 'I ~ d. ' . r- . . ~ ~ ~ _ _ .~.r.r~a~r~ ~ " . . ~ _:;i'~_'~. r~ . . ~ _ _ " . _ 'fke $ "n°t~i -g5 ' ~4 „ ? ~ ~ ~ ~ ~ ~ . _ . _ .n_ . , 1"" F~~ . d.~~__