Loading...
HomeMy WebLinkAbout2615 ~ ~i . ~ - ~893 - . _ - - . _ _ CERTlFICATE OF DEATH D.p.n~t.i .I tk.l~ .d R~L.L.Iwa.e ~e..inr, *rwTC F~lc Ho. unrvcw c~ i~_~ ia F L O R I D A 1~?E. O~ ~t~Ni IN r'~~~~~"~O REGI6TRAR'B NO. ~:1 ~ ~!lMAWNT ~MK ~E~a_M~~ ~,y~ ~ow~ ~~a~ SEI OAIE Of DfAM ~ ror~w, o~t, nu ~ s~c...ewo~ ra AL?~ ZT Z. ,:•!ale ,:'ove^~}~er 5, 1973 ~ ~ ~ . twCf ~:..wew.••e~c....w.. ~GE-usr ~.••w. . n.~ . wu ~ a.. , OATE W i1t7M e~~. ~COUNTr W OfATM n.a~ w~.~.. ~nus~ .os . rn ~ .w~s ~ . ~ 7iite 74 ~ ~ s.:'eb.2R 1R~9 Saint Lucie em. Town. w iouna+ or ocwm ~s~w ea. a~+n e~Tw? O~ Oi?~ER NSTttUT~Oa-rrurf ~ r w~ w u.wn, em v~~~ uo ~uw~~ ~ Ut~ 7. vfcr. nf o~ ro 1~ ~~r~ Pierce ~~S IN ~nr± nler~e `:eriorial i~~$n~+••a.ll SiwTE Oi ~M ~ r.w r ~ s.,.+..tlUt~ifM Oi ww~i COV+TtT i awLED. ~EVEi ~ueliED,• jSUtVNNG SrOUSf ~ w ue. a«e w~a~ .u~re ~ • cor.~. ~ wiDOMt4 ~vOR~~ +recr~ . 1 uwursee..n . Penns~?2i-~nia . ..-::o::eu~ ..er ~ece.~eo SOCw SECII~ KIWEt YSUY OCMwi~Ow ~e.w a.w a.or w.e ow~a .oa~ w aiw of Mis~+ESS w w+ousnr u.es r wr up~.y ~w. ne~ r~oru r . ; +a-_n ~ , ~eccrat~a~ ~r 18~ 23-3059 Fa_n 4~er :i3n er 1,~ e~~~ " ry~e cm ~rws STtEEt ANO ?~UwEt •o..u.o-.. ~ES~OEwCE-S)wtt COUMY Q1'~'. tOw~+. Ot lOGnO~+ { ~ YeC~IV ~~f p MO ~ ' r' i 11~j l•'i~:(~i:l L.OI:~t ~a .^30~1."jd ~w J't. LL•C3~~~? :~O~t =~1G'~.:.C_ ~w ~'@S u. fATK\-lYME ~rF rmt! uf~ ~MOTMf~-A40ENHAMF ~~Y +N01t u3~ Jacob - ~ er = j nni~ ';~ichard n Ia~ORMAM-ru~ME lauar~G ~D6~E55 ~v~en w~.ri. ..o . em a ro.,., s+.s. [r~ ".rs. Centon Pickel ?~321 `'apl~ :?ve., Lancaster, Pa. 17i;03 ~ti •~/\O{~+?1~ ~wif~ry ! ~~ui ~ OEwu~ wwi CwStO t~: _ ~Mr[e O?a? O~+E Gu6E rE~ irE r0~ NL M1l. k)1 _ ur.~er NS~~ ~MD M~iM • u . ' i ! N~ ~~.1.~ -1`~~ Y~i~~~t-(r"y~~LG :1~ f'~ ~r~ " F . . ? • ~ co.«no.s. .r., t . ~jIrL4=1i: -{~"f~=''~`L' ~il i ~ ~.~c. nu w~ A! -=-i. , ~ ~~~IM~R c.vs~ w. ~ or r i M O.O~~fF 7 ~ ~1~11op t~f Yw~f? ~ t ~ l • \~1MG [~111! 1~~~ 1~ ` ~ W ' - = -<f-, . _ 2•~L~,C, t i ~~:1:-. ~ ~~li ¦ T?E~ SK,~aiCw~+T C ea.is,.'y+sw..w ro~e.+.f• r` :.no w uwu er.e~ •.~r ~ a~ ~ wlJfO?511 Y ~ES wr e r~ws~..os co»- _f ~ ~ , ~ ~ ~•u a .a~ s~w~eo ~ un~.u..o.a uuu L p O~~tw ~ , ~ ~ • ~ ~ - , ~ s y C~-c ' v L,c ' ~'~~,N : : ~ r 1~ t KCIDf~SIJK~OE D~ ~~~M. Y~~ 1 ~MOtR f MOW INIURt U!!EO ~ e.m~ w~NN w~~ivn ~w rur ~ o~ ?.n mr ~ ~ ~KlOf_ Ol 1/~OEiHr/~ED ~ ~ 1 ~ ~ ~ lIt M ~ MI = tNlun wi v+0e[ HKE Of Nlun.~ ~o.e. •.a.. sr~., ..oon. ~~OUiWr+ ~ smn a~...~. w.. c~n w~o.n., s+~tt ~ g . arec.~. n s w..o ~ o~v ~ue .~c ~ vec~ ~ 5 j~ ~XS a ~ CEffiK~t~ON- ~w~ M• ~ n.~ i .o+~ r. .e.~ ..o us. s..~ .riwe~ urw o-. ~ ao/ao .oi r.nr ne OutM OCwntD ~w~ ....ce. c.~ n.e ~ ~ IM1SK~~N: ~ rd•1w W~ ftu ~00'~ alq~ Ol~1M. IWV~1 { D~tt. ~M. q M MS~ l jO r ~ I ~ W r~ ~r~OrtlOGl. Cu! ~ .~+e«oes ..~f / 1 ~ 1 - ~ i > t~~ ~ )4 N~ ro n.e ewfe~si sr.rto v T4 oea.s~o..o.. ~ ~ 7 ~7~ X,. CE~Ti1UtiOn-riED~CwI E[AarEt O! C0~0~4t or nr u» a~r .ow e. oe.n ; r•e ea rw.~ou o •o ~ li~~uf0• O~ ~00~ ~•O/d M~SrG~*P. er w O/~O•. rWm Mt R~~ wOU• ~ M~w OC[M!V O+ 1! YR i/~ ~O r! 416~~L lVlY µ 1 ~ M. = CE~iN~ ~n.e n . S+G?+~T . ane d nne ; OwTE S~G++fO ~•a+m, o.•. .w ~ a ~ - •7~ ~1i ~ \ ~ • ~n' 7~~ • ~ ~ ;w; w,~~ ~u qfifE! s• n cv • c r1~'t~ , un o~ ro~~ sr~a in C ' ,E:~ c~~ S ~y o. - ~ - e,tL- ~ ~UifAl. OfMAT10M. E u~ TH'? OR C1fnMTOi~-ww~E E IOCAt10?~~ urt w a~» sr.n ,~~3urial ~ e~ce '~^e :ery : ort Pierce, i~ loric~a r. - - ~s OATE • ~.or+. e~~ ~e.*~ Rn+EtK MOrif-,l+nwiE wND ~4aFSS s~~eti {a~ y. w 1C . si~~j [~r ~ r%lA • 3?/! ~O :Y ~ ~ _ :a-.~~ .~di~_ '~?`T r zerce, . ;-ov. P i,73 ~_..._..s > > a ~ own ~tcE~rto ar ~ow ~ca~sr~~~ v. s. ~611 ~ur,cig, t~erot-s+c,wrwe ~ ~ ~ -s~e+..ruac ':OV~~'~^,nr+ ? 1~t73 eer.14J0 ~ J/ "~1._lt, ^'~'i~`-t/=~lr z« t~ ;>t ~ F~eroby osrtify this t~ be e frus and aomsct ooPY of tfis locel ~ Repistrars r~oord on fil~ in th~ St. Iruci~ Count~? N~shh D~pwt- - ri1lnt st FO~ Pi~Yp, fIOfI~. (Warning: ivot valid unlsu raised seal of the St. luci~ - . h~'.~. r Couniy Health Oepartment is affixed.) ~ _ : , - z• _ N. D. MILIER, M. D. ~ CpuntY_jiealth Officer b lou! ReQiptr~r _ - ~ ' . \ ~ ~ , . ~ ' ~ ~ .p„~ i)s~w1y toul Ree~?,~. • ~ _ . . ~ . , J J;~ ~r, J S~r: R 6 P.^~ :2~~3F.~ . p ' 2f~3t ~n:- ~ ~c:::av~.-ci Q ` L ~ort Iauderd~le. F~~nda 33~ 1~ 900~ Pac~ 2613 - - :~:s v~ - - ~4 _ . - ~ ~ - ~r ` ' • _ _ , : _ . ~ _ _