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HomeMy WebLinkAbout2789 VTCKERS 10020763 , t ~ / - ~ - - - - - ` ' - - ~ ~~~~8 . CERTIFICATE~OF DEATH Dep~A~awl ~1 Ik~l~l u~ ReIrL1111N1n $enke~ f7ATC FIL[ NO. n~~ls~or~ aF ~w~.rn F L O R I D A 1 Tt?E. W?~~Ni IN ~+wweawnwe REGIiTRAR•i NO- 51~ HtMANINT INK ~~p_N~ q„~ rrw~ ~st ~X OATE W OE,TM ~•o"rr. ffI YMI00{l0i ; ~SiWI11011! ~ i. ~ACE NNO. ~wutu~ w~'4 AGE-Wt wa~ u.a~~ ~ ea~ OA1E O~ WM ~rw~. ~v. C01MiV Of OEAiN i NEGRO w""53,•••,~ p.~~ "'~ctober 19, 91$AINT LUCIE 66~'1 . TOM~M. . rw~ c.n ~r+i IIOSMTAI O~ OTME~ NSTIM ~ ~11 M0~ IM ~~M~. on~ ~~rn .~r .w~n ~ wu.. ~n o~.a : FORT PIER~E YES FORT PIERCE MEMORIAL HOSPITAL ~ =tATE q WM ~r rOt ~ ~.~.n.. rur GTtiW O~ Vvlu?f COIRJiR1I ~uttlfD. MEwEt rWihEO. SIIIYNNG SlO1KE ~r ~w. Mn r.r~..«r ~ • tp~w~1 W+OOMIEO. WV~OlCED ~fncn~ ' YNMIYfNMtf FLORIDA S u. R E C ~ ~ra ~.w SOCu? SEGUeitt MJwE! USIW OCCWwtAr+ ~aa ar.~ a~.o~ eow wwa ..w~ a KIr~D W MKr+Etf Ot MOUSiat ~ 1/w~- • ~l~M ~Or~O a~l. F Z 265-54-5319 ~#bffS~WIFE = .~ce ...o.. ortr. tovrK a~otwna+ c.. w. snett ~wo Nu.ufa ~ ~s~ocnu-sr•n co~wer FORT PIERCE ~YES «p ~w FIARIDA ,oSAINT LUCI 4. 1906 Avenue "N" ' fAI1rt~-NAME ~~tlt ~rw! uY MOTMFi-MAIO[M N~Mf ~W rOM~ ~ i \ ~ If 1~ i ~ W WM~?+1-+Mn~E w~~wG ~DGtEii ~w~n a u~. .o.. c~+ o~ ww. wp. iv~-. R C • ~ ~~T ~A~ w~ /Y~ ~ Y110~~~1~ ~r:l~~~ - ENtEi O~ar p~F CwuSE ?ft t~+E IOR h~ Pl ~ kN uer~~. o+srt ..s ~~.rw µ w ~ _ . , IN /LG ~t~-~ COwM~OMf, ~M. ' ~ - ' 1 ~r~tr 0~~~ ~ N q iI^~~ ~3"- , t u~~M~N C~11~~ M4 ~ M q. Y~~MYMKe ~ \nw~ t ~N 1~N ,M f ' t ~ wYfO?S+I M YES r~u ~~MMMO~ co»- ' p ~ CON~1~0M1 (O~/M~.p-+ ~+O q~~M Wt MW ~ ~ W L~1IM OA~M Iw ~Y M ~ ?yT OTME~ SIC~WICANT ~ ~ .V ~ ~ ~~~0 ~n~ w ..or a iii. w~u.....w t.es~ ~ ~w ~ ~w. ~ E ~ p.~N~ ~.0.*~. r~, u.~~ MOW IN1Vlr OCCWtfO ~ u~~ w~~w O, r.wv w r.H ~ o~ rur w, ~u. ~ ; E ~ WMK~pt~ pl YlO~t O ~ A ~~v~I~ •s ]D~ %k. M. AI. . INJU~T A~ WOtK ~twCE Oi tuul~ wo.e. ~..ti w.~n. ~.nw•. ~OCwT10r~ ~ wnn o~ ~r.~. ro.. e.n w w.w. a.~ ~ ~ ~ ~~MW~R~O~MO~ OMK~MM..~~[. ~MK/A1 . . ~ ~ ~ ~ CEeTfiCwT~O~a- .as rr wu .a.w w rw ..r ui~ w../.e~ rwe o.~ ~ w/w..w .~.r w oe~n~ oeewaeo w~ n.n. a. w INTIK~~N: TO /O~~M M~ AY ~0~~ ~/4~ M~R 1~011~1 NU. ~MC. ~O M Mit ~ ~ .m~.. 1962 rese. not 7 : 30 ~ a °V' n. N~~.w...o. ~t ~k. 9 11 7 3 zs~. ii. u,o ...~o. Q ~ M ~KfMw~ ~u nOrOwCN N~1 ' GEtiUKatWra-MEOKJ~t Ex~~+f~ Cqd+E~~ o+ow~ ~s a w~ .ow o. oa.w nu .ow ~ ~~..w.eo.. w M ~w. w/w ~r w~snw.w~+. ~ N... occws w~r w.w w wr wwm ww~. • ~j D.~ n? ~ 11 7.3 • JD D. ~ . tH [l we~. o....w~ ~ CEqY1El-NA1ME ~nrt o~ rw.n ~ v~ e rE S~Q ~7~ /.i ~ • o hn h'. Sims M ~ i,~. 9/1 ~ R + Pierce~'°~""rlorida 3~'YSO ~ '~D°"b~` `~v~` 6th Street : or,. , ~ ?IlR1A?. C~FMA~~Of~ ~EMO'VM TERr OR CfEM~iO[ - IOCATWN an o~ o.rw n•n _ ~ sMC~ ~ ~ H~. H? ~ ~ JM. ~ ~ i. DATE ~W E~M NOME- wNJ ~DOZiSS ~ uun o~ ~.r.o. w0., car w w.n., s~.n. :o ~ } ~ ~pT ~~t l~i, 97 ~gpg' S!~rMORIAL CHAPEL 728 Ave. "D" Ft. Pierce Fla. , u Y. S. ~612 Fu~+E WRECt cEG: -S+G+vwiUtj~ . . OwtE tECEnEO ~T ~OG~ YGtStW ° ~ A~Y~ 19~0 .4 ~//VL i ~f1. CP t T~r --9- _ i o~^ - ~ 3 3 3 t~ :te `~5 fILEO ~?1t~ ~ECORQEp 6~ . , " ST_L0~!E C~)UMTY FIA, . , ~ ~ ~ f harot~Y co~tiiy this to 0o a trus and correct copY of tM Loce1 itOCEF F•11TR~S ~ , `i~~s~•~r~~~~~', Repistrers recard on file in tFw St. luue Cou~tY Hc~l~+ ~°OA- CLER~ ..~.,~J1T C0~1RT RfCORt~ vficiF~t~...~.-!~ , ~ rr~nt st Fort Pisrte. Florida. ~ . ~l ' - . ' (YVaminy: Not va~id unless ra~s~i se~l of th~ St. L~cis q os QM : Y• ( County Heahh Department is affixad.) ~IAY ` I~,~~ . . , ~ N. p. MIIIER, M. D. , . ty H~ith Offiur b I Rpistret ~ ~jL 3, (i - ~ ~ > ~ - = ~M (,pu~ Qpisfrer . ~-~3 ao~x226 ~.,~E2787 - - ~ _ _ _ _ - . ~ a y; : . ~ _ . .H . ~ ~ _ _ , . . : , _ . „ _