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HomeMy WebLinkAbout2247 ~ T ~ i • ~ ''r. ~ ~ ~ CERTIFiCATE OF DEATH ' inis e•- rrwTi .owRO a? N~TM Rwn ~~w• ~,,.es • ~uauu o~ v~Yw~. Rw~nR~u ~I~OSID1~ lr~~l tte- P~d1~T11A11•• NO. ord •Ata BIRTH NO. L YfYA<A[{IOtNC~Il~wrrwrdMd !lwawM~ Rrr.rM/r~~/~.w.~1 p r o p~ r 1~ GOO t HO. ~ STATE ~ ~NTM ~..~~~.a i..u?cc °..u?rn St. Lucie , couwnr •nd ¦~11 ~ ~ a K R[S~OENCE : Da pl~e~A GTf.TOwM.O1llOCATqM t_ K KACC Of OE~TN t. CITI/.TOMM.OR IOC~T~OM ~NS~OE C~Tf ltwltit i in y•r- irs~oc uTr uM~TS~ e e rES ~ i ~~p~p~ Y[S ? tll~. I. STrtEET ADW~ESS f 1. ~uYE Os ' lIf s~t Iw WWr.1+~ urat N4ewl ~osnT•~o+~ 21?. E Arbor Ave. River Pa°k) ~ ,~T~T,~~ r~ ~.r ~.r wTC u«u~ ar Yw 3 ~M[ OE ' occiwuo BECKER o°EFwrM ;'2TCh 6, 19b? t~yve r~t.t) 41ILLI ~I'1 B • # ~~c ~h ~w ~ ~ ~ ~w uwca:~ ~ws. t. ~:c ~ S. SEX CO1011 OR ~ACE MARRIED ~~V[R MARIIQO I~..J ~ Q 7! 1M~)~~~1) XwV~ Ww Nwn . Mua' . W rnoowco D avo~cw N~32'Ch 15 ~ o b : r r t t• j~ t pmp oF rwt tawmri vi•i•l~ 10~. YSUAlOCC11?ATpMlQlltki~INsM~M~t IOD-KINDOiWS1MESSORINDUSTRY 11. WTNKAC[ISt~ft~/~MWRtN~h~I USA ~ •itA y~r- Ir?I~~~MNw+~I~~•~~UrdutQ ~nOt C FY•~0~3R1sN.Y. f a~n~et 0 erator YpTN[R'S YA10[M MI1wC . bY~et lst 13. i~TNE11'S ?urE t Adol h Becker N.arie Rilliag y c ~y•.r 1 Nr wllrra ~c socuw sccu~iTr Mo. ~?ew ~ NQMATYR[ pierce, F14. G6S-10-1 82 Kath~'Vn Becke^ IhT[I1V~l ~ET~[CN 1~. CAYK O~ O[~TN (6wta NM t~we Dn litr f'~ (s). ~a1 lt1.j ONSET AMD TN ~ Funer~l MIITI D[ATMwI~SUYS[D/r: ~I'$• air+eser ~yMEpy~ C?'i O.'11C R~'1CUn13L~C Neart Disease r~i. the e~~- cfrle•e• Ce¦~il~.a..~l~*r. ouc To (~1 . i ee <~?K? nre .u~ a 1 o e• 1 ~Dwt caru (il• n~K t~_ . WAS AUTOKT reglstr~~ t~ r~r- OG[ TO (d • 1 t t~ \ O 7'1 O ~MT 11. OT~ SIC1~i1CY1T WMOITIO/d GOMiW{RMG i0 OGTM RR IqT R[IATCD i0 TM TTR11YMl OIY?S[ C,OIOIi10N GIY[II M fNT 1(~) ~(IIFO~MEC) . Aours af- F 1rf5? +p~ tcr deatp ~ . o ~ 4e for• _ lPr ~b) mb. DESC11tK MOW YUURY OCtuR11E0. (61fa s~?[ ~/~~?t in PHf I M Prt-11 ~/ilrw /~J ~~klPs •p7 ~ ~ ACCIOENT SUKIOE IqYKiOE ~ dlspe~t- u ~ ~ ~ cie• o~ ~ 20t TIME OF tlerr Yost~, a~. Y~a DonY. V ~w1u11r ~ ~ D• STATE - OOtINTt i Tc 20d. lMJ1:11Y OCWAw[O ZQt. KACE OF INJUAY Il M r+N! ~~If. IOJ. QTr. TONN_ OR IOCATION , t w~~~c sT Q wr vr~KC ~ /~~.lu+o+r. «..w. Nice aN•. nc.> Mp~K AT NIORK ~ ~ 'z . ~o •ndlut a~~ ~ ~ ~lir~ on 2~. /~tt~nd~dfMd~cNS~dlrom D~~th occurr~d ~t ~ 1'~ A m on fA~ d~a st~ud ~bo?~: ~nd fo tA~ b~at o! ml x^or~~~. /rom tA~ uus~s ~t~t~d. , IIA AD~1ES5 22c. DATE 5r6~4D ~ A11 !tl~t jj~ i16MAT4R[ - (l/tp[tM/Yl[i ~o D. port St. Iu cie Shopping Ctr. 3/9/b7 i ~ ~,.a,.o.. Bernard D. Ross,M.D. E •Ceul~tl. Z~ ~~_~~l,nl ~ p~TE 23t NAMEOfCCMET[N~O(1CREMA7pRY 23/. ~OGT~ON(Cif1.lKR.MteaWl ~ Bur~aj. 3-9-6 crzst Mem. Gdns. Ft.P=erce, Florida jd 12 2S F~'~E~ ~ELT011 5 516N~TURE A 55 • 2S. DATE RECO. Y tOCAI RE6. 26. REGISTMII'S SWMATV~ ':~lton W. Baird Ft. Pierce,Fla. 3-~3-b7 Anna Lee Denisoz, d.r. Rer•1965 - _ .r.--,--....-~--- ~ : ~ . -a . ~ - . r - a'•t _ ~ = ' ):/I/ tj ~+~~~<<~~.~ '~~r s~~~-•: . , ? 1'; - '1 C~. o# tfi~ Local fILED AN^ RECOROlO , ;be • true and corre~t copy ~ ST.IUC?~ COUNTY F~A. ~r; • rs 8_.in the St. Lucie Coiinty Haatih Depa . COGE4 Pt?'.iAAS ~ ~ = t et.~.~orf~~ ' ~LERK C:RCUi' COURT ~ ~ n,f~~~`" tm~ unless roised sea! of the St. Lucie • RrC~F.^ VE?~=~tD c~' hh Rment is affixeci.) ~ ~ M~Y tt ia 30 ~M'1~1 f~~? I~~' N. O. MILLfR. M. D. is rar • County Health Offiur b Local Reg t ; r/'yt ~ +~~4t~ , , ;1. ~ . ' ~ - -J - ~ • . . . r \ . _4 F_ ~ JF ~ ~.L1~~--- ! ~ , Dato DcputY Loca~ Re9~strar a. r- . ~ ~ ~ ` ~ y ~ ~ 1~ ~ r ~ ~ i - - - - ~::-~.n ~ ~ r.~ ; - ~~1~~~~ ~ a~'~