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HomeMy WebLinkAbout1056 ° S- -~,~6 . ~ . . . . ~ j'j ~ . ~ ~ ~ ------r+ - - 28-~96'7 ~ i~l> n~T~ w~wo o~ CERTIFICATE OF DEATH srwn ~~s Na ~o.•• • ¦uRawu or v~rw~. ~*wrisric~ F L O 8I D A l~a~l f~n- REGI6TRAA•S NO• . erd •~~A BI T N . y~~P~~l~ 1. KACt N~t11TN - GOD[ N0. ~ YfYA~II[N~tMii(~a«4r~dAw; !1~ A~~~rNh~. .:.~~e.a Florida St. Lucie °°~"t" L 66-02 a ~:~~~E D• ~1•e~~ ? 6 rtACE Os OEnTN s. M11.7:fwN.011 IaC~Tqw lw p~• ~ 1NS10E C1TY UMITSI . N1510E CIT1/ LIMITST •~~~~t YES 110? YES[y Iq? fll~- ~ t, ~((T App11ESS OM A fAIIMI NlIME Oi (U Mt 1~ ~M/11~1. /iN Mrd ~/hw) STAY IM 1~ ~ ."sn'~~~ Ft. Pierce yem. Hos . 903 S~~se Blvd. ~S O"~~l a?rc ~r.,u D~. r~.. IMMS es !'b,e Ni/ff. ~ • ~ occusae , ouTM I7Yvr «s~M) ~r ~mcw i fw vw~ s. iws. wTE os M~TM 9. n6E l6 re+n S. SEX f. OOLOQ 0~ ~ACE MAR111E0 ~ MMAMWtI[D JN1WWq) Y,.Y~ D~M Ywr. Niw. . i s• F W ~noorco O aw~cco Se~t la 18 6 ~ a~ ~~i * 1~1111 ~ ~a. uw.~ oow.•no¦`oi.. u.r yw.? ~ 1~. Kp1O0F NRYIESS 01l WOIJSMr 11. tiRTNKACE (BTdt M~tY~ ~1~ .st~ ~~r- twfyswt~/nrtWqF.~Y~~~1 x B Q Hous llask fl~t t7. FATIKII'S M~M[ 1~. ~ Alice Crear~er t~~~rle~r Geor Lin~kin ts. w~s occc~sco cvc~ r~ u. s~wco ro~ccs~ K. socu~ sccu~mr ~a. 17. u~ s s~aw?n?wc SCOtt I/r.r.~.~r.d Ul~+.i~wrriwd.~w•~ A16ta ^ •~1 . IIfiERYAL ~E71MEP~ I~w~ r~ 1 1~ CAY~[ N WTN I~ w~f ~wr t~r+s Yn Me l~r (u. (e). p! K1.) OMSf? MD OEATt ~i~.ss~~ r~~ eurn~wscwsco~r~ C. Of I.un w~a~a cwec W w.s t~l• s~• s~r- sf[la~t• ~.i/p/. 1 pyE Tp sit~ tl• ~?irt ~ ~ 1• e • 1 l~ l ~ti~/ Qs ~~/e?- ~ r~s~~er~r 4~I erue 1Mf. O{~ T~ . MAS AYTO?SY I . f c~ i¦~s o ~~~~~rtwc ro ourN wR Mor ~mo To rnc ~rwrw~ oarwsc aowi~w c~ w?~wr H.~ rc~oRrcot 1~~r• •t- r- res? uo? E a~r d~~tY ~ ~ •r t•r• i ~oe. ocsc~~ ~w+w Nuwr oauRRCa (aro w.wr ytwlwr u. P+..t I r P.?r y vrs a.) ~ ..ti.s .w~ ~ ~?ocwcKr - w~aoc ~ou~c~c E ~ p O •t mc. itrE 0~ llwv a/wN. Dq. Ywr ~ ~ ullNtr ~ o ~ s. STATE i Iw. wu~r oocauco 20t• ~t. ~ortd. ~~es M ~.Mnt. IO% GT1f. TOtKM. On LOGTqM OOUNTv . MNILE AT ~ M07 wMKE ~ MO~K AT MOAK ~ ,n~' 21. 1~n~ndrr t1r ~wr Irom. DEC . 6'~ , ro ~+a~' -=~~ndlut M~r A m~li~~ on 1 s~1~~ DNtA ooaarnl ~t ~ P~- m on tM d~t~ st~t~d ~bo?~: ~nd to tM 6Mt o! mf 1~~w~N• /rom th~ uuaa ~t~t~d_ ?11 ss~¦. Zts. ~ooRCSS 7?c. wTCSw~o 7L- slow?riwt ' (DMa sr ~Yk) " Ft. Pierce rla. _1J'6 a••r1ie• • John D. Broxnin M. D. - •e~~r~t~. 27e. ~urE OF tEMETEII~ Oll CRE~uTOi11/ 2~. wur~ (Cit?. tw.s. r nr.t~) (St~re) . t~a. w...i. nouno~. z3~. a1E ~~S ' Ft P ~j F P' Ce Ceclete ~ ~`~~~.~~Ty~ r. s. /eis t~. ~c•"~ ~s s~c+un~ ~ooecss ts. o~~ ~cca ~r wc~ Rca. a...~oss y[ilton Baird ~l ~f 7th S~ _22_6 Anna Lee ~Jenison d r ft~f` : , ~ ;~~EO ~ ~ ~ ST. t~~ . . : :ti'. ` Fl~. . . ' M J F • ,~~~y ~ • -r ' , ~ ,~~`~~~.r.~''••. , ~ qrtify thb to b~ s trw and corroct copY af tt~ 1~0 JUN f ~ ~~~i~ h, y~__ , ~ _ Y file in tiw St. lucie Gounty H~elth D~e , Ropistre~s reoord on ~ , ~ y - ~ mont ~t Fort P~wce. Flaida. ~S39s`7 . _ ~ Not vsJid unless ra~sed ~eal of ths St• Lut~ . ~ _ - . _ (Vyarning: nment is affix~d.) ~ ' ~ , Counry Hesl~h Depa ~ ~ ~ ~ ~ a ~ - ~ N. MIIIER. AA. D. ~ ~ : . . i ty Hwith Officsr 3 R~istrsr ~ y_, . - ~ ~ ~ p~puf~r Loul R~oistrsr ^y~ ~QS~ ~ ~ ~ - _ - - _ _ . _ . _ : - ~~_~~x