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HomeMy WebLinkAbout1473 ~ ' " r ' _ _ ~ "r ' ~ . . . ~ 1 z-~.....-..~~.-~ - - ~~)7e 1. . GN~7 ia?• ~TwT[ ~OMO of M~wL.7f1 CE~~~C+A~ OF ~EA~ { ~ ceis• • ~YRt/1u OR YiTAL fTwT11R1p !TA?t IAi ~q ~ leaal e~sr - era FLOSIDlI R ~s~w~ue•s rw. i prep•el~ s~ TM No i :•e¦t•a 1. PLACE OF DEATH ooo[ ~ USUAL RESID6NCE cs~..~.wr..a ar.u~.w: ~i. i .wa .lii a CouNir ffAi[ ~.OOIIMtY µ~e~~ ~ ~ i• ~~r- CITr tft ..rM..www. wa ..w soaat.~ lfMCiM OF ~ GIY at ~rY ..~wb lr~ ..M. 1tv~aL~ . ¦a~~~t Ol iiArarMM~i Oi • ' r i i.. to'wN g ~awN ; x a. wu ~+~wE oF ar..,....w.arr.r,.a......~.w.~~.~u.~ ~ .a. r~+w.~ ; IN~fTI t111T1OM ~ 3. NAME OF a lnst) ?(1~~) a lL~t) . t W?ii /1~) lD~s) (Yd*) DECEASED . j (ttrM ~~1 # i. SiX 1. C01AR Ot ~ACE 7. OA1E OF M~M 1. AGi p~ r N~ ~ nu w~~ ~w ~ rt ~YI~w1 llrlr OV~ ~ 1[Ia ' i rrss• r f i1j IM. 11SIIAl OGGU~ATIOM~ade ud 1 Nr. Oq0 Of lIKIMBi Ot IM- !L ~ M~ ~MV~ 1!. dTIZEIi Of WMAT ~r~erfr.td~M~w~It~W1 OYiiR OOYqT~Yf ¦~a~~t ?laat t~k q, FATi1rd'S NA11i ~ •r s~*~~?it~• IS. 1NAS DECE/1SE0 MI 11. S./1Wt~ t li fOC1AL ~ If. MOWANTS - 1r.....~~+rw1 ar 7.a. M•..r •~a. f..+r M0. AOOiESS ~~I • 2 . • e 2`C A 8~ rnn•r.l 1~. CAYfE Of OfA1M MEDIGL CER'i1FiCAT10N wTntrw~ ~s~wssw dir~et~r Ea4r wb ~ ~ ii6$@At.6I~C Tnromboaia ~ ~TM ¦r~t tll• 1K 1~~e l~ Ia)~ l~l a~r cY• e~r- ~ (sl «r,a.~. Arteriac2erosia ; ; . f s* a?. •tAr.l.r. w.e w.e. «w e..iiefr.~ t1.~. I~•+~~ ~ ' 1• e• 1 ti~ tw~~ d bdV. N W~Mw ~t (N ~t- ' I we! q ~a~srt 1~~. ~ r~alstr~r ~~t~i~.~ts. ltsw~~ ~ ~O~ ~w~ i~' OIIEIp ~ ' • f tAl~ 7f t`~ lisMN~ it1~~f. ~ i ~orr• ~t- n~f~+~ ~~t~i N.OTlIKfICNNiCAl1i00i101T10MS ~ t~~ ~~~t~ Intt Cw~ awbii~aN M W/W? i~ srt ~ fi~ or l~hr~ ~wi N t~e fi~°s~ °wJit'w 1Wt j ¦atl~s ~~7 Iti OA7E OF ~ H~. 1/INOt p11OM1id OF MHA110N ' 71~ AYTOffTl ' ~ ~ ~ ei.~~~t- ~ - ~ ef•a •f ~ O ~ ~ ~ ST~MMUI tl~ RA~CE Oi NIJYd hi.Y~WS L~ ~Gi~Ol10MN I~MR) ~T~?TE) ~ , ti~. wec~vwr ~..u ~s ~.+R. ~r.rt. i. Wb. ral =~ii. Mr~ 1013: ~ su~c~o[ ~ t11. iIYE t1~~ ~t ~T~.f ci~f ~a YYIItY 00~ ~ ~ i ~F f~l~p wTAt/ . ~ IN1Y~ ~Mt ? ONU ~ , ~ n.- I ke.~by «rWr [I~.c l.ue~i tis i~sed J.oa 5_~ , il~1, t~~- . ls t~t I i.st aan [~s dce~nsed ~ i i t i a.¦. aUvt o~ - -1! m~i !~l Jea/L ou+~rrri ~t ! P t4 onua ad ew f~s 1~ts a!oled abo~Y. ~ ar~ t• 1~ StGNATURE t~P~ R~) ~TE~~~ ' f e~~~l~t• i •~e•••~•. J.T.~cDermid l~.D. Ft. Pierce Fla. -2 - _ 21a. ~ U R t A L, CJ11E 7~r. NAYE Of CBfE1EiT Ot Cl6iATOtY fM. t01'.AiION 1C14. 1rw~. R wat)) li1W) n g`~Or"`"idpi1 Pine vrove Ft. Pierce Fla. own a~u s~? ~ocru a~usn~ss sKwn~ wNer~t o~~rcroas s~?tv~ ~+KS ` ; r.a./soo y ; - - _ ~ ; • ~ f ~ ~ fIlEO +~%7 ~ECOltDE~ . ` s • ~ st.~uc~t c~uMais~ ' ~ ti . . ` _ ROCcF . 3~ ~ `•Y • ' CIE~+~ Ci -CUtt CBUaT . z F~ 1 Mf'~bf~ aAif~l tAr b b~ ~ tn~ ~nd aon~ct aoP'r oF th~ I~on~ ~ r R~ ~l r c. F~ Q ~ , Rpbtr~s eroord on fiti M 1h~ SI. lucie GouM1l HMhh O~»~~' Sa . z ~ RE ~ . ` ~ ~ m~nt ~t FoA Pi~ra~. fb?ida. ~j ~1 9 . : ~ ~ - ~yy~rning: Not v~iid u~+bss tais~d wal of tl» St. Wci~ . ~ ~ CqM~ H~Skh pepe?tnNM is ~ffi~cda • s ' N. D. MIILER. IYl D. . i _ ~ . . . - - ~Hrith Offiar a . j ~ • ; - f . , C~' • /j ~ _ . i';, r ~ ~ i _ ~ ` ~ ~ / 228 ~i~470 ~ - - . _ , ~ - ' , ~ ~ , . „ , - ~:;~.r ~ ' a~ v fi'~vi: G~.~_ui ._.s.~e.. ~ ~ ~e. ~ . ~."J~ L~.~