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HomeMy WebLinkAbout1842 _ " ~t . _ ~Y~...--+~- - • - ~Jri~rs ~rt., CERTIFICATE OF DEATH ~ ' ~(~rt~.ed .t 1 k.l~? ..A R~?.I~IIw„.e Se..r.. trwrt F~LC No. : . , „n~,~, F L O R I D A eY~E, Ot ?lIMT ~M ~M~~~~'~~ NEGI~TNAR•f NO. ! f[tMAMIM INK nqt rywt .~~f~ SE)I DAiE OF OEA1M ~ roMtr, n~u SEE YNI00[ f0~ ~~-w~wt , ~ y~ , Male , Jwye 8 1974 , ~ RA~E wrw. wow. ~•~„cu~ ww~. AGf-i•s~ w~ee~ ~ ru• w+a~ ~uiE OF ~IlIM ~.o.wr. w~. COIJNtr Oi OEAiN , . ~x. ~ M.,».. .b. ~ Dec. 4, 1918 St. I~ucie ~ 6602 ~ `dzite 5~ w C111I. tOMM. O~ l AM ..sw cu~ .r~n NOSMtAI O~ OT~H NS IOM- Ma w. am fne~~ .w wre~ ~ • anun ~es w ~+o Ft. Pieroe Yes „ Ft. Pieroe Mano~3,al Fiospital - A y~yry~ ~/p{~s( ~ r.rt, ow~ .~~e.~ wu.e ~ STAIE KOf =~M-M ~ M MOt M r.~.~.. anie+ a w~u~ ca~nr MA~tlEO. NEVE! MAR~IE~O,K.r' ~.a uIJ~J ~ uwu rfeew[! ~ N 11. ..rr ~ec~n~~ yp~W SEGUMr MMVtR VSU~I OCCINAT~ON ~u.~ ¦..e or .wi ~we w~MS .~w~ p Rt0 Of NSf~[SS q WIISMY i~. r M~r ~O~ tw. Mw r ~t~ ~ ~[1}Yf l ~ oM 302-07-4898 1! ,~siM twr ir~f STtEEt ANO NIIWf ~ewa.Ke ~erwe Cnt. TOWM. Ot IOCAi10N ~arsswn. ~ES~DE?KE-SIAtE COIN~1t1/ ~arK • nf w w ~y Fl~i,da ,q St. Lucie Ft. Pieroe ,w '~Yes ,w 810 Beaah Owrt uSt MOTME!-MAbEN NAMf v~~ ~ fAT1Et-NM~E r~~ 1s " j~t D. Q'1dI1~? MdU~ II1~C8 1?~fORM~?A-~ME w~IlwG wDGtESS ~sm~r w~.r.~. ..o . cm o~ ro.... su~e. tr~ Med~o~a ~ar~r ,n 810 Be+aCh Dou~ct~ Ft. P3sxne~ Flox'id~ 33450 ?~tt pew1M wwt CwuSED ~r~ ~(Ewrtt w4r W+E c~usE rEt tr~[ /Ot NA AL ~ kll N~'~'tlM~OMfl1 ~M N~1~ N ~ ~ ~ + (~1 ~~,~~!/G~' 77/ C~ (f] • . w ~ . ~ ~ r-~ COMMIOM3. ~M~. " _ " ~~~CY O~~E ~~ft M I h~ . ~rrlM~tt C~YfI M. ~ ~ p. p~ ~p., ~w~.ce a: ~ 1t~~IMO fM! YN~I~ - ~f ~ ' \t~MO C~~N l~ft / ar j~A h ~ r- y stu L~ tK wYtOK~ rt ~ES .ue r~ws~ras ca+• ?Ati • OiNE~ SK,N~KAMi tONMtWNS~ cwanws cawaMUn w K.w ~vi ..o~ aune w uo+~ oMr r. r.n ~ w. ~nf w~q~ rwn~ a~e~.u..ww 4vu • _ W O~~tM ~w 7~ ~w ~ ~ i ~ e.m~ .,.Nr or .r~vn rur ~ w r~n u, wer ~ {p?.~~ee!!11~~ 1 KuOt~~~~ A ~ra+*¦.e.~,•t?e~ ?~OU~ NpW IN1Utt OCCU~tEO NdMIC/0E~ O! IROET[W1NED ~ ,tSNCNrI ~ ~ M ~y ~ ~ ' IN1U~t Ai M~O~K KACE Of Ml~ •o.a. r.~., snen, ~.noo. lOtwi~On `nm o~ ~.r.~. ~+o.. cm o~ ?o.w. u~x ~ ~swan .~s w ~.o~ O~K! MW .~K ~~~1 1M ~ ~ ; ~ CERtiKwT~OH- on~ w* .au .o..~. w. ~as" Mi~~ ~u~ ~ioe~~~u~+e~ a.•~a•r w~ el~~occumo e.n ..~~io ~ ws~ • tNrSK~.m.~we+~t `O resent 6 4 74 not ,,,2:00 P o~'.~ ° { n. ~~~.ue ..a MaY 1958 P / ~ .«.a... ..~.~E. ~.e ~ CEtTYKATqN-MED~CAI E7tA~YNft OR CO~ONER: ow n.~ uNS o~ wa wow a a.~• . ~ ........~.a...a...~~a........~.~...,...a..~... 2.0o P. 6 8 74. 2.0~ p. , N~Iw OCCY~KO Ow M MR wM M q M C~YSI~H ft~A~. , th S~~N ~ a nru DA SIGNED i+wM, rr, nui i CEtriNER-NAMf l,iv M D ~ 6 14 7 4 n. ohn N. Sims M. D. PA t~ ; a ~3~450 ~r MAIMIG A SS-CEfTI[R ' i o ierce Flori a t ~IMIAI. ClE?NTIOH. ~EMONAI fIAETE~11 4R CJFMAIO~~-N LOCA110H an o~ qM~ sun airial Hill,ctest . Gardes~s Ft. Pi~erce Flari,da ~ ~ OAtE ~ w~ nu~ WNEULL MO/+E-?~~F ~?A ~ODfF55 ~ srnn w~.r.~. ..o.. cm o~ ro~, sr~n. jv ~ F]~aric3a 33450 ~ ~ ty 11~~ 1974 F~ME,901 N 7th St., Ft. Pierce. , r. S. /612 ~ eEG~ -s+cN~?~WE o tt nctneo n totn sto~sruu ! ~ R~v.19T0 ra 1 . f ~ . • ~ , , ~ fILED AH=' °`-~OROEO ~ ~ h~y o~tify Mb to b~ e trw ~nd corr~ct copY of tM Loca~ ST.IUC~E~ vUNTY FIA. i in th~ St. Lucie Gounty H~alth OoPa ROGE .P.AS C _;=',Q,(f R~Oi~tr~rs reoord o~ fib CtfFK C;'' ~'J1T COURT t - 7C~yQ ~ J'. ~ mM~t ~t FoA Pi~?te. Flaida. ' ) : RfCQFr> y~> riFC ~ y"-~•6 Not vslid unless raised seal of ths St. Luc1~ . (~NOtnirlg: ~ ' ~t - - ~ County He~bh Depe?tment is sffix~d.) ``I 3 31 PN : vu ~i, ~ l ~ _ - ~ N. D. MIIIER, M. R ~str~r ~~4a~26 - ~ i a~ ~ - ~ ~ , : . C~o1~ty ~Fl~ilth Offiur i p' , j ' ~ ~ . .1. ~ . ~ ~ ( A , _ ~ . ~ ~ ~ ; • . ~ p~puty tAUI R~aht~K BOOK ~C7 PAGE ~peJO . _ " _ _ _ _ _ . _ . . " - _ S ~ ~N . ~ i j~' '~..h --z.:~ i .x~~ s" ~ ~t~~' ~ .~__~.,~t_ . _ . j`~~`f~