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HomeMy WebLinkAbout2105 . , • ~ ~ . • . . , . . ~ , ~ ~ . . , ' . . ~ ~ ~ . ~ • ~ I~r~?V~7VV CERTIFICATE OF DEA't'H ~~o .t H..h? .d ~ s...k.. ar..~...~ F L O R I D A e~o~srw~~•. Mo, nrt, Of w~n w OwtE O~ OE~M ~••orr., w., .•u. i ?ttMANlM INK ~_NM~E r~~ 1 773 Zitter ~!ale , Nbve~nber 30. ~f0°' a' Charles .sn.aa~ ~ w?rt a rrm ~.o.ti cour~. a awrN RACE w.w~. w~p- ~+rc.r ww.. ~GE-us. wa ~ nu wa ~ w .ua ~ ~K. ~M«•~~ Seot.S 1920 ..Indian River 1lhite ,.53 w ~ ~ r~re en ~.+in MOSMUL O~ OTMER NSiiM10H- ~r ~ w~~~• iw~ s~r~t w ~wr~t~ ~ l~ x CIT/. tO~MI'~. W IOCAt10~~ A~ frtcrr n~ M+o ~ ~ 1).5.~ 1 ".O . ?+IAR~EO. w.Y11?HG sI~01K! ~..r...«......~ .r... ' STAiE Of WM ~ r wOt w ~E~ a MI11Ai OUn~Y w~DO~woE~O OIrOKEO ~ wtn ~ ~~.Churva Pauline a lor ~~ew York Cit . U.S . A. N Married =.r........na .on o. n+o a wSNtss o~ rOlnm . AN MCt~M~ ~ul SECtMbtr MW~E~ USU~t OCMwnOt~+ ~uw a..~ a.w. we w~»o ~~~ie .~aro uw ~wr r rw~w ~ Gruman Aero-Space °~;,'ti.~ o,.. ~~i9-14-37fi0 "~PChanic ~ •vw«ce ~eror ~ qtt,1pMM. Ot IOCAt10N e° ~'M SilEET AMO M7n~E! .o..~aw.. lES~DENCE-fT~TE COIM~~ ~wcr~ rt~ a w r~p ~..Rt 2 Box3772 ~ ,..Flori~a „ St. Lucie r^t: Pierce r,,, us~ MOtnER-MADEN NM~f ~rs~ ayw~ i~tnEl-NArE 7~ Pl" N. ~(1 f act ~s ~ l PP?1P , w~wG woOeEit ~ern w..r~. w., w+ o~ w~. e+~ ~~o~+t-?~ P erce. Florida ~+rs. C:~urva P. itter R t 2, I 3 ox 3771. Ft. _ , IN ~ 'J C MTn~IM 1~y M~t ?A~T 1 p[/1M WAS CMlSfO ~Y~ ([HiEf OlAY O~~ UUSE ~E! l~ fOt ML AL ~ . ..rww cu~a EiGL : ~'+iRAS ~ , i Cf•1;R Severe~t Aorta ciF:.' . ~ ~o-«~b-• M•M Severe -!~~as s ive Trauma to Ches t a..r .~...a ~ w~ ws~~.•n c~~u w. w~ q. o~ .a • towa~or.ra w: {t~t~MO OM~~i- .putomobile Accident wuto?sr M ~ES w..«.•. co.. (puMl~Orf CONIMMwO ~O M~M M MO~ YMR~ q t~11N M~ r I~M 1 M~ ~~e3 ~ a ~ Yes .w•• ~ ?At7 OtME! S1GN~KIIM~ LON~t10NS' ~w. ~ ~ t~~ wM! p w/11~? w n~f ~ M~u~ K wer U 1 ~.w~.., wr, ~u~~ MOW IN1V~~ OCCW~EO M ~ ~'E'"~"O , pp Auto- Accident Accic~ent l 1 /3n/73 ~ Prn. ~ ,,.a, ?uCE Oi N11K~? .o.e. ..u, u.en, ..nw•. lOCwnON ~ Mnn a u~. ..o.. eu~ a w.r. ~NIUtY wT WO~K ~K~ ~ ~'orth Inclian River Wunty ~ n. U.S. ~ lliPhway ~ .qr~ yf ~[u uy W~ Lr w./w~ urh OM ~ M/~ N.~ w~ Ol~:,OCC~M~lO w~ M Ms Cl~tiKwt~ON- .~o~u¦ w n~a .p.,~r nu wn p:r croruw~, h ~rnSKUM: TO 11/. tM IL t0 f~f CwMW tuw• MrN~ ~M m Iic - t1~ N(~~H~ ~q~ W MCf0~~1 ~~3 ~~OW~~ N ~ J , . CE~TIi1Ut10H-irEOKAI EtAMl1E! O~ CO~ONEt_ o.. n~ a.s~s o~ ~•~a a(~ p./.~/~ p -30 '~3 ~30 Pr~. ~~~rr.t.Ow M w~ ~W~ wM/M Iw~ «v~L~T.?tOw. r~~ O~MOn• J t lJ\/ ry I• - Oe~~r OeGMUO O~ ~ MU M Wl q 1y C~vM~N s~~ti• A p 1~. y~~. tW I ~t. wTUec • 12 1 73 CEIT~f~E~-NAMf ~nn w rwp / • I!.L. Scho~ield Jr.~'.n. ~ H L 1$40 25`t"h°: ve. V each, Fla: .Rw..+c~oo~tss_cc~rrr~r. . . Schof le~ct Jr. , tb tOCw cm w w.. sua Wn~u. cREw?t~0~+. tEMOVw~ [w~ErEn Ot C~EMwtOtr-n~E ~ ~ Gar~le Sr. Lucie Count . Florida Burial „.iil3crest ~~emo. _ ~ iW+ERAt NOw~E-r+M+! ~~+D ~ESS ~ smn w~.~.w wo., c.n o~ ws... sun. tr ~ OATE ..o.u¦. ~?r. ~a.~~ • t /ti 73 ts.F10V/j tT'12f1~~ ?-1~nAr~l I~A111P 2~1n5 1~lto re nceneo~ ~ouu nan~u S. ~612 uNEUi~~ q- ~ tEG+s»w -src++wrwt ~ / d , / :w 4~r.1970 ~ ~ • ~ "I hereby certify t:~e above ta be a true and correct copy of ~ the local re~istrar's record on file in the xndian River CounLy ~ Health Depattmen*_ at Vero 13each, Floxida - va '~=va~ess the raised seal of the Indian '.2iver + ~ This is not ~~d ~.,ti. _ ~ County Health; ~~'•?~t~~'~; is a?ffixed. ~ - - - r- ~ ~ . ~ t. - ' ~ ~ , ~ County Health Dir. Local Reg. • : I .i~,~.,:_ _;"x:~-_~ ~f.~(j,!-~?-~J^.--_ . ~7 .~.~~-,aa:.#: . , t.; - ~ 600lI 7 f ar ` ~ , vr~.~~~''`~. ` ~ ~ : _ - ~ ~ . • - -~;~_~.~=ti- - e: . . a.~ ~ ~ r , - - 3 . _c.- ..J Y . . 3 ~~a 5~~y ~~r - ~s:~.... . . .