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Home My WebLink About2902 CERTIf- ICATE O~ DCATi-1 ~ [~+~teneul o~ ~ leal~h .pd R~~wl.ili4i~ire $r~rlce~ tTATE FII.E NO. _ a~~~~cr~u~~~u~ FT.ORIDA tYPF, OR ftl?Y. IN ~~r~°'LL~•~*"~ RCGIGTRA/t'S NO. ; i'[RIMl~INi INK ~C[ASED-N~ r'001~ ~~ft SEX OAIE Of GiA1H t.owtw, o•., ~t.u Sf( M/RDlOOI IQt c.slcan~aK , Ray~o11d J Rosnond l;al.o , 1~tay 4 19T4 RACE wwu. w~cto. a..~~KU~ wouw, AG!-i•at ~w~ ~+eu •~.o~~ ~ c•~ OA1E :N 6:RIN ~.a«rw, o~~. COllNT1f OF DE1TM - • !K. 1 M~Cq~ 1 ~~~n.n.. ~~i~n~ ..os. c~.n ra+u 'w ~ - ~ Suly- 26 1918 Srot~tard _ - - - tmite w 55 ~ ~ -3---- Crt~, lOW?~. O~ laR1~0?~ OF awiH wsw~ c~. u+ns IK75hi~t OR OinfR NS11TU110N-HAtitE ~u ..o~ w uuu~, aw: ~~aei~ .~o ..u.uu~ . sncr~ us oa no J ; w Hol~•:ood yes ?~iecwrial Hosoital STAIF Oi tiR1H ~r Mo~ w ~r.f.~.. ~+~rt C1112[N Of MfHAi COI~iRY MJJtRiED. NfYtR MARUEO. St/~~'~N?dC+ SPOUSE ty ~u~. 6n! ru~wtw uW 1 = ~pMj~~~ WID05nED.U RtEO~vetw~ ~~~.~.~s~.~.. t:ew York • USA n 2•iarrie~d u Be~ty Filippelli w ~~~i cec~.uo ~ul S[CUUfr !lJMtER USV~! OCN?~iiOti ia~.t ¦~.o w~wa oa.i awu.~e ..os~ a K~4O OF WSM+fSS Oi tt~t151RY ~ 1~.1~. u OlATM MpI[W3 l:l~. !r!N M~lf~~tD 1 = a IAii.ldin Proctiicts = 0~~-03 7G3 Hindo~r Installor ~ ~e~ ci..c~ ~e.c~e v:sw~ ui+ ?r.m S:~iEI Iw0 NJMiLt ' ~:~s~o++- tES1U[NCE-SiA1f CWN1Y CRtf, iOWN. OR IOCAT1pN ~ ~s.ua. ~~s w .a F~.OT1Cl8. ~o. BTOWc'~I`(1 ~a ~:21`El ''I` ~u YGS u. ZS1O $H ~Z'C g u. fwTMiR-f.µ~f nu~ r+oa~ w~ MOIMfR-~w~fN H~w~E rrsi ~a~ ~'u J ~ -,s_ Folix Rospond Antonina Unot~t~in~ble ~ s INfOil~MNi-NAMf MAIUJG ADGifSS ~sutn oa a.~.s...o., an ~u.~, s:~a. tu~ : 2srs. Bctty Rosuond ~n2820 S~: G8 Ave T~ira*r.ar~ Florida 33~23~.r~,M_^T^} v. fwRi 1. pE/?M WAS U~JSfD l1f: [fNTEt ~ r ONf CAUSE fft LtJf fAi (o?. (~A A?~ (cN ~~n+eiN n.s» •.a c ~ wuou.a w+a~ . N) `-i i C~C t 'T f- , • co..uow - ' ~ towsmoNS, u a~er, M ~ / ~ .t_ C,C-+ ~ •MtCM 44Y! ~13f 1J / ~ 'l 4~l' L / ~i""7 uuatel~tt C~YS! io~, Wt p. p~ ~f ~ COM1Wa4+Ct Oh . {laflMG 1N1 VMOI~' ~ ~11N0 «YS! t~f1 • . , k~ cl=z ~ . ~ ~c -~c ~ ~ 1~-~-~ - ~~-.c~.. _ IARI OTMIR SKs1~IfKAN1 CONOITfONS: COMD~TWS COM~VY1u~G ~O M~M ~Y~ MOt ~[uitY t0 Uu1ft GMr~ w I~ft ~ l0l AUtOPS1f Y YES rrce ~~.,+~M~s a, 'I ins o+ w oe.iM~ cnu..~u~c c~ I h. nfl ib. p.aE~o1,1~~ ACGD[NT, SWC~'~E 02 DAT ~URY ~.Owtw, p~~, rta~~ HOIK HQW INIUtY OCCURREO 1lM~l M~1W! W~MIVt~ IM 1a~t 1 a I~ti tl~ n;,. ?t~uC~Sf; Ot 1M`VEIEW.I~tED ~°M ~ 7k. M. to1 " INJUiY AT wOfK MACE Ot tv1UZ1f wo..e. u~r, s~an. ~.ex~a.. IOCwT10N ~ s~eee~ a~.~.o_ ..o., em o~ wvw, sun ~ ~ ~non tu o~ .+o~ oR~ce 4ne.. iK. ~ s~KN* ~ 70.. ± CER71F1:l~ilON- ..o.aiw wr n.~ rw~w w. • ~w w.n us~ s.r .c.a/r[~ .un a. ~ mo/ow .+o~ .~n+ i~.e DEATN OCCltaEO .r oe r..~e. o-~ a~o..a e~~ nu ~OOi wtit~ Ot~M. I~OY~1 e.n. .~o. i~ > ?IIfSK~AN: ' 7O ' _ . O* ri [~ijr;!:G! ~ ~ •ni~wo Twe ~ _ f 2~. 72 't1? ~ tIc ~ ~C1 ' tN. . ~.~0 ( !1. 8.C) ~ ro r~e ewar•s~ s•-~ ' !b wu.seo ~eor • f CERlY1UTICtd-MED:C.AL f7AAVNf[ O2 COxO.vIR: o~ twe t~s~i p n~e wow o~ oe.~w oiccw«r ~„3 nor.w..u~ oe•o ~ ~1~MMat~d~ O~ W[1 ~MD/W IM MlS7~(.4fbN. W/iT ~IM10M. O~~ 1[~f IIOJ\ ` lf : O ~ f~z - w.ew oee~rnea w w wn ...o a,e ~o r.K uvsi~v sr•no_ . ' M m •7 _ ]i. CERllflft-?uuf ~m oa r~:.+rr S~C,NAiy E j aen~ o+ nne - OATE StGr~E~ t7~~?ne ~t. Johnson, b~ • i ~ - , _ Yi ,k s`--5= 7~ - ± c, y , 1~t~1WG ADD~:ESS-CERf?Frtt x011 s*OeOti' •~1V~. ~~O~~~lOOd, FL 33021 sr.n ru = 3939 tU~3Al. CkEMAT10N. REINOVAI EMEIEAT Ut CRFMAIO~Y-N/IMf . I~CATION Un O+ q'Mr - st•t[ ~ ~~~w~ ~ Queens tler,r Yor~ } ~ ~ Removal St Johns Cer~etery s OATE ~noeru~, wr, nu~ FUNERAI HO7~lE--NANF AND ~DD~ESS ~ suiti or e.r o. ..o., un o~ io.r~, sr•re, r~r~ ~~i ' K. t;ay 6,~~ n. Bo 'd~ s F`I 61G0 Ilolln~:ood Bl~?d ~~oll}r~,rood Fla 3302r~ S. i41~ K REGSSiRP.4- ~K-Na_~~~cj c~ OAf( ftCE1vED ~f ~OC~i ~fL~1'.i~[ r f:n`: :A: ^.'i: vt:tiU F e Y. 19T0 ~ , e,...... ~i~ ~ ~ ~ ~9 1i~.~- =~-~-ti IU> > ~~...r h~~ . _ ~ C~~'i'IFLD COPY - ~ ~~~~JJ I hereby certif~ the above to ~e a true and correct copy of the Local ~egi~trar's recor3 on iilc ;n the IIro::ard Count;/ i~ealth Del.artt~ent at ` T Fort Lau~=~dale, Florida. ~ • , r• ~ _i.~s~111~ ~ '~To~~ ~ ~ ~ ~?~g: Zle~~"?~calid unl~ss raised seal o~ tl:e Brot~ard Co•.in~y Health ~ - . T~Y : '?Je~~~ent is affixed.) N •~~~,3Z o ::r j~~//~ N ~~-+C ~ ~ ' .a 1.~ a • ~ c~'~i/ p ~ j ~ . - • Y. . C N ~10 ~ ~~~;..Y~.,1~,3=:;.~i` ~ ; - Cou _,.y ~~alt`~ Oi:ic~' and Local ~?~gi~trar = ~ ~o 't~`. -~~o t ~ ~ ~ ~ F _ ~ ~ ~ ''••...•r~~.,'~ ~ ~ ~~"~~fTA~ ` - Dep~s~y Loc 1 ~egistrar ' - ~ d00K ~ P~Li ~ ~.~.Y.:~- , - _ - - - _ - ~ ~ u v~ ~ a~ r ~ .~s~ r r.~,~;'~~.`~.--~-~ ~ ~ r ,..e~ ~ .