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HomeMy WebLinkAbout0211 - ~ ~ _ _ . _ . . _ _ ~~'7`713 , - - - - - _r- ~ ` ~ C~.R7IFIC~ :'E OF DEATH ` pe/~A.e~1 .f Ik.11~ ..J ReL~i1N.u.e Se.dce. srwTS f~LC tio. . on~on as ~sw~n+ F L O 8 I D A 372 ~ i~~E. OR ~pM IM RCGItTNAR'i NO. HlMANlNt INR ~A~~MANE na~ .w~~ w~ y~]t OAfE OI DEI?1N ~ ro..o. ~.r. nu ~ : ~~"~10-°t ~ . Fe~a le ~ Ju 1 17 1974 ¦sn~crMrs ~ Aax aret clilliaas Ga t~?CE ~n4 MeMO. uwruw rwr. w6E-uw wota ~ wi ::+~.s~ s:+Y ~w*~ 4! !@tTM ..o~ww, Mt. [d1N11 O/ OE/?iM . . ~ n[. 1 1Nt~ ~ ~ W~?~ 1 tiY! f r01. M*{ MOMf rM. ~GY ~ _ 6602 ~ White 60 k ~ Feb 1S 1914 St . Lucie ~ ~ ~ TDy~ ~ rw an •~.w NOb~T~? O~ Oil~ !iS - ~ r w~ w iaw~, aw t*ra u~ wra ~ ? wcn ni w uo > Ft. Pierce • Yes 2021 So Indian River Dr. ~ ~ 3,RYP,NG ilOUSE ~..rr...w....w M... ~ f t~Ait Of ~M ~w rM M w..r O~ MRMT COUN1tr WWEO. ~VEt MAR~IEO, _ ' ~ yyppW[Q. p~Y~,EO ~ YKnr 1 ~ - - .,r.~„,,..,,~ Georgia USA N.I+tarriec~ •Samuel C. : .~.er www y~ i[QMRr M1WE~ YSW? OCGNwT~Oe! ~a..e a.N w w.a ~we ~w~o roa a KeiD Of M1S~+Etf Ot wrDUSiRr ue~. r~uM ~pap ure, nw r uwu~ ~ Y ouwr~ r ~ ~$G2-1S-7101 ~a. flouse~rifQ nfwx.n Kror GiY. TOMIl1. O! IOCATION r+rw c~+ ~~f ST~EEt ; ...a~o». ~ESwEnoE-sr~n couNrr u ~..Ky..,. o. i.o D7C . _ Lucie Ft. Pierce ,N Yes ,..2021 S. Indian River ,Nrlorida ~„St. ronlEa-AMw[N wwE ~+N •ra• w' ~ /wnE!-1ua~E rrp Lehnan :~lilliarns Sarah hi Dou ald u . ~~MORM~w?-1MME w?awG ~DO~ESS ~swen o~ ~..s. wo.. ew. w~o.+n. u.n. . ,k Samuol C. Gay ,n202I So Indian River Dr. Ft. -P~e rce Fla. rrut oum wws uusEO ~r: ~ {[rn[R orar or~ uust rt~ ur+t rae Nt NL ~?w Rq K~: o..so : o.e... Y ~ :~~~~:*la~-?~ ~-~.G ~1 ~ ~ • , { cor~mo..s, N rw~C~ s~w f0 ~ ' . - ~I ~nrtN~n C~Y1~ IM. NM q. O~ ~f ~ W~HOIIIKIO~c ~t~tlN~ TM~ YANt an.» c~~s~ usr ~ k' tOrM~PH COtwMwO q M~M sY~ ~Wt ~tun~ q 4Yf! OMw r~Yt 11p ~ast M YE'r r~~! /IMNMO{ COM- ?A2i OTME~ SI~,?!/~CANT CON01110N5= ~ ~+nsq~/~~ axns u. wru.~w..o twvs~ i a N~ iw ~ ~ ~ ww~w. r~, ~w ~ NOilt NOW INlU1l~ OCCYtlED ~ e.in~ www w n.w~r w~ ru~ ~ o~ r~a r. or ~ ~ IOMK~OEs O~ I~tEWMEo ~ Ik. M. ftl ~ g IN1Uft wT MfORI[ Of MlUt1~ w.e. ~u~, s~nn. ~~ew~~. tOCATiOM ~ swan a u.~. ao.. em w rorw. w.w r . ~ ~ ~ areurr ws a no ~ o~~ ww.. nc. ~ vee+~ ~ 7w. ~ ~ CE~TMKAt1ON- ~wM M~ ~fV M~ ~W ~~rb+My Mr:M~ Y~! OM ~/a0 ~ M DE,~:'OCCYttF wMM, ~w0, PO M Ysi ~ ! rNrsiuur: To 7 y'/~ w r, i.o.uou, ora ~ ~mwt~ we f ~ ~ 71l ~ / ~ ~f1~ ~ ~ / IH. ( !N. , M ~o iwe ursen~ swu. ~ tb Ncuus rw+ CfsTIflGi~ON-MEDiCJ?t Ex~~w~f~ OR ER: w rw wa w ar wws a w.r nn ~aeea.n .ru r~o.wrce~ ~eu ~ ~urM~wOM p M W~~ uO/W ln~ MvISt~W.tOM. w~n O~MW~+, rOM~M Mt ~ly MOn~ _ Ot~M OM M M N~ 10 N! 4YMW N~R~. µ rn M t7~ S~GNA E Q p~ AT D ~ ~ ~ ~ n. ~ tH. ~ ~ MARfM3 i/Iff s ~ w ~.r_~. ..o. ~ `...Q~ ~ Cr? ~ a ~ WRIAI. T101A. ~MOrAI t1t O! CREIiMiORr-NM~f IOCAi10N an o~ ~o~rw w„ ~ ~ ~VK~~ CYemation ~.r t. :'ierce Crer~ator Ft. Pierce Florida ~ OwTE ~ • ~ fUNElI1t MOME-ftAw~E MA ADD~ESS ~ s~uer o~ no., tm o~ to~w, w•n. tN ~ ~ ~ w July ~,'~9~4 „~yates ;~uneral t;ore Inc. PO Box 77~n~tryeDPierce Fla. ~ x ~ Y. 5. f612 - F REG4 srG+uTU~f ~ i9~o ~ n. ~i,f ~_.n.c~ J • !.~/.~i~'. :a July 2~, ~3 ~ ~ - • ~ ~ ~ " f 1LE~ ' ti ~~0?1MtY L ~ ~ - , . - _ ? st ~G ov~T , C ~}~y owtify thb ro b~ s trw and cornct aopy af th~ Loce1 ~.~F~ ~~~~~F'~ ~ R~gi~tr~rs reoord on file in 1M St. Lucie Counry H~elth OMart~EC~' ~u rrr~nt at fort Pi~rca. Florida. ~ O"~ « ~ (yy~ning: Not vslid unlets raised ieal of ths St. Luci~ ' , `~3~' I~~d,~ : County Heahh Oepartment is affix~d.) ~'~y YOl~ ~y ~ _ : ~'8 _ f- ~ . r ~ . '7'713 ~ ` s f ~ P ~~y~~ / . i ~ i'. ~ i "r ; ~ N. D. MIIIER, M. D. ,4` ~ , . . ~ ~ . : ~ ; 'County"Hwlth Offiur 3 lix~al R~Qittru F~ - : r .J ~ t . ~ ' , o ~ :,.~sLi.~'• - 7 - , 7 ~ . ' ~ ~.~n ~ i , ~3 a~ ~A6~~ R~OISttAr _r ~ ' ` = t ~f ~ f' , ~'-f ~f , - ~ ~ ~z ~ BOOK~VV PALE ~ r,~ . ~ - _ - ~ ~ . ~ . _ . , W~.~