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STATE OF FLORIDA v 5i ~'T~ ,
288133 ~8133 ~
COUNTY OF ST. LUCIE !
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Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County
Commissioners of St. Lu~ie County, Florida, claims a lien in the
amount of ~e Hundred Forty-four and 32/100
144.32 ) Dollars.against any real or personal property ~
or interest therein presently held or after acquired by
4 „F 1411. No. 25th St. , Fort Pierce, Florida
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(Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of said Indignet or Recipient
of welfare assistance, as follows:
Hospital- Fort Pierce Memorial
Date Admitted- 3/_26/74
Date Discharged: 3/28/~4
Number of Days: 2 at $ 72.16 per day = $ 144.32
` Less Credits None
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~ Amount of Lien $ 144.32
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Dated at Fort Pierce, Florida, this ~i~ ~ day of
July ~ 19 74
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(Signa re) • -
~ County Attorney
(Title)
r.~ Si~0~1 to and svbscribed before me
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t'r:is ~y ~li day of . ls~
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X
tiotar}~ Publi.: S~ate of Florida Large •
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~ M~.• Co.:ur.ission Expires ~ ~ . . . .
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„y:-.T \:AS PREPARE~ BY i~L•^ '
'•S lNS~R' ~ ' , . _
a~'~ RALPH B. W~~`~~• ST. LUGtE COUNTY •w ~..t..'•~ - n
~ G(9URTHOJSE. FT. PtERGE. FLORIDA , C• ,f BOOK~~ PAGE V~~
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