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HomeMy WebLinkAbout1692 - _ . 288'734 t~ ~ . ~ SARASO'1' A COUNT Y HE ALTH P. o. ~X 2658 ~ D E p A R T M E N T 1938 I,aurel Street . Sarasota, Fla. Telephone 955-8101 - CERTIFICATE OF' DEATH - 1ky~~ d H~~1~6 a.d R~6~la.u.e SK.~, STATE fiLe rca F L O R I D A REGISTRAR"J HO. ~?LNI Y AfY Ra/wO tv~E, O• ~R~Nf IN ~.,pnrw, o•~, tta~~ iI1MAH~MT ITlK ~~~~E pyt r~ooa~ utt $~X owre vf o~wrn SfE X1~100t IOl ~~ST:~R~,~ , ~ ~s srxa~c Fas~r~ ~ ~~axcx 4 i 4 RACE .wre. ..ww.••K~ca~ a.«w. AGE-us~ w~oe~ ~.w w~oe~ ~ w• DAiE OF ~etM ~.oww. s.~. COlArTY OF OEAiN M~M0~7 ~ Tf/1~51 r01 O?~'f NOI{t3 rM. ~ ~Q . a !K- 1 f~lC1I11 • oy ~QV ~ ~ QO NHI'1'S s~ 86 s~ s~ r.. U CrtY. TOWN. O! IOCwTWN OF DEwTH ~.swe cm awws HOSMiAI OR Oi11ft NSi1TUT10N-w.wE ~r wor u~ un.e~, ene sne+.w .w+se~ ~ Q sreeu+ ~es o~ .w n. Vb~ICE YE5 HII~I,NAVI~'11 Ul~ V'r'.~i C^r. r. ~ r+c srousE 1 v.tir., oi.....~ob. ~ STATE Of MRiN 1 M MOT M Y.!-a.. NuY QIIZ@1 ~ WMAT ~011t'~~r AIAIIRIf~. !'1EV~ MA~O~ ~ry ~m~ MIIOOWEO. DIVORCEO f YKIRI a:w~ i1soHK[ ~i11Q f. V A N. ~ t{. ~ »e.e o:casee ~NatY +RMyER USW?t OCQlPAi~ON ~e.+e arw o~ .ro~i oow ou+wo rou a KMO OF tUSwfSS OA tr10uSTltY { . eo ot~r. rro~ewo uh, evw r ~nu~ ~ oc.ue~to w • .~p rr~~ 1~?F ~~s.:~,ny..awt 12 Gv 1!a CJurc.nv~ :e uoe+ct a~o~e GIT1I. TOWN. Oi! lOGT10N wsw e.n ?wf SttFfT d~b :_~ssw•.. RESwE~-sr~rE eou~rt'r vE`li IC~' ~snw..eso.wo p ~ 1N. 1' liuniiMF- IA. ~A 1k IN. IN ~v ~p~ 4it M0111E~~AIApfN NA1Nf MlSt W00~~ 4Y fAD~ER-NA+rf r~n~ ~ ' 3 ' ~'Q6T$B JUL , i tf. ID~~ w?RWG AOO~ESS ~s~we* o~ ~~.n. ~.o., an a~o~n.. suw. a?i - ~ 1 fYORW Wi-MAME _ ~ ~ th ~ ~~iYii[i 17~. ~8 r , ~ (ev~e o+~r or,~ uusE ?H uN[ ro~ ~oi ry~ ~ rwm oEwrn wws cwusFO sr. . a+o ~~x ~l~111ElM OMfI~ ~MO N1~ ~ n. .reo.. uuu ~ / - 2 ~~y; ~ W N1 , ~ ~ ~ ~ coMSVwws. •.n, ~t/ ww~ew a~re ~ue ro lr1 S ~ Ir~lM~T! C~~3! lal, ro q y~~pN + ' S~~TIM6 1M! VMO~F - . S 171M6 CAYSf t~7t i - A1ffCKY tf YES .r~~e nww..aa ea, 's's ?ART 0T11ER SIGMIfK/WT CONO~fl01+Se ea+aao~s easww~wo ro w.w~ ~n wo~ ~eurt~ w uwe a.eM ?.~r ~ w i res o~ Mo? soos u. a~es+~w.a ~au pr pe~rw ~ r~ 1'~', ' r ~k! 11~. N~. " 7i t M t A ~ rOw eo~~, ~t~u ~ HOW INIUlY OCCUltEO ~ wna wnNt or wwrn w?u~ ~ O~ ~us w, ~w u~ 3 ~ ~ nG IqM OR {RO~tERMYlEO. . 4 . ~ r.y ~ ~ !w 1~. M. lY. f ~ MACE Of In1Wr•~ Mor, r•w, sren, r~cw~r. LOUiIOa ~ sneer a e.r.e. ~o.. o*r o> >o~, u.n ~ ; ~ ~ - IN1U~ AT WORK r ~ - ~ s?~on res o~ ra ~ omct roa.. i~e ~ s.a~n ~ ~ , ~u ~-~e C> 7M. = M- }(1 y c;/~ 1fC3 CER~1/KATIO~'~~ ~M ~y ~~M O~7 ~W /1M0 LLtt Sl~v/ MW/w~l~ ~Mr! OM 1 MOI tM A1! M~TM OCCYlflO *M! ~IKt• OM D~! ~ . rWtf~ O~~ RV ~OO* wtN. tMqN~ e•tf. uA. ~O s! N ~ ~ I~ H? ~ ?M/S1CIwN: TO ~ _7 V or r~ awo.aeou. e? s•a 1 AiilMOtO M~ ? G _ J~ 3 ~ 7~ 3 ~ ? r~a. n._ x.o ~ - na ofce.xo ..o.. .~Ci - Q rwe oaceoe»r .I.s rao..oir.ees .uo - ~ tERTtfIUTldt~-MEO~G?l E7cAMwEft OR CORONEt a. rne ~.s.s a n~ wow a awm ,b,~t„ w~ n.~ wu+ ~ tt~rw~n0» W M! qo~ uq/O* tM wvestr..~no++. w r~ orrwp+. ~ pVTM pp~y~yp OM wE OaR uA OY! i0 iwt 4Vf[tH futt0. A1 tl~. ~ SK~aNAT~l~ N p f~Rt ~A Sl~sf'l~0 IuOnIM. M7~TW~~ CEA11R.'t-NAME ~me oa ?swn ~ J . . 1[7~~ ~s~ l1A • d w 3 " S ~ ~ ~ rn. C1~U ~'v f1. ~i`t ~ii~itc.~.- ~ ~ - ~ ~ . o.....o. ..o ~ ~ ~ cER ~ f l3 •(/~!j ~ER o. ~ s rC~ r F/ 33'J~~ ~ EMEiE~! OR Citf/MATORT-NM+~E lOGt10N an o~ ro.~. s*.n WRIAt. CREMATION, ~EMOw~?l _ ~ s~KMr ~ . eu~u?L c~ Pn~es ~caa~ ~?a~c F ~ DATE ~..o~+*w, wr..w~ fUNERAI HOME-NMRE wM~ ADORESS t srun o~ ~.~.e. wo., cm o~ ro~+'., frwtr. nr~ ; ~ - ;.~ne MA~~ 197a n.E'~ING FUNERAL HOP'.Fr-140 E. YE~YI~ AY~NU"ae-YE~tICE FLO~ ; OR-S7GNAIURf RFGISf R-51GN~NtE OwTE RKE~rEO ~1 1~4t 1tG Stx~t ~ S~.i~i2 Eiwb • / ~ ~ _ -(0-7' ~ na r.~:G.i.'}~ . tifA~ t~ i~r!/ ~ ' . . . ~ . ~ _T ~ _ ' y~' ~ : .a_ ~ ~ A CERTIF7ED C MQST CARRY TFIE F.MHaSSED SEAL OF Tf~ REGISTRAR OF VITAL STATZSTICS.~, a ~ ; . ~'~1ed copy of a Death Record on file in the Office of the Local Registtai~;~~ ta. Florida. _ ~ .n = ~ .:T-`,-~~.~;;."~: o R 230 PacE1691 - _ - BOOK ~ ~ i - ; : l1 ~ ~ ~i12A Qd ~~0~~(.CG7/i.~~/ REGISTRAR , P_A'F^r. DEPUTY ~ - - - - . ~.t: - ~ ~ . . . . . . _ t~~' _ ,