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HomeMy WebLinkAbout0960 1'i I LL5'vUF20UGH COUlVT~! HEALTH DEPARTMENT ~E.~hE011 BtYD. P.O. BOX 173~ TEIEPMONE Y23-1311 TAMP,>. FLOi11DA 33G01 CERTIFIC/~l~E O~ DfATH ~1.~ .<nl rl 1! v~.! I;.~..~.~S:~atl.e tc~~ke~ ' fTATE tILC NO. - FLORIDA 2~ • RErt67RARS NO 2 usw~ ~cs~oiKCC ~¦.......~..ir.... a~.,.......•,...~,......, ~ ?~~c~ ~r o+~iN CODE NO. : ` _ . ~ • ST117( , ~ C4vrt~ ~ :i~lsbo: ou~~ 3~7-~~G : lorid1 Dade _ ~~i.n. tJ..~ G° .Ci~r.;? c. ~S ~~KC Cs Gt~TM ~ t. CIT~. TOw`~.0~ ~C{_~T:O• - e~S ~E: ~s:•.[ GT~ L-~ rSr MS~~i C~T1 li~reTS? ' • - ~ Ta.::pa .~5~ „op Hialean ,ES- ~ 1~~••~ C~ ~/J ticl ~n ~o~~.~~1. ptr ~trtN ~.Ilioi) ST~LtT aO~~ESS - ua ~~.LTuT.Q~i St.JOSe;!ii 62 r. $th ~jt`.. N181~ah F ~i•~ • 3_ - - --=-~---~4r?~..-: ~ l Ma+~c pr FuN Ni~e Lut ~ O~t[ - Mewea O~i Yea~ ~T~i`~ `~.,n~, ;-:ARIO CAt~RO ~*M Jan. 20, 1970 S SF ~ 6 C0.0R OR RJ1CE 7 M~IIR~CO ?*ErE~ WRIIQOC • OATE O~ ~~1TM 9 a~E (f~ ~tv~ ~ u~:t~ ~•G~ •.r .,.-~~;T.at_s IYfSMf~1~1~ .Vw~4 Mr N~v~ : Y.~ t:ale L:'hite .,~w« a,b,«<o Se t.20-1904 6 IJ~ LS.. ~L OLC~~O~Tr,~1 i~~J OJ~[N~ Ne~t 10~ tIHDOf ~~S:hE'aSOA 4\OUSTAY 11 •~~iNR~CE lS?afe e? prry~ eet~tr~l 1 GhI[~ 0~ w~Yt f8u~rar~ .~s,t r ~.a~~~ nk, n.~ ,,.K,,..~ Tar~pa-Fla . U. S . i.r~ch~~ i fAiMfA 5 N4ME ~T„E~ S ~ P.afael Canero Concepcion tilvarez , 1b SOCUI S(CU11~TT fq 11 /NIOAMAMT AIV/M ~ -o2~i ~ 904 2~?r. Arturo Car:ero 1206 20 oa ;~'lorida CAiISt O• C[ATN (~Ntr e4f/ ~4l t~Ylt Qhf~~1t fN Iti. (~1. 4d ~tl.~ w' O 1?~TCRr~L ~~~CL• ~ ?Allf 1 oc~rK w•s c~usto ~r• ~ ~ W4R I~MD ~~Rt~ ~ ,..ME~,~ ~.~u ' .oe€a ~a~ , . f ~ o~o v~FiF~EO _ Rft ` CoafUUS~. iJ~e~. pyE TO (Ol ~ r+l~:~ ~ut nar fe ~ - _ ss~c:t c~tilt (s1. it~~~/ t!t a1Qt~- tif TQ ~ ' 7 ! !/J :j CtSN i~UI / - = ~ MRf /1 Orw[~ S~Gwu~t,ui COtidTqwS CO~.!IUIIJt~wC TO OUtw ~U~ ~ R[UAO t0 iw( TiiruYl OSfASt Cd~0~fl0.1 CM~ M~Yt 1(~) . M~S ~4TOtSy ?[Ri Illy[0~ i ~ 1[S h0 ? - ~ri-c.su~ 7DD DESt~~K worr :s~u~r oCtuRSto (S~ra ~rwe y~~jsr~ iw P~?t 1~r P~?t 1i ylrre /~.1 . i +cc:cc+.r wK~oc ~+~rc~oc ~ U ? ? C J a.}[ TiwE Oi !/chr ~law!!, D~~, Yttl ~ uu~~r V n D- YI _ ~:JJ 1!~7uA16fCVaNCJ mt ?l4C[ Os iN/UAr Il ~A M~Nl ~iAt. ?Df C1Tr. TOMIN.OR IOCATION Cn1111T1 STAT[ wa~tC ~T ~ nOT NrrlC ~ Ww.lMN~. Mr~H. ~Jfkt 9IIf-. t![.) MJNX AT 11'~RR 2i / .70 O •nd I~st ~~s Aam ~f:~~ on -1'" - - : I ~tt~nded fh~d~e~~swd/rom _V' . to ~ / i lT~~tA w:./~~ed ~t _L-~''~~~~ ~n on fA~ d~p st~t~d ~bo.~: ~nd ro th~ b~sf oI ~nr lno~.l~d~~. /iom tA~ c~ui~s at~r~O IIO f1GMATUR[ ( ~~tt M f11(tl ~L ApO~IESS ~ ~IL. OA~E S•+AC'~ :~t., .~r~,,., I~. ~ Z:c E.c-~ ••~r~• ~ 211 Oa'[ Llt MavEO~C(~ETEA~011t11tw~T09r IJi/. IOCAT~ON~C~f/.f01[q.Mf9Y14// (J6ati~ ~ c~ ~•r .~y~ r_~;~1_ ; 4~ Jan,22,197 Fla ler t:e.^orial Dade F~ or~ da ~1 1i i:ilt' ~I' U_1 L'iFitlL ~[1VI17'J C tC RfCO. ~'I lOC4l AEy 26. REG~StY~R S S~GM~TYIIE ~ ~ ~c_~a_ C~l' . i r, 'l'lL1~G. .'1-2• 1Yf G r - i ~ ~ 3 _ ~y ~ i 3 : ;~rnl~/`.i+,~ ~ I}{GRERY CERTIFY TI{E AI30VE TO 13F, A TRUE AND CORRECT COPY t .t, ; OF TIIE tACAL REGISTR1\R' S RECORD ON FIT,E IN THE NII,LSIiOROUGH } ~ ` "r~r' .R ^ - COIJNTY I(CAT,TH DEPARTMENT AT TAMPA, FIARIDA (WARNING: N(1T ~ ~ 1~~~t~:~ ~•-•~.Jy V1lT.ID IINLESS RATSED SEAL OF TH£ HILLSBOROUGH COUNTY NEALTH _ . ' ~ : - • , • - . ' ~ UEPARTMENT IS AFFI~F.ifj` , ~ ~ . : ~4'~. : ' ~ R ~ ~ _ ~ ~ % . . ^ ~ ~ ~?.31 r~ 9B0 - . - . ~ ' ~ i~` " ' ` John S. Neill, M.U., .P.i{:, ireci~~r _ • = ST.l1?.,.i :Ga . = ~ •~i. _ C~u~nty llealth Officer & T,ocal R~gistrar i ~ ~ ~ T+r ~ ` , ~l L 19 ?974 ' l~ A - T~ r j,~, L' i'•' ; _ , . . ~ : DEYITTY kEG RAR N ~ =~s= : ~ _