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Home My WebLink About1772 / 2`~~8~3 ~ ; ' ~ OH10 DEP'ARTMENT OF :ALTH + Aelt• Di~t !W+ _ • Sute Fik No. ~ - DIVISION OF VITAL STATISTICS ~ ~ Pr~e~?~;Zs{. lb•~ I~o ~ ~ ~ Rcpxnr's No. ~ ~ - _ CERTIPICATE OF DEATH ~E ' NA E ti~+~ • Milu~ l.ir SEX DATE OF DEATH ~.N.~t1~, fa.~. Y•.. • a' ~ ~ t • JOhn B a rne ~ • ; : _ ^r' - «.r.~ .e ~:c.s AGE- t.,r uNoc• ~ TEAf uaaEe ~ o~. OAIE OF NfiN rn~•.e~, w~. COUNTY OF DEATN r o ~ ,f ~ n ~ . ~:.~t,~ ~ . ,i r'...~ ~ .H~i. p~ri H~rri M;s. ~ • ~.~~r y . . - . K ~ : . s.. s. k. e 1 1 Lake ~ ~,+~l. ~TY~;YIllAOl.iOR l..9q O/ DEATN INS~DE Cli~ UMIiS MOS~~UI O! OiNEt INSiliUT10H-NAMf (1/ Nf r~ til~t~. tin lh~d ~af ~a~Lt~/ ~ ' IS~f[li> >H M NI i ie~~ - . • :.'j _ ~ i. • . , 7~ 6 S 7~ ~ n`' :,~,Y Os ~1~ U.S.A., r.s~ dtiZEH Or wMwt CouNTer MAtf~FO, NEVEt rwtl~EO. SY~VWING S/OUSE /ff ~1~. s„'~ r.il~. ~.s~~ + 3- ~ ~ ~ r•. W~OOWEO, DIVOt FO /Str[i/)1 ~ ~ r ~ ~~~,~4~:~ T'• ~o. Married Na h Ha er - t~ f; wAS CECEASED EvEt ~N Y. S. AWEO fOKE51 t, YY~ 1' _ J IYIb N. r~~K~r~1 /1J ~tt. Lr~~ wI N~tq ~!?si111 • T~, ~ 1 . ~~s. Y99 • ~ f4irt ti~I ~l r~?! l~~t /rriAt w~u I(IrtO Or WSINESS O~ !MOl131lY . t. i1 rHndl ~~s. 6 g 1'~~ 9 . , '•-i Wire Lrawer .l_-~ ~-~ric Co ~ `~~1ATE COUNTT Clit, YItIAGE OR IOCJ~TION INSIOE CITT lIM1iS SiREfI ANO NUM~Ff + y~ , IS~tsiJ7 lt~ N N1 ^ ' "~pp ~a. C211 O ub. 8jC6 Ou h ~~e. ia.. • • " ~ • ~ iA1ME~--NAME ti?~~ Mifl/t Lie YOiNE!-MAIDEN NAME lir~! Mi11/t ~ ~s ohn ~ ,~rll~~;f ~ ~ INFORMANT--NAME YAlllllU AIN~~I ~1 i~~r~~i ItJ.N. .ur ~r .l!/.~~. u+~•, .~t~ ~ . ~ ~ r~.. H T~~~ ~ ~n. ' ( ~1• _ ~ • ~ , ~ ' ~~,...1~1... I' , ~ - - - ?~r•ri r~~ ~ .i r~n ~ DEATM WA USE~ BYL ~~Niff ~x~ir unr ~su~~ nr i1Nf r~~ 1t•~. ~i~u ~t~w~~~. •...;~.i ~i•,. - - - - . ~ y_. ~ _ • :~c < < C :u.~~k~~, ~ ~ ~1_.~,..,1,~-,f. _ • ~ , „ ^ • ~ ' ' IMJME~IA?E CAUSE • . DUE IO. O A ~ COnStOUFH(! O~ ) ( , ~ ~ ' ~ e.J.rio... .l ~ _ ~ ~ ~~l ` 4 ~ C~ c~v~ ti.t ; , . rFuF rar~ rn• i~ 10l a ~ • t. . 1 ___-1_ - .n~r/~~~r.+r.~ r~~, pVE i0. OhAS//~ CONSEQYI~~E Oi~ / ~ ` • ~ ~NIi~R fb• rdn• - _ . t ! ~ C~A/1 1 ~ 1 - l~i~t [~r~~ /01 ~ ~i ~ L ~ ~ f • ~ ~~AfT O~ ! SIO~i~i1CANT CONOIi1pNS~ ~/Ji~ri r ur~~rti~~ to /t b hr ~~t ?~f~td t~ r~ru prt~ a~ ?~rt I f~i Au~OKr ~i /ES rtr/ pJ~~p .o+.rr~... ~ ~ . ,Yti ~r r~ 1Htr~r~r~~ cme t...t. J i.( t~ ~ L .~1.?~~_` ~ro_ ~ ~n. • ~CGDENf. SUKtDE. M(N`tKiDE OA/E Oi INWtY NOU~ MOW INIUlY OCWRRE~ IE~tn wtwt nprr~ i~ ?~?f i~r ?~rt !l. ~t~r Ih. -r-~ R~ OR YNDEiEfMIh7E0 (S?~ri~71 I~M~~t~• D~7• Y~~s~ a` ~ ~pp ?Oc_ K :?i ~ ~ - m ~NNlY AT WO~R ruCE of eatu~i .U be.~. /n.~. in•.r. 1•n~. ~~nOr ISne~r R.F.D. ca~ w rill.se. iw~. s~~l c• ~ h fSl~rilf )n sr M? e9icr N/s.. eu. ISp~il1! ~ . 4. H ~ ~ - CEfi~~ICATION- - .Ne~lb U~1 Y~n Newtb Dn n?~O IAS~ SAW NIM/MEt 1 DIO/DID NOT DEwiM OCWRREO L Ibr 1/ir. ' ~l1131CIAN ? AL~vE O?~ VIEW TNE WOY (M~HtI ~b~ J+te ~ra j t ATIENOEO iME ~Y /{J 17t0 l'~ ~ JM~~tb Dn )~tn AFTE! OEATN. ~ ~br b~~r o. w ~~ordrlst. ~r~ , 71s CECEASEO flOr ~ ~IS ~ 71c f ~ ~ ~ tU_ ~ ~ ~`'v /y JI~. ( . M. ~br uwtf+l ~l+tt~ CEti~l~tAt~ON -COtOnE! (l~ !bt b+~i~ el /~'t ~i~~iiutie~ ller• J~tlb T`f I!L/I/I/ YIl'1111~Af/~ IfIJ E ~I fbr ~rs/f ~~%or flrt ~~rafisd~~s. i~ ~ y~~iow. le.rb ~ .M~wtb D~~ Y~s N~r~ ! o~rrrrt/ o~ ~b~ l~tr ~d /~i f~ !ie [ou~i/ udel. ~ ~~o. j ~ ~z°- / CEliII~E!-HAMf fT ~?t N p•istt S~QN~ URf D tt ~r tftlt ~AiE S~GNfD ~ Heni~yr A. Gim~:erman ~~r~ j* ~y ~/u"~_. ~ ~ . ~ , ~ . ~ WIU?+G AODtESS--C=e'~/1 SL~t O~ R i O r+4 \ U+• Ot v~llAGf SiAiF I~? i j~~~l~ ;,,1..•~. t - `l~~ C'~' ~ „a W~IA: C~kMAi1pN: DAtf NAME CEMFTEl~ Ot CfEMATOt11 ` IOCATION II n~, rilb~r. ~r .~r~l~: ~ S/N~ ~ .~,...,n, ~ • ' ~1-- ~ - AlleEher~v~o. ~'e~ _ ~.~urlal~7•• 11,[?6~73 orP ~olis C~mc, ter _ _ . HAME O? Er+~AIMEf IUf NO 1 - uNE~A~ ~~t S AiUtE IUC ~ ,s John n. VPU an ~jO;=~A_ ;7. _ _~10 f1lHERAI i1t1M A?q AOOff55 ISTRfEI NO 1 Gt+~ ISiAfk~ :l~? „ Lsvls ~'unerrl Iiome i~154 Clark Ave.~ r+lll~u *,h~ by Ohi~ 0~~~ DAiI ~FCO ~EGISf Af~3 SiGNAiYfE ~ y~_ ~ 'OI~TE tEfM~i ~SSU ~i , y~ O~ _~SOM ~S_i1`~.~ / ' OISt Nfi ~ TI v ~ . ~ ~~u~ s i i ~ ~ ' ~o. 7.~i , ~r . .r • ~ ' » , : ~ 2y~8~3 ~•~aGER~3i ~ A~ o~Ra vEn fif8 a4c~ ~ ~ i 8 u ~1'~~ FEE, PARKER ~ FEE, P. fR. - ATTORNEYS AT LAW POST OFFICE BOX f000 FOFtT PIERCE. FLORIDA 33430 ~Ot1r ~ un TELEPMONE:13051461-5020 - , - ~ s~•~ ~ ~ ~ ~ s,~~ . ~ ~r: . ~.~c:=~. z.