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Home My WebLink About2304 i r / ~I ~93?,~4 ~ r~i.• y nwTS ~owRO or arw~r+ CERTIFICATE OF DEATH .eo... . w~iwu oR vtTn~. ~rwr~nc~ ~rwn aut na ~ - ~~s~~ r~e- FLO$IDA II~.., •r~ •~~w SIR N. R[GI A11•• NO. ~~~~~~lr Coos N0. L USUAL RESIOBNCft Ias+~raw+M+.l uWt~~w~n~~+K"' •:~e~t~~ 1. PLACE OF DF.~1TH ~ ~A~ ~ .,~1 counn L lorida St. Lu~e ~i.~.~ i. c~rr ~u .r.w a..«n. ww. ..w sux.ia c. lEl+am oF e. cm a.M.r...,.w u.w. ..w aoa,?w . . .....t ot sT~trc~~.uww ~ Ft. Pierae rii.. towN d W ll NAME Of lu w~ 1~ Mrrw1 ~r M.tu~1w dn ~tnK Mh+w ~ YwMN 1. ~ t! wd. tlw M~MMtl HOS1iTAl OR iNSTITYTION 7. NAME OR (~i*~l) 1. l1lMi1~) •(Lrt) L DAii (1hat1) iDal) (l~ar) ~ oecews~ ~ Saunder ~?n+ Dea. 20-1 ~ ~c - ca.oa oa uu ~u?~R~En. N~?Ee wuwc~. a?n of aarn ~i ~ ~,i ' n;.. a"~:."•••~i~: wioowEC. arro~u «.da~ t 06 ' •iwl~ IM. ItSUALOOCU?AiION~O:w ud d wt IM~. KIND OF WSINEf! OR Ili~ 'Ih 31t1~IKACi ppM ~r 1~~M wnqt IL GTIZH! OfVYMAT • i t~~~ r- `r i~ert ~rt d w~w M~w wr ~t wuwil ' OYMY ~QIjNT~Y1 ' ¦aw~~t ti@ BVeII F''la• U:3A - 11~ek l~t ~W~ N. NOTHEI's IWpfiN NAY~ . tn~~eft~~ ' ~s, wns eccewsEO iN u. s.~u?~r~o Fo~c soc~~ stcuRmr u. uaou~n s~au?~use J.w. Yates ' ; ! ' 1lM. r. ~r wt..wt Iu 7~. MN wr ~r 4w d w~in) ' NO. , AD~tESf 8. ~ r+.•r•~ n. u?usE oF oEwrn MEDICAL CERTtFICATION w~rr~~wv~w.qap.w~w e l r~ e te r Lts ~ab Me a 1. DISEASE O! CONDITION ti 11 j ~~8 ~ •~~t ttl• !a 1~ ~(~1• t?)• ~~~~Y tfADING t0 OE/1TH'~~ ' from breast ; euie.s• ~ • f t ~ t?~ 'tl~r. J«..~ sw~ Y~~ u~. ~;,;y~E TO ~ 1• s w 1 !b w~ia N~1. riM b W aMN e~s (s! ~F ~ r~si~trar ~d u Aw! J~n. ~ ~ ~ ~ a~tJl..fa, ~ts. It +~n.~ DUE TO c Ht~U 1• W Ji1Mwl, (s~~M. ~err• •f- ~~~~1Il~ 11. OTHE~ SIGNIFICANT CONDIiIONi s•. a.aer e.w8et.w~ e..erihb.t a es. /~.U? lre..e l~f~r• tai t~ t4 ~iaea~e wa~iti~w [~stl. ¦~ktos ~w~ Na. DAiE OF O~ERA• Iri- MAJO! FINDIN6S Of O/E~AiION ~ AUTOKYl . ~ A~ TIOM . ~u ? no ? ~ ~ •t ii'r~MWI tM~s) 210. ?LACE OF INJUIY (at.1~K~wt Zic. (GiYOtTOWN IOOYNiY) 1nA~) ZI~. ACtIDO~7 Mw• fY~• t~epq. Me'at. ~V6. M'/ I~ l~~l. ~br ~Qf?Ll ~ sv~e~oe lla. TI?AE l~U tDq/ tTw~ ~swr? 11~. INJURY OGCUt~FD t H O Y R OF r~~u ~i wT ~N~u INJUtr ~ ~o~c ? ~itoa[ ? ti. I Aenby certiJY that t au slu dcuased /rom 19~:,io lleC.2~ ID~ tAol 1 last aoa lAs dtuosed ; •11 i e'¦. rt[ive nw ~eC . 2019 ~med ll~n~ deall? oceurrtd ot - m. ~~a wd ow eke da~s ieatcd abo~~e. : •r• t• 1~ SIGNATURE (Desrw-~r ttt)e) '1~b. ADORESS rie. DwTESt6N~D ~ ~ 08 S. 6th. St. Ft. Pie el2 20 I} •ae~r~e~. Richard F• $~Z1210tt 1~.D. Na. ~ U R 1 A L. CIEMA- M. D~?TE l~c. N~?ME OF CEMETEir OR CREMATOIY iW. lOCd1T10N (QtT t~w~. K«otf) t8tst~) . T1°~~~}"jid41 Dec. 21, 1 54 Ft. Pierce Ceme ery Ft. Pierce, Fle. GATi RECO ~Y IOCA~ ttGIiTRAI'f S16NATURE tf. WNEML DItECfOR'f tIGNAi11~E 12-21-5 Anna Lee Denison, s. . Joseph w. Yates, F~. Pierce, Fla. t , ; . ~ f t~EO Ateh RECOR4E9 -y~'' ' : ~ . -..r - ~ lUC1E ~OUMTT FU. ,..uu, L~ ' . ROGEa ~p1TAAS ' , : _ ~ 1 hK+b1r a~~Y M?N a b. ~ Kw and co~r.a ooPY of th. Lou~nERQ Ci.~'~11iT COURT ~o` Y~\~1~~~I~/f y•-. fil~ In 11N 51. L~Kit Go~~r?1Y Fi~alfh D~(11R1C..Ra ~;=:1=lED ^-ti`~ -''~Y :~oV ~~.:.t , ~ Rpiftrers r~ootd Flaids. ' ' . ' ~ ~ ,,,«,t ~ ~ P~.~«. M t . t~^. ~ - ' r . ' ~ f~,. Oc~r 10 I 4s P ~ r~-: ~ ` ~ (yyKninq: Not v~1id unles: raised wa o ~ ~ 'R= :a. 1`~ a is aifizd.) ~ ~nfi, Hs~lrh Ospsn^"s~'t . ~ ~i ~i~'';~l'~! f~''~y N. o. MIIIER. N?. o. 2~3~,,4 o~... ~:1 ~ . ~ Ith Officsr 6 Local Ntr~ _ -~~~A1}~l~ . ± ~ , ? ~1 ,i~ ^ . . ~i-.~ ~ , . , p~pulr Lot~l R~o~3trK . , ~ ~1 . 600K ~J~ f'AGi ~O~ - ~ - - . _ . _ - . . . ~ ~ , , : } ~ - . . ~ ~~..n - ~`r~~~~~~ ~ _ _ = z ~,K r ~{y ~„'S,~ 4 ~ i ~ S ~s,~ . _ . . ,w''~,,. r.~ " ...o... .