Loading...
HomeMy WebLinkAbout1838 t i 1 i ~ - , . . ' ~ / - f lE A~~ R , ALACHUA COUNTY~~, HEALTH D a T 29 - e~a a. w. ROtJRTM AV6NU6 CLERk C~*"•CUIi M ~~~0 ' ~ ItFCQ~D vER~FiED _ GAINESVILLE. FL.ORI~A 32 01 Walter E. Murphree, M.D. ~ u~~~~ X D~RECTOR ~aJS~ I O ' TQLEPHONE ~7e-Sl21 P. O. BQX tl27 ~ - CERTtFiCATE OF DEATH ~ Dep.rt.enl d 11e~ItL ..a ReL.W1n.N.. Sa.~oa s~rwTe nu llo. o~.moiv c~ r~a~TM F L O R I D A t~~E. OR ?tl?~R IN ~M~°"~~°71O R[GISTIIAR•t HO. ?ERMAN[NT iNK ~_N~ . rusi r~oae us~ ~x DATE OF OEA1N 1 roMtw, Owt, ~u~ ~ SFE KJ1~Of00t f0t - ' ~z~"~'~ 6EN HAROLD KEENEY Male 1 June 1 1 RAtE .nKn, ne6w. .,~uc.M wou.~, wGE-usr w~a~ ~.ue won i w~ DATE OF i~TM ~ rwn~w. M~. COiJNT11 OF OEwTH ex. ~ s?ecw+? ~~w~s.• ~.e~~s~ ..os_ w~s wows +..t 'w ~ ~ White s. 60 k. ~ June 10 1 11 Alachua 1 I~~ OwN. OR lOG? OEA11i wsre un ~.nn FqSMUI OR OiN6t NSttM - ~~s-.or w tme~, an~ anee~ ..e wwra ? sn~s, ns w ~+o n. Gatnesville Yes ~.Shands Teachin Hos ital STATE OF t~tTM ~ M wor a+ v.s.~.. «u~e UT1ZR~ Of Mrt1A1 COUrAR1? MARlIED. t~ER MARRIE~.. . SU~vNlIG SrOtlSE ~r vrw. owe r~ow ~«re ~ ~~+.~~es~M« ~ Oklahomd ~nited States Marri~~ed ~~~A~ Fra~ces Lough .~en oewue SOGAt SENRIri MJMlE~ USUwt OCClMwT10N ~a~.a cra a.on oo~n awwa .~oa a KN~ OF MJSsrE55 OR Ir+W7Sitr U~'FD. 11 M~1M MO~M6 UR. Mw a tlMf01 ' OCCVtttO M 440-0 -4 Labore r 011 f i e l ds .~une»u a+o.e w.s~« c~,r ~.r+s sntEET ANo <o.uss~o.._ REyDENCE-STATE COIMtIf Ufr. T~WN. OR tOU1WH ~ ~ y~c++ *es o~ w ~•.Florida ~e. St tucie ~k- Ft Pierce ~a. Yes w214 North 4Ath Street ~ fAT1#R-NMef n~st ~ rmae ~ ua MO7ME~-MA10EN NAME ~rst~ r~oa! usr . ~s Jack Keene Mar Walls ~ ~"~o"'"""t- ~ed i ~?~?a~ ~?o~~u ~smn w a.ra..q., cw? o~ +o.n+, u.n, ir~ 326ot 6 ~~~rfh. ,nShands Teachin Nos ital Gainesville Floridaµ - 4 vun oewt?~ wns tY: (ENtER ONtr O?~E UVSE ~ER~IwE FOR k~. (Sb ~ kA .m.eeM oMU..w e~.m 1~ ~ ~rMOUR GYSE s•?Cardiac arrest • ~ A - CONOITIOMf. 1~ ~M, O ~ r H ~ rM1~.M 0~~~ ~1~~ 1~ ~r . IrrtO/~f! C~YSt ~M, ~ ~O. pr: . S~AfIM6 TM~ YNO!!~ - ' ~ttIMO C~YS! l~fT . - ~ ~ ~ ?AR~ OiMER S~Gr11FKAM COlIOITWMS: ewanws towawu~na ~o eewM art ror ~ne ro twse oweu a. ru~ ~ wi AVIOK~ M rES rtet n~awof toM- _ ~.ES w no~ a oew°rw anuurn+o uws~ . Oid Histo asmos s - ~ ~~1~~ 0~1lNO~TER~MwE ~ ~ rw*n, w~, n~~ ~ MOW IWVl~ OCCURREC ~ tiwea wtu~e or nuun ~w r~n ~ w?ur n, a~r ~ ~Ys - ~ 1R. M. 2U. IN1VR1f AT wO~x IIALE OF NJtR~' No.r, r~.., sr~m, rwcrm. tOCAi10N ~ snet+ p u.~. Mo.. emr o~ a~+M, u.n ~ - ~ tsttrn ns w~•8 ~ wna wno., ~x. ~ sra~n ~ 7~e. ~M. ~ Ctitss+twrqN- .o..*M o.. .r.. ..o..w~ w. .w .,o us, s~. M..iNee .?ne w~ wiae .~w .~n. se oEwn~ oeeuneo .r ea .ua. a+ w •KrseeuN: T~ ra.m rr n.~e wor un~ a.w~. ~ww~ o.n, we. ~o wy ~es? n. ««:HO%'•o•'. Juns 1 1 June 11 1 1 r~ June i l 1 1:,• Dt d th ; 0 M- o TM~ L*°»°`- CERTIfKnTlON-~Kwl F%~Y~R OR CORONER: a+ *wE uHS w ne ~wu~ a oewm rne oeceoe~.r r.i r~o..wnceo ew eurwnw a ae ww ~.n/o~ ne r~+esnwno.., n. ,n or.non, - .o.ew w. nw~ ww oe~n~ oeeueno w we o~n w.ro eue ~o nr uvuw s.~no. ~ l~l rl1. Al CESTIHER-NAME ur.e w rw+n SIGNA IJRE r aeni w~nu OA SiG~+ED ~•o..a., w~, ~w~ Ma~k E.Faith M.D. r,~ • 1~ ~ ~ 6~19~7~ ~ MA0.1MCs ADDtESS-CERf~fIER strtr w~.r.o. .a. u o~ w~rM w.st ~u nr Shands Teachin Hos ital Gainesville Florida 2601 W~MI. CREMwT~ON. REMOVwI fMEtERV OR CRfMATORt~-NM~E IOG~~ON cm oe a.r. s,wn ~sntat~ zN Removul-Burial nf Ft.Pierce Cemeter Pierce Florida 4 0 OAtE r.~o..~w, wr, .eu~ FUNfU?L NWeE-?+AME MrD MORf15 ~ snen a a.r.o.~+w.. e ~ro.w, s+.n. ter~ ,y 12 1971 Bai rd Funeral Home 01 " ire C'.Ft Pierce Florida 0 v. 5. *612 fu?+ ~ ~ REWStitw , wtE , ow?t ~c ervco ar ?oewi aeisru~ R~v.19T0 ~ CL~ ia- , ~ ~ ~y : 4 ~ _ -3• ~ = j'i-, ~ ,+r?',<s~' _ _ I HEREBY CERTIFY THE ASOVE TO BE A'~~ d~~~ DEATH CERTIFICATE FILED IN THIS OFFICE. ':1 i z . - ~ • , - s ~ S i ~ ' ~ . . ~ - r~t~;~ MyrtZe ~ 2ratr?e li',! y~uty Registrar , ~.~c 1~ /q ~l _ ` (DATE) 600X~rVV PACE~C~~ ~ ~ - ` ' ,,,z ~ : r ~