Loading...
HomeMy WebLinkAbout2180 z~s3~s RE; Lots 9, 10 and 11, Block 3 of PINBHURST, a subdivision ~ according to a plat thereof recorded in Plat Book 6, page ~ 9 of the public records of St. Lucie County, Florida. ~ . , . ~DADE COUNTY. . ' . ' . , ~ ~ DEPARTDd~NT OF PUBLIC HEALTH MILTON S. SASLAM, MO. MPM, ~ _ lZ~. i~s0 N. W. FOURTEENTH sTREaT p~qECTOR : . ~ _ " MIAMI~ FLORIDA 5312:f • - - ~ ~ - • ~ I HSREB~~~Ir!'IFY '14iIS TO BE A TRIIS COPY QF TH8 I~tX'AL I~GISTRAR•S RECORD OF DBATEi. ~ ' T~M3tlAQ ' ING: ~ ~ - ~ ~ valid unless the raised seal DSPUTY ~GIS ; "=r'~''' ~ ' ~ VITAL RSCORDS UNIT ~~#w ':l~a~ • - '1 e Bureau of Vital Statistics ti ~c ixed. ) OADB COi~1TY HBAL~i D~~l~RTt~t~1T ' ~~''~~j - I+lIAMI FIARID~A ~ 1•:f~ ~ 'L'ic:'i~.t ` . _ ~ I tt • ~ 1. ~ ~.G':r ~ ~ A '3''}~• ja~s..~ T : ~ •~~U1~t+~:i~.~~~ ~~"'fi'= . !1~ ~~'1~: -i ~ t 9~,~.F ~ ~ ~~E2TIFICATE OF DEATH I)rparirntnt ~t a~. . F L O R I D A aTAT[ FILR NO. ^ I~+'~^~-~-_'_~` ` pEGISTRAR•S NO. ~14~~ , ECE~ SfD-NAME ' - _ a~ • . ..~oeu ~~s~ SEX DAiE Of OEAlT/ ~ ro.rtw. wr. ~eu ~ ' ~ ~ i A~RIL 11 1973 e_~E ..~~tt, r~fGe'J. ~rE~K~M u~D1~M, wGE-ust u~we~ uwe~ ~ w~ OF . w?. COIINir OF DEwTH . . irec~s. ~ Nmio~r ~*tw~s~ ros. wrs ~aws .w nu~ . ` _ _SY.~Z'E.- A A. k. • ~ i~. . ~~~~Q~' ~ r, pwri. O~ IOCATION Of OEATN wsroe cm ~r.m MOSMTAt OR Oil~ NSi1M10N-N~f IM ~Ot fN t1Mtt, 4n~! Shct1 ~~O MIiYlf 1 ~ 1: JU Y f - s.ecu..es o~ Ko St. ~UC _n:FRAS ~ ~ ~ InN ~o~~r r ~;7 COURt S~~rF OF 6ikiN ~ u ror ~N u.s ~~rt UTIZB~ OF M~MAT COUNTRY MARlIfD. NEVER MIARRIE~. ' StlRVIVNG SrOUSE 1 N vME. GnF r~0[M M~rf / co~n+m ~ wIDOwED. DIViORCED ~ s~tcr~ i ~tF Ct~ =t.: V: ~ i' 7~ 1 ~ ai s~ECB Tv~ R USU/LL OC A ION ~wrt cwo w wec oow oun.~c rosl w KWD Oi~~ T~ ' i'~ ~ •r~c.+~ ~ue, evew u nmw ~ I~I 413r1Q-Z3 ~y ~s. T DEhCE-SiAfE GOIiNTY CIT1r. TOWN. OR IOCATION wsro[ tm tr~ts STtEET AHD N11M~ER . i{ T ~w ST. LUCIE ~k a~, ~S~ ~u ~k s ~:e-..cq_ r~~ME r~ar rwat usi MO~MER-MAIOENNM~E r~es~ .~oou i?sr ~ Unobtainable (Unobtainable) ~ i~.~:/µ1ANT-N/1ME INgO FR~M vA "~ss ISittli p~ t.l0. MO. CKT d iOrw, St~~l. IDI . . . in 1 S FLA 3125 ' ; , ....o.~ ~ OEATH WAS UUSED ~Y: (ENifR ONiY ONE UUSE IER tllF fOR (o?. (b}. AIrD (~N ~ttrtt.. ouff~ ..~o oe~m . ~ WrtDUe( U4H ~ i,~ Carcinoma af the lung with metastasis , ~S ~ C MSlOVtNCF O~: . .'~.!+O~rION1, if AM, .~,..o ~ ib? ....1o,~it GwUSt bl, I ~*O, W~S ~ COMStOVtwCE O~: S*~"vG 1Mt VNOf4 . G C~US[ ~1~5~ ' OiKER SIGrJNKANT CONWilONS: ~~nws co~+~wu~u+c ro oc~n~ ~u~ ~+or nut[o io uuu cmM ~w rur ~ w~ f YES re~ ~~NNN07 COM• . ~ ~ies w r.o~ s.weto xr ocreu...wc c~vst p ot~rw H~ 11~ i a.CUDENT. W1C10E OR DA ~ n6ntM. wt, ~l~~ ~ ffOUR HOW INIURY OCCURiED ~ e.~te~ lunME W~MIYN IM ~~fl ~ Of ~Yf n, ~e[w ~ • .-_4::=:~jE. OR U~OEiElMINED ~ . . '~1 _ 1'N ih. M. 7M AT WORK - ~IACE OF NJUR~ ~ore, r•t~+. sn[n. r.non, IOCATION ~ snen w~.r.o. ~.o., an o~ ro~..~, fi•u ~ ~ :~t;'~.rr 1E5 Ot NOI QI/K! ~/OG.~lK. l5~lCU?1 ~ ' 'ER?iF':C.~TION- : rO+n~ Wt ttu rOuw~ D~T Ru uO uSr S~w wr/wt~ ~uM O~+ ~ po/a0 rOt ntr mf Ot~M OCCWlEO ~t ~we ru[t. On M ~ a S~. C! ~ r~ : ' r0~•TM W~ i[Y ~00~ ~E~ 0l~M. ~ w0~~ ~ OwR. ~u0. q M ~l3~ ~;5 0°. M FEB. 25~ 1973 iO~~ APR. 11~ 1973n~ APR 11 1973 !~u! :k 2:45A~,,~ ° ~R; ~E~ti~;C~t~Or+-MEOIUt ExAMWER OR COROnER: or+ n~ us~s a me wou~ d w.~w ~Mt oecea«r v.ws ~w.ceo oe.o V+O ..~;pr. ot TW q0~ ~D/Ot nrt wvlSt~Gwr,pH. w r~ dMM~+, rp~iw W~ MDY~ •O ~cCUe~tO O.~ O~Tf ~++0 01rt 10 M! C~I/SEISI S~~RD. ~ M. 77~ ~ M T i: E a- NnME ~me a?e..n SIGNAiU~~ r ~ o~ene w nni OATE S~GNED i..o»e.. w., nu ~ 27~. / / 6~ ~ i~' ' ~ tk 1 ~7 ~ •+G AODRfSS-CERftflER • snen w~.r.o. rw. un w x.w ru 12 1 16th St I FLA 3125 ~l. C4EMAT10N. REMOVAL CfMFTERY OR CREAVITORY-NAMf IOCA un o~ io... si~a ~ ~i.. : ~ riemoval-Burial ,N. Ft. Pierce Cemet,ery t P e ce F~ orida ~ 'f TE .A r 13, ~19'73 ~ ~ aird ~ eral H~~ _901l,N 7th $t Ft~~~ierce, F'lorida ~ . _ ~ i._!<E2A ~TC' C~ ~G1 _ _ x AIE fECEi~/E0 ~I IQCAt tEGli~~ ~ l!~ ~ ~A..vc'lj ~ / , tw Ao~ ~n - - - . • - _ _ , ~ ! ~ ' ~ , ~ - - - •r~.~, - r - r ~ ~-~`z - ~.k.-^`-~ie~'~,---- i ..z . ,'.r _ , r _ _ ~ . _ ~~a