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HomeMy WebLinkAbout2521 / . ~ • ' E ~ ~ V _ CERTIFIC~~TE OF DEATH ~SSOi~r Qiep~dMe~wt ~:le~llb ~ad ReL~l~Ililatlve $errices KATt RiLt NO. ~ ~~rnF~ FLORIDA ~ 'f, OR ?tlNT IN ' 4° _ - REGI6TRAR•f NO_ RMANftif INQ ~w~0-k~ r~y~ ~e~e ~•s+ yE7~ DATE Of DEAiN 1 MOMiN~ w•, .eu ~ if[ N4MIOOR FOt wsn~~aia , . Paul A. Lewis Male June 21 1973 RACE vrwn. Meaw. wreuc.u .ruw, AGE-w~ woe~ ~~n.~ woe~ ~ w DwTE Of ~iRTN ~no.nM. w~. C01!l1~r Of OEAtM - - ~c. ~ sncv. ~ M~au.. ~ nu~ ~ .o~. wn rouas ~ ~ • White 46 A k • Aug. 13,1926 Broward , tOMM. OR lOGT10N Of OEwM ws~e cwr u.ns 1105MfAt Q! OTNER tiSililR - ~u ~ w. em~a, an sitcr u+o. wwne ~ ~ 6 . wcr. ns oa .a „F ~Ft. Lauderdale Yes u. Holy Cross Hospital STATE Of ~1RT1i ~ r~.o~ w v.s.•.. N.re i1ZEH Of wlY?T OOIMIRII MAItR1EO. NEVER MARRIEO, SURVNNG S~OtlSE vrw, swe auMt« ww ~ ~ ~a~~. Ohio U.S.A. N. arr~""`~'~ Marjorie Hyde ~ ~cw~. ~ sECUim M~~ USU~?l OCCU?ATION ~one cw o~ ~roa ~u eu~a+o +w~i W icr~o of ws~ss o~ wousm v~o. r eaM roaw w. ern~ r Knns ~ "~tl`°M 273-22-9762 Electrical Bn ineer Electrical En ineerin 4-' ..nnrtwu. o~.. p,~, 8 ~s. 8 8 ts+nlwte ~erw! aussaK ~51DENCE-STATE COIMI~ plr. TONM. OR lOGT10N r~sae cm wms Sit~i AN6 NYWE „Q ~ ~vetwe ns w No . ,w.Florida ,a_ Bro~ward ,k Lauderhill Yes ,w.2210 N.id. 47th Avenu'~ FAiNER-NA?~E • ~nst r~oae ua MOi?ER-MAIDEN NAME frtt r~oaE uW ~ ~s William A. LeWis u. Delia ~ - M. BattleS ~t+ror~uNT-i+~ME wu?aNG ~owEU ~s~a. w u~. wo., un w a.~., s..a, s.~ N Mrs. Marjorie I.eWis „~2210 N.~i. 47[h Ave., Lauderhilly Florida ~k ~nitr oEwm wws uusED sr: ([e~rER a+tr or~ uusE rER i~ roe h um.M'a r..~e ew~. u. ST.LUC~E COU~~TY ~A. ai Cardioyascular Collapse ROCf~t PO RAS ~ ' , ~ . RECORO VEBI~IED ~ "o: : .;u o n~ Abdominal 'Sepsis ' u..ea•u c~~u ~m. a y w ca~xaia.a a: 3 tr~*~ro ~M~ ~MOe~- ~TM~~ ~i* kt Regional Enteritis and small Bowel Fistula ?l1tT OT11Et S1GN1fICJWT COt~Drt10NS: S~~s co.~w~nwa m ee.r an wo~ ~[une w uwsa a~w+ r~ rur ~ w AIROKI/ If YES ren nrawof Co~ ~rii~O 1 frNlN ~M OttEYN1W6 4Yf[ p CE1~IM 11~. ~ HDrrKaoE; OR 1RO~TBMYIED ~ rwrw. a~r, r[wa ~ HOW INJURY OCCURRE~ ~ ewne w~wn w wiun u~ ~war ~ w rwn N, aer u~ I ~ ~ 71c M. !M. INJUtr Ai w0!!C Of lUlR1f w~ woue. r.u., u~etr. uc*o~*. lOCwiION t saen a a.r.e. wo., an o~ rww. u•x ~ ~~.w~. ns o~ .a~ ow~ce rsc..ac_ ~viani 1M. - iM. ~..AL~N- ro~aM awr ttu racni e?r ~+w wt s+r w+/+:t~ u++s ew ~ r~/w.. .r.~ w» c•_.~": ML_"!=^ : ...s ?IIYSICIAII: MOK~M O~* -~f/V ~OM AlR~ 04111 INOY~1 W1fl. ~11C. VO L1[ K31 TM~ 5 11 73 TO June 21 19~3 6 20 73 not 1. 20 a. p ~ 7b. sECe•xo nor lt~. ~ !lc fN. tM. M. ro na wrs[u~ sutte_ CERTIf1Ut10N-MEDICAL EtAMNER O~ CO[ONEt: o« nu usn a ne ww a oE.n TMt ~u tW~M~~q~ O~ D! ~00~ ~ND/O! iwt rirltiGwnOM. M r7 W~wO~+. rOMM M~ T4l ~OY~ Ol~IN OCCW~LO OM 11! OwA ANO FI! 1D AIF CAYStW ffnllO. ~ ~ ~ CERTIFIfR-NAME mre oa wwn awi p mu • DATE SIGNEO ~ro.~m, wr, tWi n.. n.. . 4. G_~!-?s /MKl1GAppRE55-QRi~E! 4701 N. ~''eaera ~ ighway Lauderdale, '~'1a. 3~'308 WRIAI. CRfIrtAT10N. REMO~AI OR UEMAiORY-NAJNE IOCAiION tmr ot ~ow~~ sw[ ~ srecw ~ ' ,N. Removal ,q. Ashtabula, Ohio ` r r OATE r norew, w~, rewa ~ fUNERI?l HOME-ltAMf AND ADDRESS ~ srae[r o~ ~.s.e. wo., cm w ~o.rM, sT~tt, ia ~ ~.June 23 1973 n.. Baird-Case F.H. Inc. 4701 N. State Rd. ~7, TamaraC, Fla. V• S. f614 fUNERAL SIGNAiU~E ![GiSnI1R- C~-a.a~(~/V nw~e trveo ~ow eEG~srue R.,,, i9~o ,A ~y. • ~~.SL.,, n.. at / ~ 9 9 K... - . . . . : . . . _ n~ o~at.a€co~oa e~o~ . • - • - . . ~ ' ~ OF BROWAit(f CbUNiY, fl08tp~ ~J , • , • . ` CERTIFIED COPY ' ' ~ ~ . E: _Iyi. ~32RQBEI: _ . ~ • ' . ` - ~ . ~ • ' oouxrr c~rwt~~ . • ' - x hcreby acrtify thc ubove~to bc a true nnd correct copy of the Local 12egintrar ~ re.cord on . file in tho Broward Couuty. Realth Department ati fi.s. ~ ' ~ : ~ ~ort I.aud~rdale, Florida. . . . ~ . - - - a . • ~ = ~ :s~~i. ~~(~t~: . ~ • • ~ ' ' l t ' • • ~ ;p,• ~'V 4tot valid unle'ss raiocd seal. o~ thc IIroward Count liealth ~ y~-~ . > Y r..,. . . - _ . • • ~ [ ~~''~:1~ ~rtwcnt i6 Affixcd. ) ~ ' . . . . • r; ° 9 ~ . r - , ' G , . - •3 '~1 X ~ ~ 7 ~ ~ ~ : • f . . • J » ~ . ~ . ~ : -r~ v y - . ; , ,t~:~a~l. ; f~ . • ~ • O ~ 2 . . . .-r ` - . ' ~.'.,~w yi ~ ' ~ ~ Ci1'/r`/S/,C' ? I~I .~j ' ~ ' , ~ ! . ~l • _ ~ ' j a F • ' ~ ~S': .r ' " . . ~ . ~ . . -~-~-~~•~'~~~`~~~s; C~unty Hcalth Of~icc.~~aud Local Itegi~strar . ~•o . ~ - • ; '`iL'~X~~~•s''`~ . . ~`y~ ~ ~ ~ ~ ' 1 , . . 'w~. '':.r`• : • --yG" ' ~...1' ' . . , ~ . - . r • ~ , . . . ~ - fL. * . ~4~~/~l~l/ ,,~,C?iC~. .P ~ ~ . . • . ~ ~ _ SQ~~~~~~19 • ~ . ' . ~ o~ . . . . ~ _ ___..r.__ ~ ~ L~%` ~ ' , ~ Dcputy 1.oc~1 1tc~i.ctrai• • • ~ ~ ~ ~r ~ ~ : : ~ ~ -