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HomeMy WebLinkAbout2149 , ~ . , . ~ - 1 CERTIFICATE OF DEATH ~ ~ ~`"w' ~ av~wo~ ~~u.~ ~ L O lt I D!L sT~TS n~s Na n?e. w wMr w •'~•••••"•"•,••O •catsTM~~•s No. ntru?wMt MMC ~rn ~.o«•....,, ~101 ~ ANDRBW JAGBR t. Male ~ December 7, 2974 ~ ~ ~E wq. woq. ~•rrw wwr. I1GE-u.a ~ nu ww~ GwtE q Nt1M ~.aw~. COIMtY Of OEw1N ~ fK. 1 ~'11 WM~T ITWl1 ~M. M~ MOMt r~L ~M~1 '~ite 66 k ~ Jul 8 1908 Braward .~sw ca~ u.~>s Al O~ O:f1ER NS - ~a w ~a~r~, a~w sw~~ w.rn ~ • wcrr ws o~ wo Pembroke Parlc Yes Com~uni Hos ital of South ~Broward STAIE ~ 1M~IM ~ M MO\ M Y.f.~., wre O~ wMAT O01MftY MA~MED. I~E~ ~EO. iuinn~+G 3~3'v3E ~ r.w. «.s .o.::.. : ~ ~ ~ • ~i ~ Illinois OSA ~M~arria ed ~ n- Lottie Cienkus = .nea ~ecuwr ~TM U6unt OCCtM/?T~p+ a~+~ a.oa w.e o~ra •~oa w KINO Of /61St~ESS O! tOUSttr , 1111Y. 1~ M~M ~~Ip ~yl~ ~ylM Y11~~ 1 ~1 OCMA~M~OMM6M ~ 332-09-5288 u. Mover House and Machiner ~ ~eswErxe-:urt couHrr cmr. toww. dt totwtioN w+~ c.. u... sn~t ~r+u ~ ~ncr,r ni o~ .w w. Florida ~w. St. Lucie ~.~.Port St. Lucie Yes 8 Alhambra South fATlE!-NAMt ~ru rMM~ . Wt MOT/rtR-AtA10EN HAME ~rN wa! wt ,s L't~alt Jager u Hilda - - Iti'O~MIW1-NMNE w1\NG AODRESS ~smn w u.~. w.. cwr w www. u•w. tr~ Lottie Jager 8 Alhambra South, Port St. Lucie, Florida ~et ~ oEwu~ wws twsE~ ~r: (trrtat owr a+t uust r~t u~ ~ ro1(si ..~.ee+ own .w «.e~ /1 w:• v .s- - - ii. v ie ii«V~i i fv . N~ . ~ ~Q~G~B r"OIT~1A! . ~-'CrV REC4R0 VEF+F~tD con~arows, u •wr, r~tM O~r! ~It! q ~...ua•n e.~rie ar. w~ a. oe .s • co.a~o~«a : ~ fi~flM~ 1Mt YM~N- . ~~Md 4.rt~ 1~f1 ~ ~~lt II_ OTMER SIC~aFKwMT C01~01T10NS: eaawws ~o w a.M aM .ar ~e ro c.~u arr« .+'.n' w~ AAltOKr i IIES ~en n.N«a~ ea.- ~m p w~ aa~M anuuuNa c~ne No ~w ~ ~/'oESE~ ~ rOM~M. M~~ 1tV ~ ~QW INw~Y «~E~ 1~Ml~ N~N~ p IM1rN IM ~~ft 1 O~ IVt N. 1~ ~ f ~ E ~ s~ ?r. i~l. ~ Ml~I~Y AT WORR ~1ACE Of NJ1~Y.~ ro+e. ~.r.. sr~?. anw*. IOCAi10N ~ snta p as.~. wo., an o~ +o~. w~e ~ ~ sMwr ns o~ ro ~ ow~ee we., nc. ~ snc~nr ~ ~ ~ ~ ~ . CER~~KA1bN- .brM M~ tfY .~OMM Owt t4t u0 ult L•r w~./wH ~tM OM ~ MO MOt mlw - OtAtN OCCYtllO ~i n~! r.Kf. O.. t~! fNffK~~M: rOMG WT ~!Y WN IwO1M1 9~1~. ~~+0. M 7M a. x°.~. S~rN 12-7-19 74 ~u ! L-~ I S~ n~ ~r 12 : S5~„ o~~~ ° C~?IFIGTIWi- t OR CORdrER: a+ me rsa o~ ne ww a our nu aceoeM .r.s rwMo~w.ces ow ei...w.uo~. a se wm ..oiw na .~+tsnc.nw, a. .n o.wia.. . no~nn reu .ow uo . ww. oawee w~e ~ww .~w ~a ~o n~e c.u~rw s~.w~. t!? CE~iN1ER-NAME nrre w?r.n / ~u - j, OwTE SIGnED ~••o..m. w~. nu~ ~ q G - 1 - j 1i MA~lIG AOOfESS- tfrF1E* u~[ ~~.w w. an oe u.n tr t11 W~1M. CfEMAT10N. ~EMOVAt EMESEIt OR QEMATO~Y-NAME IOCAiION un w w.r - u.n ~ veer~ ~ Burial H?floll ood Mem. Gardens ~ Hollywood, Florida ~ OATE ,..o..m. ~.r. a.~i WNERAI NOME-NAStf ANO ~OORf55 ~ s~~tv w~ r.e. wo.. cm w ro.w, st.n. tu, Dec. 10~ I974 ,s. FRED AUNTER F[T,~IERAL HO ' 6 Y. 5. f612 F~NEe~? OR- 1Silt~e-SK.n~iut[ o~re ~ttc~ eo s. ~otu uc~s~u ~ Rt r. 1970 seGt.~~ ~ ~JJ t• tY 4` 7~ . CERTIFIED COPY . . . i"-' "r • ~s . . - J I hereb .~C..~f~?,~~-,t~he above to be a true and correct copy of the Local . ~ Y. . ;i;:~I~ ' Regh3~~r~a~~.'`'s' '~.~n-_file in the Bro~ard County Health Department at ~ ' - F'o~~t id~. e , ~ • .:i. ^ > - • - : : _ ~ : 3- ' :(N~ ~ ,No~'~ . Y~~e.ss raised seal of the Broward County Health . .__"Jf I . i :-~.`1/ ' " ~ *_t 4' . "-~~s affixed. ) , . _ y~ ` ~ 1~~ ~,4- =':-•.=,L g'~";~~~~, Cou y Health Offic and I.ocal Registrar ~ 0(~R{~ ~ f SUI:X ~r~~~ y ~ . Deputy Loca egistrar - . - . . : ~ ~ ~ ~ k - ~ ,