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HomeMy WebLinkAbout0497 . ' ~98503 ~ CERTlFICAT.:. OF DEATH ' p.,-•~,...~ .t ik.1~L •.d R~.I.~bu~wr 4..kes ~rwT[ ~~~s Mo. ' INV(y0(V (K 11fAI ill F L O R I D A RCGISTIIM'• No. 64 ~ . Ir?E.•O~ ~t~N~ ~M ~M~~~~~~ ~ i~s~ ytl Ow~E Of OEw1N ~ roM~, r~~~ ~ ~~~MAt/lM INR ~y, t ~SEO-NAME ~wft t. ~111010°` N' ~ 1(p~, F. c~.IS~F1~~R ~ Male ~ Decenber 17 1974 ; rKt~Ktq~1i ~ _ lACE .rrn. .NNO. wat~w w~M~w, AGE-~~st uw~~ ~ 1.• ~~w~ ~ o~~ OATE Oi i1RM ~.a~. Nr. COIJMi~ Of OEATN 2 ~.c. ~wcw~~ ~w.. ~n~u~ .os. I ; wow~ ` 18,1903 .St. ukCl@ $ ~ V~klite ~..71 w _ ~ ~ rs~e c.n ..un MOSI1tw1 O~ O'MEf NST ~ r uw ~mr~. oen snee~ w ww~ ~ ~ 6 6 0 2 u"'• rowr+. w i nor+ oE~rN .o w..o ~ Ft. Pi.eroe Yes Ft. Pierce Merorial Bos~ital _ ~~j IM M~. OM YrfM IY~f 1 surt w wm ~ w..o. unzeu d w~u~ cow+rar MWR1fD. NEVE~ ~tlEO. - ~ ~w,,,,~, w~oowEO. pvo~o ~ v.c.. ~ Marl@ $tOCjCP.Y' ~Y ~ U.SA M~'rl `1VU H1M~K~ ~ N~f MCf~1lO s«IK SECIN1Tr NtlWE~ USUA1 OCQNAT~O?J ioM a~ O~ ~'O~a ~aN w~+w +~M~ p KM~O O~ NISMESS O~ M~IISilY ~~~10 ~I M~0 rp~[r01~. Mr r 4n~N ~ L7,~e.~.^w~ L. ww~.Y Occv~w ~1. 1~ ~G.7~4L,+ Gr1GLl.i~ ~~4NM~+C MMM » 15'1-07-8570 S1tfEi ~NO ?NWR~ ~ ~ .w~?~o... ~ESiOEwCE-Sr~iE COW+n G~tt. tOW?+.0~ IOCwT~Or+ I~v~cw+ .is w.o ,N Florida St. Iucie Ft. Pie~ 1~~+ N~ ~N 207 Rio uista Drive /AIMf~-l4~Mf rNff ~~OOaf uM M~OiNEt-MAOEN N~ME ~NV ~ ~s Unabt. Unobt. ~ ~txpW~uiT-N~ME rwRU+G woD~ESi ~f+nna ~.r• .a. cw~ a w.~.. s~.w. [rr ~ ,,,Marie Weise~b~acher ,n 207 Rio Vista Drive Ft. Pi~exoe Flori,da 33450 ~ ~~~w~w^ ! v~a ~ul OEwm ww3 CwuSEO ~r: [NiE~ O~w? W~F C~uSE rE~ ~a+f ~Or Nl. M1l. ~ l~p uti~~.. o.~s~~ • M~m ~ • 4 ~w ~ ~ ~ ~L 3 ~ S ~ ,J ~ . ~ • ~I 1[~Y~ ~ ~ J COr~~nOu~. ~~n. _ ~ ~ ~ ~ ~r~Cw O~q ~.u M ~ 1?) ~ . ~~rlN~t~ C~Yf~ ~M. M q. M~f ~ t W~ ~t,~ ~~~t~w0 tw~ Yr~~~~ ~ 4 t~0 C~YN t~~~ ~ ~ ~ ~t~ wvtOnr r r[S ~~MNMO~ CO~~' ! ?A~i ¦ OiME~ S1fiNK ~110N5. c n ~ can MO W N~M \'I MOT ~\~~l~ tO C~VSf G1AM M~Yf ~ yl i nf d ~ ra~e~ ~r Nn~r...re ewM ~ ~ 1 w ~~•~w f 3 ~ ~ is ~w ~ ~ p.NeW~ 1 wCGOFwt,- O N ~.w•r. nu. (~N +nOw ~w/V~1 OCCU~tEO ~e..n~...~w a ,w~ ••n ~ o~ .n w. we. m s ~QM.KM(~ W 1I~0l~lMOWtD ~ ' ~ I ~ M ~ n ~ 7 ~ IN1N~~ A/ WOfR MwCE Or wxir? wo+e. ~•~r, f~Mn, ~.cw~. I IOCATION ~ s.n~~ W~ r• ro . c~n M ro~w, ~r.w . ~ ~~M(~I~ t~f O~ w0~ OAK~ MM.~K ~NK+~~ - 1w ~ C Mt t~Y ~0~~ O~~ •~u ~M u)t L~ ww/M~ Y~+t OM ~ M/~~~~ v~~~ fM OE~TN OCCV~~lO M NKI. OM M Ct~i~K~1~0?~- ow¦ 1 ~ ..o..a wr nu ww .rn~ w.~ ~.ow~ ~.n. u+s. w er ~e~~ ?wrfKuw: t0 M ~•~or.~ea. w~ •n~r~~ M / ~ ' . ~ tl~ ~4 ~ 0 ~ M ~O ~N (uiY~f1 3~~4• ~u e~cuus ~w. 2124L69 itq 1~i7 74 ~t~ Noa.n .~orou•Kn Nu ~E~irKwi~Ow-?iFOK~~ Ei~wrrt~ O~ CO~OwE~ a. ~u.~ a iw ~wv. w N. t .a.~+. n.. .ow f~~riw~~W~ d H ~W~ ~M/d M ~n~ft~C.~nW+. w r~ Wr41. ry~s OCCVNM O+ M NA ~M MI~ ~O N C~Hf~f~ ft~AO ~ ' M . 1M . - -'rn- - .OwtE S~G?~ED ~+o»~'. e••.•w~ CE~TN~E~-NAM( ~r~n o! •~w:~ , S. yR , aaa~ p•~nr Me1vi Wo~kowskv M D ~ - L(~ ~k 12/20 74 ~ulwG • SS-C[i~ ~E~ s~n~• or ~+o w o ~••n r+ 80~Nort~i 7th Street F o r t Pi erce F1 da 33450 ~ ~ ~uRULL. UEMATIO~~. ~EMOVAI CfMllE~r OR G~EMniOt~-w~ME 10C <.n w q.» s••p Hillcrest N'.em4rial Cdns ~ Ft. Pierce Flarida , t~? Bllrldl _~H~ - - -L?a - ' 3 o~rE _ _o.: - i.. ~ /UNE~AL HOME - N~~ ~ ~ o. a.. w .o~ ~..n o ~ Florirla 33450 ` i~; ~ ~g~4 9dY N. St. , ; 7M O~fE ~fCPr~O ~t ~OC~~ ~fGqu~~ v. 5. ~6 1? ~tM+Ei/~? CR siGr+~? ' REG~SNr!~-S'~++~rw( r 1 5 A~r.1970 ry~ / / ' C, _ . i~.~~'' , - .js=N-~-µ~ ~N Decerr,ber 27 I974 _ ~ . . FlLEC Gn-. G+sR0E0 ~ ST.LUCl~ _4':HTr FLA_ ~i of ttw ?,cc.~?~ V o~ti Mb to 0o s trw and corroct coPY RU~- ~e5 ? h~tWY ~ ::s C~_ lucie Gounry Haelth O~eR• C~f=~. _;~.1= i01!!lT Npist•eIs retord o^ - RF.^."_F i' 0" r~nt N FO~ PiarCa. F ide. ~ Ny~ni~y: h01 velid unless ra~sc~i se~l uf th~ St. l~ci~ ~ ,1;` :,i . ~ ~~ry He~~~h pepertment is sffix~l.) ~11 ~ i Za PH ~ ~ MIUER, M. D. 2~~503 - ~ ~ . ' N. D. . ~ ~ ~ y Ni.rith Offic~r 6 I~rxsl RoOistru . x ~ J - - ~~2 7_.? - I ` ~ ' ~ ' ~ poqAy l,oc,~l Rr~~st.~~ . ~ ~ ~ ' ~ 0 R 4~ ~ 50c~ ~ . _ . . _ , ~ _r~~