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HomeMy WebLinkAbout0574 r ~f . ~ 298569 - ~ CE~ i~r ICATE OF DEATH RAT[ FIL[ NO. + pep~rt.e.~ ~t Ik.~~l ..1 eelabluutlve sn.kes i ~ F¢A~TM F L O RI D A pEd~~pAA•s NO. ` ~~st SEll OAiE Oi OEA1N ~ O+d . ~ fr~E. Ot !llNi iN ~~~~~~~p ~ ~ i o~ wi °KE'~°-"'"""` •u•~ -T~ Female , January 7, 1974 _ ~ ~s~wcia~ bVA W• ~S t ~ RwCE •,~n. Mww. .r~ocw ww», wGE-ui~ w~w~ ~.e.~ woa~ ~ w~ O~iE Of W'1M ~.~o.~. ~a~. COIlHfY Of OEw +w ~ , ~ ....n.. .o~ a,. ~ ~ Feb 23 1 St. ?~cie rw k ~ ~ ni'Ll'~ A. 90 ws~e cn ...n NOSM?wl OR OT?fE~ MSTrtUf - ~+•~o~ n+ em~e~, one srea •~we~ ~ 6002 ~m!• tOM~H. OR lOUi10N O~ OEATM veca• +~s w~.o Ft. Pieroe Yes Ft. Pierv~ Mecbiral ~iospital = 7? SYtVIrNG S~OIISE ~ r rrt. own r?~w w~rt ~ ! nr .uuneo.r+EVee.umco. STATE Of 4tiM . r wo~ w ~1-s-•.. ....a CITIZB~ Of MRMT C011J '~~0, . ~ Narth Caroli~"'i 'a"~ ~ USA ~s~.....«.«. • ..eu we~.»e ~w SECUbTf ?~11WEt YSNwt OCCWwT~O?~ ~uva w~.wa ww awwo ros~ o~ KwO Oi MlSNESS Ol WdK1RY ~~r10. q Of~M ~/O~~O \M!. MM Y YMt01 A_w 27 " 240-74-4927 „ ~nva• rn.a~c .,.,~,p... Han~ Makc~s .euae.ce ~eror ~r w~t ewr ?rus ST~EET AND NU~E~ . ur, rowr.. oe ~ou~a~+ 716 S. lOth St. .ar+ss+oM- lE51DENCE-STAff cou~+n Pierce '?~'~`Yps°~ ~ ,a- Fia~'id~a St. I3ucie Ft. IM Ip yy~~t uir fAt11ER-NAME r~W rwa~ ut7 MOTNEt-MA~EN NAME ~ Paul Winstead SZie Carter ~s " ~ WOIU~uNi-ruA~E wuau+G ~ODRESS ~smn a a.ri. w.. car o~ w.~.~. sr•w. tr~ r~ ,h Elsie Dixqn ~n. 716 S. lOth St. r 1~`t. 'P3~roE.'? FlO~].ds1 33450 ~ ~/~ql~W ~wll~~Y ~ ~ rwn awm wws uusco ir- ~cN o?xr or~rt uusE r[+~ ir~ roe hl~ Al~ ~ kM n,...w o..+n .~.e w.~. ~ rrww . ~ " 3~'f~- ~ ~ ~ 3 : coMwno.s, ~r ~M. ~ wM~Cw 0~~~ ~~3! t0 ~ n~ ~ ~ ~ ~rreN~t! C~~f! 1W. ~ p. ~y ~ OVlKt M: ! ~ ! 1t ~ Stl1~1M0 11~! rM~l~- i ~tINO C~Yi~ ~.ai ~ s ~ (q AyfplSll ~f rE5 .w nw~»os cc..- ~ ~ ~ ca'M torwur. ~O ww~ ~rt .Wr ~tu ~O u~u 6n w w .w r a~ ~ ?wtT ~ OTHEt StG?~M C ~S~ ^Q"~ A ~~s a~~ a ieiw °~rt~~~a cww r ~ M ± € ~C.. s w p,~oe~~~ ti_T y~p~ A ~ . w+, in~ ~ MOW IHIUR OCCURlED ~ t.ae~ w~we o~ ~rwn ~r r•~~ ~ a rw ~n. ~ ~ ~pruppE; p! UNDETE~M1NfD ~ ~ ~~~~t I~.~~18~73 71c. . 7~1. ~ ~ r.u.. sran. ~.non. lOCw710N ~ swcn o~ ~.r.~. wo., un w~o~, sun ~ uuuar wT wOat N~•• iO"'. ~,..~.,.~a.b~ p.~« ~ 716 S. 1 ~,,n, r~ w .a+~ w. ~w uO 41t Lr wr/M!~ u~ OM ~ Meiao w~ .r. wr Dl1~M OCGYUfD ae ruai rs~ CE~tiKwTqN- ro.~w. w~ nu ws~ un~ a•~.. t 1=+3~ ww. wo. ~ ~ ~ ?Nt3K~~N: i0 or r~ [wowuou, ou~ 1~R~NOtO M! ~ 18 73 't1~. ~t]7 tic 1 7 74 tl~ C;1L~ IIOt ~o nn cwx~s~ s~.ns. T• O!Cl~SlD /~O+ A1! OKtOlM 11tl NONOVKlY OlW CE[T1f1GT10N-MED~CAt E7tAMwER Ot COROMEe: o.~ r»~ ~.f~s o~ rw • a w•e. a? nV .~ow a ~urM~~O~+ M M ~00~ uolW sMl MY[fnW~w~+. M rt O?r+ar. ~ Ol~A OCCYMlY ON M 01!! ~NO OY! q~M! t/1Y1t1/1 f~~AO M rn M. oeGM! ATE D ~ o. !u~ _ n' " 6 i ~ ~ ~~ivan M.D. ~rn _ ~ s~wn o~ o c~n a w.~~ ~ ,";~'''~j'~"~. P. O. Bcac 162 ' _ IOCATION un o~ w~w¦ sr•n •URULL. CREMAl~ON. REMOv~I fFMETERY OR CitErMiOR~- Fl~'],dc'i ~ ~ rk Ft. Pireroe Buri.al. Ft. Pieroe 1 ti~, owrE ~..o..*« c.. wt~tE~uu Mo~tE-,~wME,wo ~ESS o..•.a. rw.. c~,. o. w~ .,•p,n•~' FlA~i,da 33450 ~ Jan. 9, 1974 i,,. 1~JI~EtAL f~,9o1 N. 7th St., • n ~..wu..~owi••• ~ ~ 11 i37~ ~ r. s..b 12 ~~++E~x ~ JaT? R~t.1970 ~~~-C ~ _ ~ ~M~: KECORDE~ : of tM i+otn~ fIIED NTr ft1?- . ~ i~rwY ~'fY Mb ro oo a trw ~~d corract co~Y T.IU~•E ;OU V . : ~ istrers recotd on file in 14w St. luck GounrY HceltM+ O~C'°rt- S R4~~: ~~'tRAS ^ ~ ~t ~t fort Pio~ce. Flaide. ~~aR~~. ~F C,O~Q1fRj -`:.~'.•";1L,Y~~d,~Of~"-`',~7':i_ i. . G ~ ' • ' ~ arniny: t va~id Lnless raise.i ~eal Of ihs St. L+Ki~ RE~ ~ L a~~; T: ~yy NO 0~' ~~ty }UesHh Departme~+t is affizad.) ~ r 3,,~P~1 15~~ ,r,~;~~,~~ ;6yyy~~~.yyy~:~ 0 _ ~ Y~ . N. 0. MIIIER. Ah. D. ~ ,/~',i s~f:~~~s_i ~ ith OffFur 6 1 RpistrW *~a76~ ~ . Y~'•~ _ ty l~i~~ , ~ ' Y ` _ lYO,.~'r' . _ ~ , ,N`,~~; . ~ - - '~1 , ~,~~9 ~11 1 populy 1,ou1 Rwistrsr , . ~ ~ 0~ ; ~ 2~35 5?.3 i ~ ~ d ~ _ ~ - _ : _ _ _