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HomeMy WebLinkAbout0840 ' ' • - ' ---t .r ~8~~' _ _ ~ . . . CERTIFICATE OF DEATH ' De~rt~e~t ~1 ~ka111~ uw~ ReL~bi~li~e $e~ice~ RAT[ FILt NO. nn~on aF ~.u.ni F L O 8 I D A T11?E, Ot ~tlM IN ~~~~~°~O NEGIRRAN•f NO. H~MAN[N? INK ~_NAMf ~NS~ ••rK~ ~~st SEI OAIE Of OEA1N t rortw, w~. nu ~ ~ Pete a^+s *~al ~ ?~:arch 2 Q RACf w~. uYat~w ~wr. AGE-usr wa~ ~ nu w+sa ~ e.~ OATE q M[fM ~.ar. Nr. COIRi11 Of OEA1M ~K. ~ Wtn~ rnw~~r ~~uu~~ .os. ~.ts ~w~s ra ~u~ . Ne ro ~ ~ k. »]_v 1 1 18 St i,ucie , iOW W. Ot l Ai11 •~+»e tn .re NObMTAI O! Q1/1E~ !KT(Nf - ~r na w lar~, a.~ ura .r w~w~ ~ 6602 ~ ~ Fort P' rce Yes H.?~A I~'t. Pierce ?~`e-~orial Hos ital SiATE Of MRM ~ w rOt ~r ~.s-~.. ww Of w1NT CQIl~ITtr MAR~IED. HEVER MAtNEO. fIJlYIYNG S1'ONSt ww. ~ Mna~ wir ~ . oow~n ~ WIDOwEO. WVOlCEO ~ wcn ~ .w~..a~e..n ATorth Car. olina J . S . A , w. ; n~ E ' ~'T' °f' ~ .¦er Mn.r~ SOq~I SKYOt~ MWrEt 1lSW?t OCCWwiqN ~an ew a.wi w.r wr.w .oa a 6!~ Of Mlt~ESS Ot w01Rit? u.e~_ r ww ~orew uw. iwu r aws ~ 'M u 242-01- 420 ~k r L Citrus eearu.a wo~ r.yN cn urw sieHt N~ ~~Mt+w_ ~ESIDENCE-SiA/E C01Mlf~ G1r. TOMM. O~ IOCAiIOH ' ~vec+s a Mo iw. 1 r' i ir.F i~'C . ~u Nn ~a.1 R1 Dd 1~ith COllrt fATNEt-NAME ~Np .wwe w~ MOilEl-MADEN NAME wtlt wwt uu ,s ? s 7~iz?ie Unitno~m ~ WOMMANt-NAME w?rr+G ADO~ESS ~swn w~.~i. w.. c~* w w.u. a.w, a~~ P ~a~~ ~n 1 A1'~ t1 1~th Court' Ft Pierce T'la.. r~tr ~ oewm wws wis[o ~w ~r.,?[t au? a+c aus[ ree uwE ro~ 1•1 AL ~uo kJ1 .n.ee. o.~... .«..w µ a~ ~'i9ROiAc /9/~~ES i- P~~,cn~oyr~.~ty ~i9/~ vRE k • 4 coN~moMS,.ra~n, ! /9.ST/9~~ C~RG~/?~~A / BY1/V•E, ~ .w~cw o~•~ ~~a w ~ M ~ ~ ~wM~n n~i~ w. ~w a, a.s . oo..sewe~.a w: s i~iw~ ciiii uii ~ ~ k, PRl'S ~ AT,E ~O~`ND C/jft!'!/YDyl~} ~ ~ ?IMf OMEt SIC,NIfIC/Wf CONOff10~+S~ eo.awa~s ewrw~wo q wiw Mw rw ruw~ w nvs~ a~w~. r.~n . w AY~O?St If 1/ES ~~~e n..~wos eow y ~wt a~ w~ oi ~ie: w~anu.ww cww 6 M H~ p ~.a.rw. Yr, ~w ~ NOM IMll/tr OCCY~tEO ~ t.m~ wwwe or w~wo w?ut ~ w rw w, wu ~ e rJ ~~i~/'r ~ ~ ~ ~RAL •2 7 ~ ~ ~M. ~ ~ ~?-UM? At wORK Of MAlR~/ wo.+. ~u., snen. ~.ao~+. IOCwT10M ~ aweo w~r.~. .w.. u.r o~ +o.~..= ~w ~ - . ~!Ilc~ ~e~ o~ ro~ ow~[l r~O..~~t. ~vKwn~ ~ t~ ~ MF ~ /3 . E ~ _ l CERfWCAT10M- no.wr ~w~ rw .wM 'uu ,~.o w~ a.v w~?~ une w i w/e~ w+ ~ Me ot~rN otcuuto we ruci. w w IM~SKIAM: . M~ AY ~O~'~ YR~ ~t~11~ 1wOM1 MR. uO. q Me MA ~•mwt~ ~wt TO ~j~ ~ or r• ew~n~oGe. we " fla ' eta~s~e nor fl~ tk ~ fN.IO/Q /VlT iM. O K ro ~w cwsas~ suao. CEti~fKAT~ON-MEOKAI U[~MwE~ OR CORONEt: ow +~e a.s.s a ae woM a a.w~ j-- me ~ ~u ~w+a~+en wa nu wow fWN~~O~ d M~~ uy/O~ n! ~lStW~W~. w rr O~r+W.1. ~ Ot~m OO[MM~ OM M MR OY~JD M - n, Y.`~'Y' ~ tir r E-~ ~ 7 M ~ CE~tlfw"f-NAME m~e a rwn 1 S~GNwiUtE eee~n o~ SK',tEO ~ . rr. nu~ ~ IL ~ ~ t 2- . A~. `C tk. ~Q ~ ~ ~ q... ~ ~ rL ~ ~ nrte ~ , ! /9 L E ~ /~l~ wmru. c~uy?non. ~.wvu Eer oe a~w?TOa.-ruMC ?ouna+ u.. o..o..~ s..n ~ t4. ~t~,~+;-,1 ~11;_- __~n,ri, ^~-,-^,',+..~...r i~ p~nti. e ~'~n'^~_"' ~k. ~ OATE _ ~.ws. .w~ iuHEaAI'MOME-NM~E ~r~0 ~OOtEif ~ sn~n o~ ~a.~. wo.. ce. o~ w.w. u•n, n~ ~ , W,•,,,,,r;_ 7 ~~7n. n, ,~rnS ?*T 7th St Ft Pi c'.~'r:P. F~_~. 3?450 i s~ ' r _y~AT~ OAfE tECElvEO ~t IOCAI ~EfilffW ' ~ ~ v. s..Gi2 ru+w~ o.- 974 ~ R~v.1910 = f / ~ ` i - ~ ~ ;'is ~ ~}~y artify d?b ro b~ e m?~ snd corr~ct copy of tM Loca?~~LED t.rU ~tECUROED ~ lhptsirers reoord o~ fik in th~ St• lucie CoumY H~°~~h ~°RST. LUCIk COUN~Y F~A. , f,.., Fioride. ROoEw M'v11RAS a ~ _ ~ rtMnt ~t FoR PiNte. . _ ' CLERK CI~CUIi COUR • - ~ va1id unless raised seal of th~ St. luci~ "F~r~E~ (yysrning: Not RECAF.~ '1: ~ ~ hh rtment is affix~d.) ?C ' ~ ~ J''J ~ ~ ~ Cpunty Hea ~Pa ~ ~ 'G i9 H ~ 1 J ~ ~ ~ ~ ~ • - 7n~ . ~ N. MIIIER. M. D. ~S I S3 ~ ` Hai1M Offiur 6 1 Rpist?ar ~ ~ i, ~ ~ i . = ~ : ~ 3_ ~ ~ : , , - ~ p~ - p~puty lrocai R~aisnK . ` ~ ~ ~ ~ ~ noo~ 235 ~~E 8~9 ~ . ~ _ _ - -