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HomeMy WebLinkAbout1576 CERTIFICATE OF DEATH ~ ~ep~A~l o~ 11ea~1~ u~ Re~u61~11aNoe $enic~s fTAT! FIL[ NO. _ FLOAIDA 'E, O! ?tlNi IN ~dO~~"'~R"~"'~ RE61ST11AR•S NO. !MAlHNT INK DEGEASf~-rtAM[ ~ufr r+ea~ uit OATE Of DEAiM ~ ~o..~M, o•~, te•~ ~ ia ni~iiiwl i$i ¦srncrars p, I,a htoa : Male A st 1, 19'73 RACE.n+n. ¦eaw..wnc.M wouw, AGE-us~ wae~ ~,e.e v.roe~ ~ w. O~iE Of uRM ~.~o~.M. u+?. COUNT1f OF OEwi?1 • nc. ~ snan ~ MtM~~t I 1l~~f / ros. w~s wws rr. nu ~ . White s. 66 s~ s. ~ Dec. 18 1906 Broward C111?. iOwN. OR lOGT10N OF OfwiM r.see an ur~n ~Mnl O! OME! liSTRUf~Wi- ~ u..a ~N unK~. a~ srrer .w ~.uwe• ~ sncw .~s o~ »o ~ Ft. I~?uderdale Yes Broward General Hedical Center ' S1ATE Of W/M t r Not w u.s.•., M.re GITIZBI Of WMAT COUNTlY MAtflEO, f~VE! MAtflEO. SIltVIVNG S~OUSE ~r vnt. a~rt woe« wrt ? Ca••TM, S A w Plaw~• onoe~EO ~..«r. ~ n~. • New Jerse II. a rriecl Vera Trozzo nree oecusee ~ul SENRIiIr NU~ER uwn? acvr~raN ~ave ar.e a wea saw oueuw rou a KMp p/ ~~u pR prp~uiRlf veo. r eur ~ ~coueo w rouMO wf. MM Y Mn~lO ~ ~ 151-07-3000 Harine Mechanic htarine Repair t ~w~.~. o..isswa_ RES~OENCE-STAtE COUNTIf dTY. TOWN. OR lOGT10N wsa c~. urns STREEt M~O NtiMiE~ , ~ sncr~ ~es o~ ~o ~aFlos`ida ,a Blowe~ld ~«.08tk]8nd Park ,u. Yes ,w1608 N.E. 35th St. ?ATMER-NIME ~nft rO01! WT MOTMER-MAIDfN NAMf ~~qt ri001! utt - ,s Charles Iaughton,~. Alice Penk ~ IIMORMnM-NAME MAIYJG ADDlESS ismo oa u.o..a., cm o~ ~o..~, s~.n. tr~ Mrs. Vera Lau ton 1608 N.E. 35th St., Oakland Park, Florida ~ART 1. p~TM W~ UIlSEO \ll: (fNiER ONLY 0?~E GUSf IER lNE fOf (o~ (b~, wwp (cn NTr!lNiO«Stl ~w0 0l~M ll ~rWOUt! Y ~ ~ / t ~ F N~ ~ F ~ % j~ t CONOIi10M~• ~I ~M, ' i •MI~M G~Y! ~If! 10 / ~ ~ ~rrlM~t! C~Vf! 10/. ~ ! ~ iT~TIN6 ~N! YMO[t- ' ~ t71M0 C~YfE USI , . : t ' [ , ~ART OiHEt 51GNIf1GwT C : caasa+s owrau~.w w oewiw ~ur.a~ uno w cMM w. ~ w~ IF 1IE .re~e r~MSi~as cas- ~ 17ls MOl $Otleo ~w Ot1lWNwa 4Yf! ; a eewrr E ~w!~M~ w ~ iw ~ lDM~OGE: Ot tM~OEif WwED ~ ~ roNm, wr, re~~ ~ IIOW INJURY OCCURRED ~ t.m~ wrwe or ~rwn u. rur ~ w r~n a, inr ~ ; ~ 7M M. IN. ~ IN1Uf1/ AT wObC MACE Of HR1RT •i wor. rur, sr~en. ~.aon. lOUt10N ~ inen oa u_e. Mo., cm o~ a•rw. s~~n i ~veun nso~ ~.o~ ow~ce asc..ewc. ~srenrr~ i . 7l~. 7JI. 7~ ~ i ~cenriu?iwn- ..w.. o.. nu ~..o~..~ w• .uu '.,~e w~ a.~ ~...Me...~e a. ~~siao w..~n. we~oc~n~ occvueo ...~e rw~. a. w~c ~ ~NtSKw+: T~ ro..m e~i ew ~oer wm~ sews~ ~wow~ o~n. uw, w s~e nsr ~ ~ .~.~o M~ ~ P a ~ E tla wu•uo ~~o. / ~ ~l! A • 1 1~f'j n~. n~. t~. 'i : M. ro m[ uuse~s~ sr.ne E CNTNIGT~ON-MED l. lU?MINE OR CORONER: p. rwe s.s~s a nt ,qw a o~.a, rwt otce no.~ounces oe.o ~ !lY'M~110H M M[ WOT ~MD/W 11~ W1IlSTIG~TIW~. W r O/MIO~~. YWIM MT 1l~t t OUM OCC4ftl0 pN Mt O~1E y~10 OYf i0 1Mt 4YSt/31 17~ D. ~ n. ~ rn. ~ E cfRn i o. / ^ o. oArE u~ .~•..e..~ F ~ g n 0 S51-C ER . sr~ o~ ~ suR a ~ l~1. - ~1 i~7 ~ . . ' . ~ - ~ ~ WR1Al CREMATION. Al ERY OR CREMATORT-NwME IOCAi10N an p wo.rM sun 1 ~recr* ~ ~ ~a Removal " H.. Iaurel Grove Cemete Little F'alls, Nex Jersey ~ ~ OATE .oNrM o~r, ~tu~ fUNERAI HOME-NAh~E ~ND ADOtESS ~ sran p~ e.r.o. ro., cm o~ torw, st~it, iv ~ ~ :w g- 'r~, n. Baird-Case F.H.Inc 43~j N.F d.H . Ft.Lauderdale,Florida 3 Y. S. a~ll'j FWgAI W~NATURf -SIGP/ OyR~4ECE1vED ~T~ ~tSiRA! ~ RlY.1970 ~ . . . ~f j IM. ~ t ~ ~ • _r. . ~ ~ . ~ CE~tTIF2ED COPY . - _ . 3 . . Y I hereby certify the above to be a true and correct copy of the Local ~1~ - fi Regietrlr' c record on file in i.he Brovard Couuty. Healt}~ Department txt ~ r Fort Lauderdt,lc, Florida. _ , . , " _ ~ ~ . i ~ ' . : , . . • ~ (Wurain~:. I{ot~~~alid unle'ss raised seal of the }lroward County Itealth I w~ ~ . L ' ~ o°° oaw ''r`" ~ . .,,~!PpA}'1kQ~~~lt ~6 Arr1XCC~. ~ w • • . - y.A, - . . . . ' . • ~ v ~ - . ~D ~ a.~ i5 •'t ~ ~t+~ . 1~ • . - _ K~i?O ~ ' . yi • U~~ ~ fi~ ~ _ _Y ~.1~~"~~C~~~~~~'~i~~~%~ " ~~ts0 • ~ is• I ~ w i/~~~~ n ~ . .':,`~a `Gs ~ `j : ~ / b ~ounty Ncalth Ufficc,g" And Local llegistrar • ' ~ Fi~>.-. ~a~~ ' w '~r ~ al~i~f~ ~ ' ` / • ~ ~ 0 K'1 ~ ~ . ..Dti?Q,l,[c ^ ./1 ' ? c ~ ~ • • - - • s ~ l ~ ~ $ 1 D r3 ' ~ ' ~ ~',l.GL~C~ ~,Q "G..~ . ' ~ ; • 8-3-73. - ~ ' - ~ G~~C ' . . ~ . • - ~y,;A L~t . : • Deputy I.ocal kc~ictrar pp~ PA~~57 " ~ ~ ~ 5 ~z . - - - - m:a _ ~ _ _ . , . _ ' . ' . . f~~_