Loading...
HomeMy WebLinkAbout0928 3U3423 ~ ~ CERTIFICATE OF DEATH - TAts ' iTAT[ ¦OARD OF N[A6T11 ~'TAT[ ?fL[ NO. ~ a.~ ~unuu or YITAL rrrwr~mc~ F L O A I D A les~l t~a- . R[OI6TNA NO. , erd •A~n B1RTN NO. prep~~l7 1. KAtt ~I ~[AiN ~ CODt NO. Z':WT T1~[NKNCt1~wl~.rdMw; l/~ Ii~:M.~N/.~r.wV+) ~..~.e.e ~p,,,,n, bb-~z Florida St. Lucie .~e .~11 SL. LuCle s• .~•e•a t. K IIESMENCE aTr. Tov~. o~ wu?t~ t. K~IACE O~ OEAM qTY. TOMM.011 IOCATIOM ,~,oc cm urirn !w IuS~OE C~Tr l~w~TSr Fort Yierce . ~csQ~ ~+00 }~ort Pierce ~s f?1~. STIIEET ~OD11E35 I. M~ME Oi (II Mf 1~ ~MjY~1.Ii~t W?t!1 N4tN) ?,osnT.i o~ 200 ~j. 13t. St. ~*~T~"~" Ft,. Pierce ;:em Hos . I'1nt NMrte Lw wTE J?lMf~ D~/ Yt~r . ~ oiei~iio CAHEL WILLIAI+LS ~rN DeC. 13~ 19d4 (Trv~ r r•~•tl OTI $ s ~noc~ ~.w u~oE~ t~ ~ws. S- SEl[ i COIOII 011 IIACE 7 M~11111E0 MEYE~MAUI11E0? WTE 01 ~IIITM 1 (I y f, NwY Ww Mwn Xla- . i e. l: ~4 rnooK~aO avo~cco l+ug. 15~ 935 ~ ~ ar¢~ or .M., o~o~.mn+ D 1~ f w 1~ la. y~~l p~n??~1TqN (OYe tiw~ ~/r~?! ~e~t 100. K~MDO~ ~USII~ES30~1 ~MOUSTIIY 11. N~iM?L~CE (Sldt M~rl p e~~fr~) USA ~••'ZSp•••~ atorH r~k,•~*,~•a~~~ ~,agline Brantley, Alabama •~n~nt ~l~Ok /IIk ~~T~~~s ~ME 1~. MOTMEA~S MAIOEN II~YE Nina t~. Jokers e»..r~a.r R.N. h'illiat~ls IS. *~S DECf~S[O EYEII M~ U. i AlIMfO i0i1CESf K. SOCUL SECUIIITY MO. 17. IM ~~~~ri~ ~ ~?r. r....l...d lrI r... w~.•r••~w..?..•.•.d / 2' -ta~-7ov" A/btu i' t.. [ 1@I'C@~ OY'1 a Vo : . 1!(fERY?l ~~ME[N ?rn~~~l CAVK N~[ATN (6w(e? wl/ Mt tNW /M Il~t f~/ (~l. {0). ~+1 (tl.~ ONSET ANO DEATN ~ - etr~~ser ~~~T~- ~~TMx~suvsEO~r~ $ujlet Wound wrcou?n uux (•1 ~ ...s tu. j tM• tK- j tt[l~~t• C~wl4inu.1/MI. pUE TO ~ •ft~ tA• r~k~ /ae r l~ ~ E ~ . e . ~ ~..~''t.~. _ ; .r.N.~ ~k ..a.. . •~61~tr~r f~1y l~aK fYf. ~ TO «l . MAS~UTOrSr i ~ t~ f e 73 O ~MT N. OT1f1 SKI~(1CYf? OOMO~iIQ6 OOM~MRM TO OG~M RR N6t RRARD 10 iME 1G~1M1 OIRASE 0010111011 GIYE71 ~1?MT 1(~l ?ERiORMEDt ~ ~o~r• •f- 7E5? NO? ~ N• duth s ~ er e~fer• ~ p~ pEx~~~ ~ w~u~r occuRRCO. (S+rn ~rtin NE+h~?1 M~/r ~ I! yMrn If.) ¦~tf~6 ~w1 ~ ACCIOENT 311~C~DE MOMK~~ i .•r••+- ~ p ~ O Snot himself in r~outh with rifle ~ • lew •t p~ T~ME O~ /fwr JN~+t~. M~. Yee ~ N~~. ~ IwIUR~ a. u~. ~ 2~ w. ~ 2~~ ~ ST~TE c i 2W nUU11Y OCCU~~EO mt. K~CE Os ~M/U11v (e. fw r~1 ~wt. 301 dT11. ~OMM. 011 tOUT10M COUNTY ; q, Mr 0 te N tlt.) _ NMREAT ~ MorwwiLE ~ ~'jp~';~~ Ft. Pierce, St. Lucie, Florida ' M011K ~T MOIIK ~ 21. 1~N~nd~d tA~ d~e~o~d /rom . to •nd LM u~ A,T ~/i~~ on ~ D~~fA oceurr~d ~t~..! _(1~ on th. d~N ~t~ad ~bo.~: ~nd ro tM b~~t o! ml ~^o~I~d~~. /rom tA~ u~Na ~t~t~d. ~ • ?IA ADOrtE55 ?2t. DATE S~CNEO ~ ~11 1t~~• j~~ HOwATYw[ (Dr/~ttNWkl ~ `O " v ti. ort St.Iucie,Shoppin Ctr. 12/19/64 ~••P~ie• • •iernard itoss . a. •OlUf ~t~. ~M~i1p~ 2~ O~i[ 27[ N~ME O~ CEMETEIIY OR C11Ey~TOllr 23/. IOCATION (GY/.lNe*. M lNyt~1. ierc~y ~ a~or.. isa~h~ , ~ Yt. Pierce Cemete Ft. Pierce, Florida ~ ~ Buriai 12-~0-6~+ ~ r.1. te i a 2~. lUMC~~L DME 011 S SKM~TU~IE (]!1' I~~ES~p • St aTE ~ECO. ~ti LOCAL IIEa. REOKTIIAII-S SIGNATUIIE ~ R...~•es . I;ilton Baird Ft. Pierce Fla. 12-23-64 Anna Lee Denison, d.r. ~ ; ~ - • t fILED ~~e HECOROEO ' i ST. LUCIE COUNtIf FU• ~ ~ h~y oKtify thu to b~ s trw ~~~d corrKl copy of t1~ ~1 R0~*"_~ rbITRAS . Rvpistrers reco~d o~ file in th~ S~. lude Cou^~Y H~ef~F? ~~A'RECOr~~vFP,~ctc~ COURT~ .,.,,,.,j mM~t ~t FoA Pit~te. Flo?ide. , ' ~ v ''r= . (yyMniny: Not velid unless ra~se~i ~eal ~f tF+~ St. luci~ 3 j y~ I z~ PN'75 - . - C,ounty Health DepertmeM is affizod.) N. D. MIIIER. M. ~ - ~ _ ~ ~sh~r ` County Hwith Off~ur 3 lAa~ Rp' ~~3 ' , s' . ~ - Y ; _n - ~~e~ ~ /~J ' t,; I • . , r r~ P. ~ ~ , ~ ~ 1 ~ - p~puty Loul Rro~strp = . evo~237 PA~ 927 : 3::i ~ ~ . . W • r~.3 5-g _ ~ _ _ . ~ ~ L': k`N- ~ . . . , ~w~,x.,l.~ . . .r