Loading...
HomeMy WebLinkAbout0467 ~ il. lUC1E t0UN1r FIA. y~5 ~ 61S' ROCFF 'rO~TRA4 ~lE•:K C~~iCU1T COiIRT RFf^•~t(` YE°'~ ~E1 Ar~ 9 ~.'1~ _ ~ ~io~~65 ~ ~ DEPARTMENT OF HEALTH AND REHABILATIVE SERVICES . . . . . . . . . . . . . . . . ~ . ~ , li~~ . . ~ ~ ~ , { ~ ~ `~iq~i~~ric~s ~ountc~ ~ea~t~i ~epartment . j . ~ DIVISION OP HEALTH STATE OF FLORIDA . ~ ~ GLENN V. HOUGH. M. O. V = • oiaccTOw ~?p,,,,~~~ COURTHOUSE ANNEX ~ ~ CERTtFICATE OF DEATH ~ ~ Dcprrtmewl oi I leal~b ~nd RcbaLilibUve $enrloes iTA7[ FILt HO. r.~v~s,o~, oF ~?u~ F L O R I D A ~ ~o~~4R~~~ REGI6TNAR•i NO. ~ : I,: l~~l ~x ~ATf Of DEAT11 1 rOwlw, N~, nY 1 • t ~ X DECEwSEO-N~E ~ua ~ Heinrich Gustav Rohde riale , February 1~ 1973 ~ ~ . . ~ I R~CE .rw~rt. ..ecw. .rucu~ u.~w~. ~GE-w~ w.oe~ ~ tt~ w.a~ ~ e~~ OAtE Of ~ItM ~•~anN. Ns. COIRiTY Of OEATN t ~ ~,c .sr~cur~ ww~~~nwn~ ro~. wn wouas rM. nu~ 1 i j . ~~11'tie S~ A S~ ~ ~ C~TY. TOWN. OR IOCATION Of OfwTM ws/a tm ~wns MOShiM OR OTMEt INSiliUlqN- ~M wa w~ ~nrn, G~t an uo wrs~ : antr. •ea o~ Mo ~ tivon Park ~ Kay Dunnaxa Nursi~n Home ~ n S~~TE Of i~RM ~ u roi w u.~.... w.ri C1ft2Efi OF WMAT COUNTtY MwtRIEO. NEwER M~RbEO. SWVIVNG S1~OUSE ~ r~rre, sM r?p~+ wiw ~ cOwm ~ A W100M~EG. DIV~ORCED ~ vKrr 1 i ~ y~ German ~ U~S• • N ~11C~OW@d 11. _ f SOCtwI SECUR(i1f NNM~Et USUK OCCU?ATION ~un ~~.e o~ .rou oau w~wo ~ M K~ND Of WSWESS Ot 1lDUSTRr : : .our.~ ~w. eve« w rMw i ~ 1 ir C1tY'L18 ts. ~i'ltl"i13 a ii.~ t ~ ~ESCDFNCF-STwiE COUNiY CITY. TOMIN. OR IOCATION w~s~e cin ~ru~s STREET ANO NUM~Et ' i sncr* ~~s a ~.o Plox'ida ~.?Hi hlands ~k Sebr' Yes 2 S E ~ . fwTMER-NAMf nW rioaf u0 MOTNEI-MAIDENNAMf ~rM roa! uW - ,S Gustav Ro2xle u ur~obta~iiable H?OW+unT-N~f Mw?aK, ~DORESS ~snu~ o~ ~.r~. .w.. cm o~ ~ow«. s~•w. i~? . i,,~ :~rs. '•tartha L. Oliver ~n 5321 LanCelot Tirive I:xliana oli ndia:'~a ~H~O~~•u~Tt ~wT[f.? : `wRT 1. pEwiM WAS UUSED ~Y: IEMER W+tY ONE GUSE ~ER lWE f0~ (o~. (bL kA ~iwe~.. o..in ..c ~e.~ a il r.roun uwse ~ ~ I ~O~ ~ ~ • 's ~ 1 ~r . ~ ~O ~ co..o~no..s. u .~n, .,~~C~ o.v~ •.st ro Ibl g rlDi~i~ C~V7F ~Gl. ~ py~ TO. W ~ i l1~11NG 11~! VMOIN • • . , ~ ItIMG CAYf! Nf~ ' . { I ~ £ A1rtOI5~ tf 1fE ~+~~e ~~wo~res a. i Irif O~ MOI s~ano ~M wn~.u.~..c w~ ~ 7wRT 11. OiFtER SIGNIfI(/WT C~NWT10N5: Cp+WAOMf COMwYh~+f. 10 OUaw Nq MOi uun~ t0 C~Ylt OMM ~w r~I 1 NI : i W H~TM j ~ ( 1*1. H~. ~ =ata.t ~:GOini, SUIC~DE Ot w ~ ra+t~. w~, n~n ~~ONt NpW IH3Yt~ OCCURtED t~M~~ a°'wn ~M ~u~ ~ o~ r~n w, m. +i~ I I ~J~.tUDE: Ot ur+DETERMw+EO { ~ ~'vec~F~ ~ - k j:w ~o? u~. M. ta. ~ ` in;uRV ~1 wORK ?uCE Of WA/R1f.i ~or, r~u., snen. ~.c~ar, lOU?iION ~ snet~ o~ ~.~.o. wo.. cm w ro•rw, ww ~ ~ s.eun ns or »o~ wnct woc.,~a- ~vKw~ .w u.s, s.. Nri~e. ..~.r on ~ oo~o~a•a. +•n. m. oc~*M occuaato nN .u~a. o.. w CF~'i~F~CAifON- ..w~w wr ~e.e ~ ra.w~ a.r ~uu ra+m w~ ~eu wo* e~ a• - ~wa; /i, s•n. •..o. ~o w«. ~ ~ ~ s ~ ~ rnrSKiwa: TO ~ '~li~ M rr c~w~+ua:~.=. ~~nn.o~a rne" ' 3 ?U. ~ tl[ 0~" 3 tl~ ~b M. 1o d! c.wu~a~ ?L:.:: ji~ DfCt~SfO ~~Or.~~ • ~.i::+fKwT~ON-:MFD ' EIfA/.W~EP O¢ CORONER: o« nu w~f or ~ wow p a~u~ i~f OK~DlMI w~s nor.w~cto oue ° ..o.nw w~ n.f ~or' ~ e a.r~+~nOr~ W~ ~/GO'? u~/O~ tMf M~restK.~iq~+. w rr O~wO~, ~ ~ ce+rn OCW~YOi~.7M~ 10 M 4Nilq~ ft~n~. ~ O 77~ ~ • . Y 1:• ~ CER7iFtER- ~ r r~ SIGNAT E uwee w nn ~TE SK,?~EO ~~TM, •:i; - • . 7J?. 0 ~ ~ a/ • 1S~ o to fu~[ t~ ~ ~ N ~iIING ` SS-~E~R~fR • • 1•+~ sn~ u.o .~o. Z " _ ~ a . ~ a~RiAI. CREMAAQK~.~ vllt ' fMEtEln C~E~MI R1f-N~F t iWM un w a.iw s~.n ; ~ i • ~ Tndi anannl3s__ 'Tr+r~; a~,a 1 # . d~ : G~ofm Hill Ce~~eterv t ~110 D~TE ,?~w~• • NNER ? -re~ME ~rr0 nDDRfSS 1 3f~lO Ot ~./.O. r0., trtt M fOVw, surt. i~1 ~ ~ .a r~y ;':3~ ~j ~ n;?e:~soa Fr.neral }Io;..e Inc. ~e~rinr Florica ~8 0 i f~re,~~~ 4 ' f(EGIST 3 S~GNAii/fF \ Dw ECtI ED ~1 ~ tfQ'vi3i}l~w! = ~ . / ` \ M \ ~ ; ' This is a true copy of the certificate filed with the Division f a h• ~ ir. sacksonville, Florida • ~ , ~ ~ - ~ ~ VOI~~•'n~THOllT SEAL Re ' ar • ~ ~ ~ Pl~ase Retum To: ~ k ' ' • • "'O:FQLK, MYERS, CURTIS, CRAIG & CRFLVS N. O. Box 1079 Lake Walls. f{orida 33853 8~~~ LAw OFFICES, WOOIFOLK, MYERS, CURTIS, CRAIG & CRENfS ~ ~ " ° 't . . S"~ffi _ tf . ws ~rs-7~°