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HomeMy WebLinkAbout1805 CERTIFICATE OF DEATH 3a~7.3S . Dkr~.w.i .t 1 k.hA .~.d R~I~.M~n.~~ G..+.Y. F L O R I D A 1TATt r~~s No. ~ ~w~c~«rv ~..i ~u T~?E. O~ •tlNt IN ' REOIiTAAp•• HO N~MAMlNT INR ~~EA3l~-NMtt a~a~ .ew~ ~~s~ ~ri DAtt W OEATN ~•orrw, n•~~ SE! WI~IOOI iM "s'~"~'s ~ IIASI~LL A. CAt•~'I313I.L : ASAI.E ~A ril lI 1975 UCE r~t~. wt0~0. ~.pK~w .rM•r. AGE-l~f~ t?w~ r v~~ woa ~ wr DATE Of WM ~rO~wr. N~, COIINTII Of OEwiM IK. ~ Wtr• ~ M~fw~~ ~ryuf~ rOf ~.•s rW~f .uw n~~~ . teihite 67 A w ' .Oct. 2 1507 Saint Lucie 66Q2 Cm, TO~M. t At10~! O~ OE~M w.UN env ~rM HOShTwI O~ O:?~E! ~aSirt1R~0?~-N ~r w.... e.~w.. a~n s.re~ ww~~ ~ ~?ecs. ,~s o~ ~+o n Fort Pierce Yes DOA-rort Pierce ~ter~orial Iiospital ~ StAIE Of W1M .r wo~ w:. a MIIEM d MmAT COU~a1It~ IrARR1fD. ?iEVEt MAttlfO. SUlVNNG SrO11SE ~r am .u~otr ww ~ - . "`r"^' w~DOWE0. ~wc.•~ ~r•~ississippi - . USA j,._t,iarrie~c~ 1lilda Gillis .en Mcufes - i~.~o r a~w~ SOCIAI SEClMIT1/ MlwEt USUAI OCCU?AT10N ~oM ~rn o. ww ear wa.w roii w i~lq Oi MISNFSS 0~ NOVSf~~ occwn~ (~owro uw, mr r nmeo r „2G~!--O1-6Gu7 a~~a..awror ,~s Paclcin I-touse Forerian Citrl3S ~e.~fs } RESIOENCE-SfAiE ~COUM1v- CITt. TOWN. O~ IOCATION ~+s~N twv ir~*f~SIffET YA NIW~ft'_-- - ~ vec+. ns o~ «o ~4 rlora.da ~•..St. Lucie Fort Pierce 1'es 90G So. l~ti~ Streel: /111?IEt-N~M( •.y~ ~~pp~ ~~ff MpiMF~-IMAIpEN N4ME ~rfr +roa~ usr Olin Cam beZl Unavailable . IMO~IMAM-H4ME MA\WG AOpRESS ~s~nn w~ ce ro . tm .f. roo~. s~~n. tr~ ~,.~•irs. I~ilda G. Ca?n bell ~n 90G So. 17th St. Ft. Pierce rla. 33~?50 tAft 1 QE~TM W~S CI~USEG ~EMff OH(Y ONE CAUSE IE~ lllE /Of (eJ, (!i, ANp l~/j • r r~.u ~w ~ ru q ,.ra• •vs~ n~r~e.. oMwr ~w «•rw c'Ak~JAc Al~R£57-' ~ . =wMNnOM1. ~r ~r.. ' CM O~t~ •~1~ ~O ) (01 ~ ~r~~1~/~ C~YfY •O• I D.i! ~f~ M ~l ~ (t~w4fOVfKf M. . ' - - ~ - - ~ 1t~~iMO t~f • •N. ,.,~o ~R 7"F_ , R/GSC~~/~G7"/ c _~FART D1SFf~.S~ 1 f~~T • niHE~ S~C'i"~~f~CAN? fON[NI~ONS [a+ano-n co~MUn~+e ro a.... .ro~ a.•ne •o uv~a one. w..•n . w~ ~ MltOKr T ~i rE5 ~~.e~ros ca.• /1,~~. i 7-y ~o Hol Ys~ ~ I~iA ~,F fi~s . ti . .n~. : ;a e;: a.~....~.o n ~~a~vi. ',reio~ G' jb~Tf~i~~..o..... u...e... T?ioix yl!~ ~ wr'~e: o~ w+cau.ra~eo ` ` ~ ~?axn ~ RRE~iS'/~I/n~n . . n , o...., .n.. ~ ~ ~~*y a ;'~~7`flv Iig` -~v ' ~ .i 4°' /j~j~li! .:w / - ~r., ~ Q w ,rw FCU~YO .f1~/~"l• G/.- T/Lr~c~ ~ U'1VR~ AT wbt ~(E Or ~r+~uR~.~ .ow. ••~r. frrn, ..c.w.. IOC~~lO~+ . snen o~ ~ . • . [~n o~ w~r ...n'/V?/~/G /ii l~it~ ~ 1~?f[IIt e~1 Ot ~+OI ~pll!I 'IM. ~Y •yK1I~~ I ' r !'SP/ T 2 i~..l iroiR~n F~1. rr i.~~i~ ~s , ~i.s f/c~u r ' Cf~TMIG~TKIN-- .Kw.~. o•. .~u u+o us. s.. wr/wt~ •~M d. . sriae wr .a. w. i ~M~SICI~N• ~f~~ i ~OM/M O~~ 1~ rb~M M~ ~tN ~Wt ~1~1~ M~~M Of~~M OCCUHfO •t ~r! ry~C~. O~'M ~ •RI~MIO ~w~ TD ~ ""W ~ O~M. ~NO. ~O M M?• . . f n~ e~c~.a•n nc. ~7q t~. ~ p ~v r• •w~n~ew w~ ~ . CEtiKKAiKMi--?~EDK~I F rA?•WFI O~ CORONtf o« nq ~~~~5 d tre nrt efc~oer~ •'1 f/'y~ • M_ro ~n uvw~~. s.•~u • w a.n~ ~ s ~rr~.ac~e e~.e ~~~~~M~~~OM . Mf ~00~ .L MI ~S•r.~.nY MM~b~. ~ rp~M O~? .~f,r~ ~ ( Of~ti ~C(1r~N~ O~ D o ~M • l1 D e•• : t~. '~I~`1~ir~~ •'~~'l~~!i.~vE,e _ _ ~ ---M~~.--~ ir 7 ~ c p ' CE~~n~E~-ii~uwE .on .n..•- 'S~•r~•ti•if - - . _ / . . oe~w~~ ~ ~ 'n~if iGHED ..M.... o.. ; ~ _1~~C 1_ 1._ x ~t 0 _ _LN i G c~ E7- ~ t~ ~ ~__C:~.~-~ j`~-s .,~.c.~: : ~C~~z.: L t ~ - / r~ : M~N WG~? ff5 - CHUrKS . - - - ~.in. nr ~ . ' T [~n o~ :p r:. f • ne - ` ( e. t . ~•T 1~ : - ~ ; e- ? ~u~ul. C~frutr0~+. AF~+Uv~~ .CEµfiE~t~ p~ CRrutO~r N~w iOC~t~O?+ • ~ ~snc~... . E DA1Reraoval Burial. '7~~ Joel Cenetery Belmont, ~iississippi • - 1- - - ,,.o•... o... IU~+H41 MO~uE- r~~~u( ~NO aDMfiS ~ wne. o• e o. ca• o~ .orr_ v.r~. n~ ~ ~ / t s Funera' Ilone Box 7? I't. Pierce ~~1 33~'S0 v. S. ~L 1~ ruN - e[G~sr s~4ruec Datf ~tCf'~[O .ran.... ~ ~ p~r~'~~" ~N ~ n.~ A ril I6 1975 ~ . , , ~ ~ . ~ ~ h~+~by cKtify thb ro b~ a trw ~nd corr~ct oopy of th~ Locei _ ~ f b~?~rs ?xad on Iile ?n tM St. lucle CounfY H~elth Ovf~e+t• FILEL ~!+E ~'fCuKDED } - Awnt ~t Forf Pi~?u, Flo?~de. S?-lUG[ ~OUNTY fLA. ~~`r` i~.id • RC:,-• F:i~~iAS ; ~~'~:O~v~. ~-y. (yy~niny: Not vslid unless ra~sed ~eal uf tM Sf. l~Ki~ CLER• COURT .r •~~y, ~•-~~i . J Counry Heal~h Oepartment is effix~d.) crrn~ - _ - 18 il i6 PN'7~ ~ y~' ; N. D. MIItER, M. ~R r~~ -;:t ,:~.q~' t ~ty H~alth Offit~r 6 tAtsl R~qistnr %'U - ~i • _ ~ . . ~J y) ~ t Y0 j~..'~ ~ - ~ / (G 7 ~ Q^' ~ ~`l~`~qS2~'~,`r. . ~ os , ~ w_.. ~ _ ; ~ ~ ~ . ~ pM~ D~pu~y Lot~) R~bistr~t t~ _ ~ ~ ~ ~ 800K ~tnT PAGf ~QV~ ~ { i ~ . ~ ' , ~~,tt~ £ , _ - _ - _ _ _ - - - Y~ . ~ 3.'.5 A. .."'J,.~ ;~4 ,-'i'~~~,~;`, ~y ' . F ~ ~ ~ _ 4..?~,ri . . . ~ 'e"~ . _ _