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HomeMy WebLinkAbout0836 30'756~ ~ ~ , , . CERTIFICATE OF DEATH ' p~.ew~ .f Ik.i~~ .w~ ReL.L~NaN.. Se..~ce. F L O R I D A KATt IIL[ NO. . ~~~~'aw~ ~ ?s~~ ir~E. W~NNt NI . 11tO1iT11A11•~ No. 195 M~MAtMNT INK a~~p_IMM[ rrtr r~t usr SEl 0+?iE OEAM ~+or~. w~. ~~u~ SEl MMiO~I IN ~ ~ N~I.IE B. CAIt~iF.R , Fenale , Ma~rch 25, 1975 ' . U1C! ~rtr. wNq. urncw w~uw. AGE-uu r~~~ ~ww~ ~~?r OAiE OI MtM ~~o.w~, Mt. COIMA~ d OEAM ~ nc. ~wc~.~ ~71~. ~.7~„w~~A.o~. «n Mows ~'~Ct. 21,1904 St. I711C3.@ 66OZ • . O~ t A rs~t c+? ~rws NOSMTAI O~ O~NN NST - .o~ ~r ~w.~~, aw~ Nen u~ ~wrw~ ~ , f~K~ ~If M MO ~ Ft. Pierce Yes N Ft. Pierce MaoOrial Hospital ~fAtE O~ Wn1 ~ r No~ .uw Cti~tN Of wNAT COtR~RiY 1NAtMEO. NErEI iM~RMEd SYl1IIYNG S~OI?SE ~r ww. Nw r?Mr r~rr ~ ~.r.. ~ Florlda ~ USA ""D4~f~iP~° ~ John Carver . •wr Mn.w• ~ ~nt~ r~taa SOCW SfilJtlhl M/M~E\ USIluI OCCUiAi~ON ~ave i~w a~wa wr wr~o rost er KND OI MlSNESS q MOIRthf otcMY~ ~O~M vir~~. MN Y~ y~MLN 1 ~s 04~[1 HQfIE ~ILN C~~MMN 1} 2 6 1~. jMlc •7Lifl~r ~~.rtWu. ~ES~DENCE-StA1E COUM~ GIt. f0~1. O~ IOCATION MvN c~n i~us Sf~EEt ANO ~NfrKt Florida St. Lucie Ft. Pieroe ""`"'S~es 318 N. 16th St. I4 IN. t4. W IM. ~AiNE~-HArE ~w~ wNt~ ua MOt?~E~-MAbfrr NAMF r~ r~M~ w~ `s „ Mortimer Buntirtig Nellie Unavailable ~nker : ~ ~wORMM+t-r+M~E ru~ar+G ~oo~ESS ~seMn a~.~. we. ew. a~o.n. v.w. tr~ ~ Alfred Welliux~ 318 N. 16th St. , Ft. Pierce, Flari.da 33450 • r~r oE~1N wns CwuSEO ~r~ iE?+r[a owr owt uusE rEa irrE rd NL AL ~v+o kq ..:.:;:'o w.:. w.r ~ N ~ ~ h~ ~.~L.r- ` ~'-y"'~,~.'4f-7 24 ` 'Ywt!L~ . ~ . tOrMrtOMf. ~~n, L .=w- ~ _ - - ' ~~Kr~Oah ~~f~ q •t~ ~ ~ ~~~-v~ cws~ ~a. w~ . n c ~ or: f~AtIMO tM~ rM~n~ . - rn~N t~~q w~ . kl ~wt~ ~ OiMF! SM',HI~KAMt fOMOtf10f4S~ Cd~MM~f Cd1RMM~lO p NaA1 M NO7 ~f4/N ~'D 4r!! ~M» M?Y~ 1 N! MJTO?S~ M ~ES .~n ~~w.ro~ ca.- : 1 tH O~ MOI MN~H NI MNVMMN ~~YM ' Or N~~M ~w O ~h 1 GDE ~~wa, Mq ~ea~ ~ NOW INIWt OCCtN~ED ~ trt~ .rTMe rM~ r rur ~ w~~w h~O.~r.~y ~ O! N~OI/E~MMO " - w. ~ew ~ • ~1 i~ 7M M. 7Y INMt AT MfOR[ RACE Of NMY u ror. .?~r. s'4n. i.nw•. IOCATION . ~ swen w ..o.. o.. w~o.+., P~w ~ ' ~wcw+ nf w Mo~ ow~t~ wso..et. ~fwcr~~ ~ ~ 1 CEets~U?TION- ~a. a.~ .w~r .eu u~ usr f~. rr~rti uiw a. ~ w~«~ .o~ .~n. w p~wm otcwno wr ~ua. w r - r~sK~..~ii.~n w.e _-TO / •a•~r wu ~ne. M•r. ~wow~ d V ww. u.~. ~o N wu M Nn~s~~ rw.r ~ I ~ L) ~ ~ t1 Z ~ ' t1~. ! 74 ~ . - M ~o r w~nen~wo~, w~ , CE~TIf1Gi~OM- AL f1fAMlIER p qONER: a+ ne usn w w~ woN p N•~ nw ~ecew.n N MY ~ i ii. i w~! w~i~w«i w~i a.¦ii.nx ~iv u we°~~°~. Cl , • •~u «ow L~ - - - r~i~ - ) ~ • cE~n~lf~_ .....w....n / Ne.e d rwu wtE ~+a.~., i.i..w~ . 11~ IA J 'V ~ tk , !'~~s . MAR • - ~TRKf / ~ ) . _ _SrM~t M ~ ~ e ' . Cmr W q~. ~ ~ f~~R ~r ~y _l i~ L -C _ ? ~ ~ V f WMnt. qEMA . ~fMOV~I E~rEIERr OR CREwu~tOar-- tOGt~p+ cn. o• s+.a "~`~$urial Ft. Pi~erce Cet~fiery ~ Ft. Pierve Flo~ri[ia ' ~a H, DAtE ~.ow.w. Mr, Ru~ iVN(~M MOME-NIA~ ANp App! S s• o~ ~R• ~ h 27, 1975 BAIRD FU1~1L H~ME, N. '~th S~ ;~t;' ~i,eroe, Florida 33950 ~ x 1t~r.1910 ' ~ v. S. 1612 ~ R o~ ` T f Y s. 5 b~ C~J~ ~ ,fw~ A`ry 11 ~ 1`J I~ 1 hM+~bY aKtify Mb lo b~ e tnr~ i~d corfoct oopy of fM Lote! ` tpi~~rsr's ?eoord on file in th~ St. ltrcis Gou~?Y H~alth D~sA• . ~ ~ECJ~DED lw;.; ~ y . . ~nt ~t FoA P~NCe. Florida. F II~D . ! . , _ - : sed fea~ of th~ St. l~ci~ ST. LU~ ~_;~~N1T FLA. . - ` (yy~ni?ty: Not vsiid unless rai R~~: ~ ~^ITRAS ~ . ; C o u n t y H e a H h ~ e p a r t m e n t i s effix o d.) r ~ E F?%-".;;,, 1 T C~ JURT ` ~ '-s - . ~ ~~~~?i: _ .,-{~i~ ' - . . N. D. MI IER, M. D. `~-:j ` ,~y, NA~ 8 t i 3a AM'75 ~ Hwith GNfic~r 6 v.nq. ~tp'+s~ar - '~i • . " ~ ~ - . j , '9•)~ry~a..S, ; ~2 . ~ I i . i ~ / ~ ~ i y d - ~ f .i a.,1 r ~5C _ ` - ~ r , ; p~ p~pwy LAaI Rsoisr.~r ~ - - . ; . > ~ • ' ' . ' ' + ` - + . ~ ~ : i 0 R . t3t~1~ n071{~.rJe7 F'A[~ ~ ~ . . . ~ . _ . 4~ . _