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Home My WebLink About2002 _ - j ~ ~ DADE COUNTY ~~8a~~ ~ / DEPARTMENT OF PUBLIC $EAIIl`~ " 1350 N. W. FOtIRTEEN STREET MIAMI~ FLORIDA 3S12S ~ ~ . : ~ DEPARTMENTOF HEALTH & REHABILITATIVE SERVICES • DIVISION OF HEALTH I E~gBgy ~if.~ ZBIS TO BS A TIt[SE COPY CF ~ IAC'.AL N'SGISTRAR' S ItBCORD CF DEA ~ ' ~ v i1t1 J,; f- ~ s • ° ~ , ~ ' rt s_ g ,'t~~; ~ .~Ftutless the raised seal REGIS ~ ' :^.,''~v. .~,.d,J . c. . ~,Ai Vltai S~tlstlC.'s VITAL RSCORD6 UNIT - L ~r~-ii: : ) MIAMI, FLORIOA --~ar;.~wQ: = ~r:- ~ . '~.t. , ? ~ - ' ~r CERTlFICATE OF DEATH - " 13rpvfreal o/ ~fe~1 -~~'~~~~p~~~S"„ - - 8TATE FIIE NO. ~i i :N "~'t" ~~.~4 F L O R I D 1~ wE~,js:see:s No. t r~DWf `l~ii gEII DAiE Of DfATN i ~or.rw, o.~, re.~ ~ +K DfCE~SED-NAMf y~ ~ , '='::~Ib~EAIf~ C. 1C~'EFiER t Female ~ MAY 4,1975 : 1UCf .wre...tcw. u.eucan a.ou.a. • AGE-~•sr w.oe~ ~.ew~ unaE~ ~ o.. DATE Of tiRTN ~.O..rM, e~?. CWNTY Of DEATH n.~ ~ t~c ~ s~etm~ 4f7M0~~ ~s[us~ rps. wy woues w.: . ~ WHITE y~ 69 ~ k ~ 3ULY S, 1905 „ D~1DE CITY, TOYVN. OR tOCAiION Of OEAM ~ u.so~ Cm urrts HOShTAI OR OTHER fiS~tTUT10N-NAMf tlf MOt IN FIIWf, GIYF ]it1~7 LLI~ NUW[~! ~ JACKSON MEMOR I AL HOSP I TAL ~ n .'~lIAMI YES ST~iE Of ~IRM ~ n Nor w u s.w., N~rE UTIZEN Of MMwT COUNTRY MARRIED. MErER MAfbED. SURVivNG SI~OUSE WME. G~t r~IDEN N~r! 1 cown+, wqOWED. UNORCED ~ srec.. ~ ~ RHODE ISLAND U. S. A. K MARRII:D u 'I~iOMAS KEEIiER ! SCxiAI SEtURIfl/ M1M6Et USW1t OCCWwT10?~ ~avc cr.o o~ woe~ oa+e ow~..c ros* w KwD OF N1511~55 OR ~NDUSiRr ~O~[1MG urt, F[N H fltHtp r ` „ 039 09 2517 ,y HOUSEWIFE OWN HOI~II: ' wsroe cm urrt~ STlEET ~NO NUM~fR ~ RfS~~ENCE-S(AiE CWNri C(fY, TOWN, QR IOCAt10N ~vecnr ~ts o~ no~ { ,w FLORIUA ~yST. LUCIE ~~ORT ST. LUCIE ,N YES ~~,3096 OVERBROOK DRIVE F fATNER-NM~f r~eSt rroaf ust MOZIfR-MAIDEN NAME rerst r,o0l! uft ~ ,s PHILIP - CASWELL MARY FLOI~NCE SIACUM ; I NfORMANT-NAME MAIM~IG AD6lESS ~uae~ oa a r.o. .w , cm d~ow.., sun, lr~ . ~ THOMAS KEEI~R ~n,3096 OVERBROOK llRIVE. PORT ST. LUCIE, FIARIDA ~ vwieT i oEwm wns uusED sr: ([NtER orar o~ uusE r[r ~r~ ~ lal rof. ~uro ~ll k; ~eM o se~ oe.,.~ ~ wroun uwse ~ V ~~l.~ ~ CORONARY ARTERY D 1 SEASE ~;~4~~ti ~ % %'~T~ ~ ,..T:b_ ~ . • • ~seou~.K . . . , i v v ~ ~~..«~~o.., .p.. RHEUMAT 1 C HEART D I SEAS ~ ~ ~ ~ ~ vrw~t. o... .~se w (~s Eti ~ ' . , ~ ~ _ _ } ~~rlw~T! C~Vf~ 10), pK t0. O~ ~f ~ COM3tO~Mr~ce q~ . r fTAtIMO iM~ YMOlf- ~ ~ a' inn6 C~Y3t 1~1f1 ~O d - i ~ ~WfOKIr If rE5 M[l~ /IMOINO> CON• . ?~Ri II. OiHER SIGPlYKANT CONDIf10NS: ~~bas cowi~uvru.c w oe.a w~ ~.oi aur~o ro c•use o~e.. ~M r.ui ~ io~ . ~ ~ns d•ai a oe ~r. oefe~.u..u~o uvse ~ - ~~Yes S ; ' ~~qMfC~OE; O! Y!OEIEfMINfD A ~+OMrr, p.~, rt~n HOUR XOW INIUR~ OCCUtREO ~ tutea .a.rutt or eN~un ~M r~n ~ o~ ~.n u, ~a~. i~ ~ - ~ M !p 70~ M tY ~r~lUlr At MlORtC MAGE Oi NJU~Y wo+a. r.ir, anen. ~•non, lOUT10N ~ snecr w ~ r o. .~o., un o~ ~o.rN, u~n ~ ; ~~rean ns a..o~ ornct wuc., ex. ~ sncws ~ ~ ~ Op ~ ~ ~ ~ CER11fKAT10N- ro.aw a.• rtM rww~ ow~ re.~ u+o us~ s.~ nwiw[~ urve or. ~ WD/Oro MO~ r~Ew nN OEATN OCCURffD •r rwe ruce. a+ a~e ~~V ~ .~~:K R~.~«o,~ ~Y 7,~975 To MAY 9,1975 MA'9~"~,~~5 n.. ~~~.a,~~ ~.~~oSPM a:;~~,"~ ~ + 71~ oec4uo rROr !D It~ !11 t4 M ro n~e wrsc~s~ s~.reo. CERTIfKAT10N-µEDKAI EJ[AMMIER OR CORONER: o.. rwE a.sn p rwe ..oua o~ w.M *~e occ[a.n . rao..w..ceo ot•o e[u.~~t~W p a! ~00~ w,AlO~ tnt wr[Si~G~tqM, w~ ri o~wW... rp~iw o~~ ~!•t wDU1 . Ol~TM OCCYI~lO ON ME W/t ~MO OY! f0 /wt f~VSttS/ SI~RO. n. M ~ CERlIfeER-NAME ~rvre o~ wMn ~ SIGNAT wcne OATE SIGNE i.~oa+~ ow?, r[ ~ ' HOOSHANG BOLOOK 1 M~ ,s ~ r~ S ~ ~ titAltpdG ApORESS-CERiBrtR ~ 7(y0 N:`"1~1°.' `1~~1 AVENUE M 1 A'PIP` OR 1 D " 33 ~ 3~'" ~ ; 1M ~ ~ 6URIAl. CREµAi1pH. AEMOYAt E?~E~ER1f OR CRfM~?TORY-NAntE tOC~T10N c~n w ~o.... sur[ i 31EC~R t ~ ~ CREMATION n~ ~~Y C~~~~~ ta DELRAY BEACH FIARIDA ~ OATE ~rOr.tM 0~~, ~e.~i fUNERAI MOME-NM~f ANO AOORf55 ~ sn[ti o~ ~~.o ..o , ctt. w to~rN, s~~~t. n?+ ~ MAY 12, 1g75 ~~JOSEPH B QOFER b SON FUNERAL JiOME 10931 NE 6 AVE. MIAMI FI~ORI A ~ =WER O~- fURE REGISTRAR iUff O~rE fCE1VE0 IOC~I REGISilA~ z 75! 7M tw V ~ ~ _ '~YR€~i,'-"~i~J - . ~"'~'vc~ ' ~ . . ~ _ ~ s..~ . ~"v ',°m ; y .~'~~a''~ §-~tr?fr~G .rN'° _'`~'"~rsk~ ~r R , _ . . '