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HomeMy WebLinkAbout0403 ~a~l-~i~} ~ CERTIFICATE OF DEATH ~t ~1 t{Nlll~ ~ Re1~61~q~N+e Gt~kN fTATt Iltt N0. , a.~o~,c~~u.~N FLOAIDA . 7rH. O! ?l1Mt ~M ~~w~'~~~~° 11tO1STRA11•f sVO. - N~MANINI INK ~y«~ ; pwn ? ~ row~w, •t. ~1~~ ~ OtCtASEO-ww! ~~~f~ f[[ t11N06i 10t ~s~ Arthur L. Bin haii~ ~ 1 ~ale ~ Au~ust 19 k ~l.nrr..~aw.••iMCU~ www. ~GE-ua ~ n.~ wa~ o~TE O~ ~utm ~w.M. w.. tounir a otwn~ ~ nu~ ~ .o~. ~.n .oru .w ~ ~ "~hite ,Se~t.10,194 Broti~ard , t TWM ws~w ce. ?r..h nOSMTUI Ot O'f~E! rati ~w w. urw~. ~M ~~~ea wwna ~ wan .~f o~ Mo - , F~. Lau erdal ~ ~~Q1.Y Crc+as Hpan . • STATt Of MlM ~w .wt w~ wa~ 11IBd Gf wMAT CIX~iIT MARt~EO. NE~f! wultt~ED. fWV1YMKi S~'OYSE ~r .w. sn~ r,~~ w~w ~ oow~wi Mf100wED. Wr'O~CEO ~vKOr~ •fw~ Mf~wtf 1t 11. T•` ~ errir Nce~sN SOCut SEC1l~iv N11WER YSWI OCCU?ATqN ~an w.wi oow ow~.a •a~ a it!!D Of WSwESi O~ IN~USM~ ura. • wM rO~twO uM. Mr r Ma~M ~ OCC1W~ M ~~w~~.~ t~ ~y~M~ 1!. Ua C!C ~88 p~ o tructio ~s+u~s~. RES~OENCE-ST~tE C011~A11 Cm, iOWN. OR tOG?TION Ms~M an ~rm St+tEEi ~?~W Nwr~E ~vecr~ ns p .a w Florida ~p St. Luci~! Port St. Lucie ~u ves 24 Kil~atrick Ave ~ATNER-1~4ME ~NA w~Mt uP MOTME!-MAIOEN MAME MW r00t~ w~ If 1~ ~ a IMlOW+?Nt-r++1ME w?tir~G ~OGtESi ~ana o~ w., un o~ aw., s?.a. ir~ r s ~ 4 , ~ ~ ~er 1. ....o.... pEwiM wAS G1uSED ~r, (El/iER ONt? OME C~USE ?ft lWE lOt bL 1A6 ~D k/1 arre~r o~+N* •w st~ IL ~ ~ A` ~ ~ ' ~ u . l. ~OMM~OMa, M w~, _ A ~natw 0~~~ ~~i~ f0 n) ~i I~X/~ ~ ~ G' IIW~NAI~ C~vf~ ~a. ft~t~MO twf rM~M• ~ p•~`y~~p. ~ ~L ~ ~ {y~ / 7_~ ~~1M0 4?Yi! Yfi wutorsr rt rES .u~ ..•w~Nos ~AR~ R 0 5~~1'1j ~~t~IT10HS~ CO~eYWnr6 ~O- ~ M Wt +M~~ q t~Y!! 6~qM 1r(/Yf 1 NI ~K/ W M01 « l~lw Olil/rMIMO _ / ,r- / ~ G/~' c~-C1.':.-E .C ~ i?~ ` C~-Gt~-~{ +~~y 1N ~+own~. Mr, nu ~ MOW INIYlf OCCYRRED ~~~wt~ w~M! W wwn w~ ~yt ~ O~ ~~p r, aw N ~ OR YnDEtEl~w+EO ~ ~ ~ M. 79i. M1JU~r AT M?OR[ Of NAJ~Y ~r w.t. ru.. snrn. ~~c~w~. IOCwT10N ~ sw~ ea u~. .q.. an o~ q~. a~t ~ • ~Mwwwsa.a~ a.wwo..e~. ~v+nw~ 71.. ~M ' ~M- , rpp . M.~ ~ ~ ~{IJ wONM Y~ ~W ~ ~ MT~ .~iu~ we~ •~M * ~ ~ .ow a O..-e.l.*.O. ~o r ~Q~ TO W ~t [rOrR~00f. 0 r. «n ~ .:o ~ ~ _ `l - 4 . • s ~ 7 2 :10~ •o ~.,,u.., CE~IiKJ?t~ON-+~EOiG?t Ex~wwEt Ot CWOr+ER: o.. ny us.s a Me .o~w p~e.~r twt OKNl~A ~ry MO~+OiNKlO O/V ~ •ur«~nw or u~e ~oo~ ..oic~ r..t wv~st~w~or. .r r~ wr~w~., ro~ww o~~ n.• ~sM N~11~ OCCWMO d+ Mt Mq ~ Ou~ 10 4~t 4ulf4 it~fH. ~ M tA . ta~nt~t~._~r~u~ .ww n~ ~~rn _ ~ ' f..-i~. ~ N'G~!! p RR/ ~ 0 ~rO~~M. O?s. ~WI • - .`j ~J I7~ ) ,i (77c. ~ • I ~ ~ A00lESS-.CER11i~ER ~ u~tn oe a.r.o. .a. st~ N J ^ . ~ -M--• J ' ~.A~iVn~ / :G~i/_~%i.~A ~y . c~' S .C~ .7 ~11 . < r NAUI. CREMATqH. ~Er+~Ovwl tEMEtEtr OR C~EMATOiT-auME lOGifON. ' c.n a h•.~ sun ~s val ~Hillcrest ?~{em.Gardens Vero Be~ch Florida OA?E ~..o~ww. ~eu ~ fUN[~/LL NOME-NA+Mf ~~v0 ~ODefSS . uetnJw ~ r~_ ro.. cm M tow~, st~n. t~r ~ ~y o ti .~~•r+ R- e li ? 7!i @ ~OZZ.Y~~'~Jd ~ i r. S. sb iZ ru~ -s+eH.nuE ~ a~s w~-s~c~.rc~ D ~EQwEO r ~osu •ee,s:... ~ t~• r ~ • R~v.1970 ~ / ~ ~ ~ . ~f ~ . ~ ~ , ~ - " ~ CERTIFIED COPY ~ ri. . ~ ~ I hereby ~er~n ~~it~ \~ibire to be a true and correct copy of the Local Registrar.~.9it~or8 0~1•.~fy,~,, in the Broward County Health Departiaent at Fort Lac~e~dafL~,p~fa~rida~ ~ ~ ~ :~?;~~R::6~5iRtiit , (Warnin~t ;~+I~nt vd~#d ~nl~~ ;~sised seal of the Broward County Health ~ ~~~~t~~~ e~~~~ced. ) ~ , - . y .t~, . . f~'•,.T~a~taQ,: . ~!•~,F~ ~~,~1 ^ - ~•/r~wt~•• ~ i!~'~J ~ ^ , County ealth Officer d Local Registrar ~ $~p6-~4 • _y- Deputy Loca e s `rar" ~ ~ . ~ ~ - - --p'` ~ ~ 3 ~ fiLEO :.•i~~ ^F~~~~ ~ Si. lU:, :•OUR~TY fl~- . F.i ~jTR(f~~~ \ ~ y`f~i. ~.I.iV 7 Y ~c~.~p:~ •;~~'*!Efl~.~+ ~ a a ~~7 3 05 PK'75 ~ eo~243 PAGE 403 - 315624 ~ ~ ; _ _ _ ~ ~.~Y ~~M-~~:~ ~_r-