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HomeMy WebLinkAbout0234 ~ C, T~i• ~rwTS .owRD or Mr~rt CERTlFICATE OR DEATH ~ i~~••• • . ¦u~uu or vnw~ ~r~rirr~e~ fT/1Tt RIL[ NO. • '•s•''•°- FLOSIDA e~d ts~4 SI T NO. RCGItT11A11•f No. 488 ~ prep~rl~ . •t~eot~~ 1. KAC[ N~[ATN CODi N0. ~wKMCtI~~..rr~Mr' ~.1 l/iwirr. R.ib...M/...i.,..u.) • •wA •fll OwMtr a STATE OOUNT1l . St. Lucie 66-025 Florid S. Lucie 1~ ~~f~ ; CITY. TOIMII.OR IOC~TqN t. eS K~CC O~ O[I1TM t. CITr. TOIrN.OII IOC~TIOM t. K RES~OENCE , •~f~l~t IIKIOf LIMITSi IMS10E TY LIY1~51 r,,.. Ft. Pierce ~E~"'j ,q~ Ft. Pierce ~S ~ : . t. NAME OF (If Yf h ~M>ihi. /rt ~bttl M6tA1 ' STII[ET A0011[SS • . ~ NOSMTAL OII 420 N. 6th St. 420 N. 6th St. 7. iYr~t XNrte l.~e~ d?TE L/wN Dq Y~a : n~ «`.?~n ANNIE MAE ~ DURBIN o?*~ November 2 3, 19 6 8 ; ~ S. SEX i CO1011 OR RAtE 7. MA1111ED ~ MEVER MA11ME0 tMTE Of p11TN !?GE (l~ rtY! • 1~Od! 1 ifY 1MOEt t~ NK. ~ ~~q~ MwrM D+r+ /w+~ Yi~ • ~ t~• F C au rnoo.co wvacto De c. 21 18 9 3 7 4 ~ ~l~fwl~ 10~. tKU~~occv?+?TqNiWrrli,~y~rtlw~ 1a.KMDOiNIfY1[~WIWOUSTAr If. M~ITMRACE(g~ftw/Nt1~tNb/1 f ornm~os~w?tmMntrr .te~ ~vl~_.wyb??fa~l~r.e~..1/?wr?M •~~~w• Home Maker Own Home Hazen Arka~sas USA ~ .i... ~Q 1 IA?MElYS tHMf . MOTMt~'3 MAIOIII IM1K ~ ~»••?s~•~ Sam Perry Belle 2sbell ~ Q aocu~ sccu~m No. n. f s~~w?w~ ~ wtf.« 63-82-571 t ~a1 Zl~• .~.c.c~-t Ft. Pierce Florida S-t r..•?.I ~l c.wi ~r Mwn~ (are...+r... a..~e ~e. tawp. c•). IN..,~ ~a.) u+rrRVa. s~ir~r[cN ~ ~ir~eae• ~AATI.OEATIMASCAY6[OtYv ? aKUtuooun~ ~ •n~t til• wrEOU~TE ~~ust (~1 ~~GiI~3SC/~~df ~ t~• e~r_ ~ ~ t~tie~t• C~.fYw.i/..~. ouc To •ice e~• .u~ ~..e .i~ u ~ . I • e a 1 ~ ~ (~1: ' ti,.~ r~si~tr~r frfM n~~e faf. ~ To • 1 tAl• Ti ~ ftAT N. SIG1r'ICM? CO1~0f(IQIS IO ONiM M NW R[U1C010 ilrt 7F~IIML WFASE C~I1KM GNtI ll ~MT 1(~) . wAS AUTO~SY ~ eenr. .t- 3 ~GA[t~ r'~~ ; ~•r a~•ti ! r[aa~ ot e.nr. < < 3 resD ~ tDA. ocsuac ~aw nuu~r occu~ao. ~Ewra ~rws yto)arr b a.t ! r Pat /I yYa~ i~J i ¦tItl~t •~j ~ Aa~OEMt S(lK~OE NOYK~OE ~t~o~~i= u ? ? ? ~ tfi~ •f T~ME Of Nwr XMf~. . ?.s~. on. t~.. uuu~r n. o P. w. ~ ~dl. IMlU11Y OCCYIlllEO me. ~LACE Oi INJ1/111/ (t. I.. h~r ~f+Nl b+w. ~A/ CITT. 70w11. O~ tOCAT1011 ~ COYIITY ST~tE tl1M1lE AT ~ Iq~ Mn1RE ~ /~?~•I~wI. ~frtd. ~~~r OIN•. dt.) - NO~K AT w+01tK 2!. I~tandsdtMd~cw r Ht_ p. O 3 L~ ~ ~v?./~R ~~6~ _ ~ __T . Io •nd fut M? ~fir~ en ~~A ~ m on eM d~t~ ~t~t~d ~bw~; ~nd te tA~ 6Nf o1 u~~ knowNdp. /rom tA~ u~ws ~t~t~d. ~11 lt~~s ~ N t~ •e• to t~/f! ~O'I .17.~ ~ ~T ~ t r ~ ~..,i.a. , t.,ti< < < ~ - 6 •ee~rat~. 2~ ~YMY GFIUT~OM. pb DA1E 2k IIAYEOrCFMET[RY011C~EMAIORY ~3/.lOGT10M(GS//, s.M(NtAf/) (&dt) ~S Hillcrest Mem. ~ Bur~a~ 1- - Gdns Ft. Pierce Florida ~.l./61S j~. iUNE~UL E OII S TYRC SS 25. OATE 11ECD_ ~Y WC11~~EC. 2i. ISTMR'i T{q1E ~ ..,.~odb r~ i~~ N. ~th st .C"iF~'~~~ . . /n• ~ Ft.Pierce F1 Nov. 26 1968 • ; r 1 haroby asrtify th(s 1o b~ ~ tnis and cotrect cnpy of th~ locai ~ . Repistra's reoord on file in the St. lucie County N~alth D~part_ ` msnt N fwf Pieroe, fbtids. t~s ~ " i- • j , _ • i. . ~ « ` (W~in~: Not valid unless raised s~al of ti» St. lucis , 't~s ~ ~q~s ' i COtN11y HN~t~1 aPlfff~Nflf ~f ~Ix~.) ;.~~s~ ~~'Lj ;t'a , ~ :'~c~~ ~ _ ; F__.V,~. i..~ - c `~~nc 1 ~ ~ t~,-, s ~ - ~ - ~ ` * A. -n _ - t't ~ ' N. D. MILLER, M. D. - . ~`r' ~ ;~y ~'~F ~ ' ~ . W _ c~ o° - . . ~-,c: ~ CouRty H~alth Offiar 3 Lad itp(sNai - ' " - - > S ~.i ~w,~ - ~ ~ i . , .t-: 't . t~•-, e~ i ~ ~ - n ~ ~ ~'C! ° ar we ~ ~ ~ . ~ ±'v: i #1 1~ ~ A ~ei ~ .~(o ~ .r n~ 4• * ~ j y sb ; D~N D~p~Ay t~ocal er r~, ~~y :,~~t ~ ~ ~t c--.~r~. , l+~ ~ `r~,..fwA~~f,~~~IQ~_~~~, i!'' . . ,ti~ .w _ .,~4'///I//~Slfl~ , ! oox 2~ ~c~ ~34 . . - : . . _ _ ~ ~ : _ _ ~ } . ~ ~ ~ ~ ~ .~r,~ ~ ° ~°.~t . . 3