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HomeMy WebLinkAbout0856 31s~o4 ~ CERTIFICATE OF DEATH ~ Deprl~lcwl ~1 Ikal1~ ~wd Re1r6i111a1M $enker ~'fAT[ FIL< NO. _ ~ a~~+rw ~ irw~.ni F L O A I D A '?E. Of ~~1NT IN ~~~~~~~v ~ ~ RE61tf1~AN'? HO. '~RMAMlNI INR OKEASEO-MAM( ~tist r.~~ uN j~ll OA/E Of OEA1M ~ rowtw, ~~t, ~~u ~ +rst~ttMS ~ lifilliau~ B~ ~E ~ r« J,ee ~ Mals , Septe~abeac 23 ~ 1975 R~tE .rw. .now. •wrcu. w~w.., AGE-a.a w~a~ ~*u~ ww~ ~ wr OATE Oi NfM ~+O~wr. Mt. COUNnI Of CEwiN ~sKCr~~ M~~.9 ~~nus~ ».o~_ rra was+ rr. ""ltarah i0~i903 St• LZ1C~6 6602 . tow~+. ~oui oe• _ • NO6ntAt W OMf~ NS «w w ~~w~. cwt ~wer .Mre~ ~ Ft. Pierce f,;~~yes H Ft. Piero~ l~e~aocisi ~oapiial St~~f O~ MtM ~r wp~ w~ v.~.a.. r..u Gfi2Ew Oi w?Ml C01R~Tl~ rWtiEO. NEVER M~frEO. SU~vNNG SiOUSE ~..w. ~~n r.~.. ww ~ uwuNwe..ce ~ N@N YQ2'li • co~~ ~(J~$~A• ~~EO u1y~CEO~rx~.~ n~~.~ C~r IT18Q v~MM NC~~ff~ tnM. Y M~M SOCIAI SECVRI/1I MW~E~ USUAI OCCUfAT~OH ~ow~ aw or ro~a ww MAr~O ~op M RWD Of M1SM~SS O~ MDNSttr ~s*mn~a.. o.w /y~~ «`N"•" 1 0. ~`~'u~"'r~ntt?"'e~'ent of Mail U.S. Postal Service ~ew~wce rror 11 ~ ~I J t~. ~ q~ •~"'~~"o"~ ~ESIDENCE-StA?E COUNt~ Gt11. tOMM. OR IOGiWN r+?yt un ~~wf SiRfE7 A?~D MMYE ~ ~ret ~ w Mo ~o~taa st. Luoi. Po~t st. Lucie ~d' „~ae N.~. s,:rrey st. ' IAi11Et-1YaME ~Nfr rOMt uY M~OiNE!-MADEN NMIF rrst wN~f ut~ . ~f '~'~1q~88 1.9A S~"'d~1 UAO~• , IMIO~M~wf-NAME w?~NG AOO~ESS ~i~un w~.~~. uo.. tw~ o~ ro.r, u•w, c~~ u.Mas. C. Lee ~n.30Q N.$. St~rey St. PaoCt St• Lucie~ Fl,a. 3~i52 rrur bum wns Cwusco ~r: (EnrEr awr a+t uusc rf~ u~ rdt NL AL .vao kA Mnr~M•OMNI u+ N~~w N a' . cerelaal vascular ecciaent 3 aa~ys : torMnowf, u •.n, n, Chr . Iynphatic Laukesi~a ~~~lN~1t C~Y~! IW. ~ p. d S~~f~MO ~A/ •N~fF \~IMO C~YM l~ft , ~Ati OTI~R SIGNr1~A~'1f ~0l~If10NYi ~OM~wOwt COM~MMO p~t~M M rW 4YN q U1q! OMM w~Yf ~ M~ A11I0?Sf i rES ~~e! hwNMOt COµ ~ INt O~ +01 YNtl~ N~ NA~W~~M f~11N . ~ VO p ~euw t?MeMrf N~ KME. a~IRO~ifWM~EP ~~o.'+w. r~, n•~ ~ NpW INIIlRY OCCYR~ED ~~~+~e~ M?Me w ww~* ~w r.n ~ O~ r~n w, ~u ~ ~ ~ ~ ~ M. !M ~NAlar Ai MlplR KACE p IN1U~Y »o.e. r.w, srrn. r.cion. tOCw110N ~~wen w~.r.~. ro.. cw~ o~ +o~r. o~w r 1~Mtln At q NO~ O~hCf MM.,~K. IMKM~~ ~ ~ ~ ~ l CE~IM1CAi10H- w~w M~ Ra1 rarrM Mr rtu w uH f~~r ~r/wM wu+! OM ~ M/s» ~+0~ +~r M OlAfN OCC11rlO ~r ~M hKt. Or M pRtK1u~: - TO ry +O~ww Mf Y ~ON ~ ~l~~M. ~rOY~r W. w. p 1t Mff ~ ~ ~n~..sts wn 1 v~ K ft~ ~ect•f~~ ~ror J ! S JI? 9 23 ! J 2 a w sr~o.~nq. wa . CEtTifKwT~ON-MEOK.~I E~ww~rtt O! CO~ONE~: o.~ me ~..w w w~ 9 3 ~ !N tw K~e rr ~w~.u wrN. . ~WY~ M M•w ww Ncea.w vu eey ' I~Y1~ut~OM d M q~~ ~M/M u! Mli~W~O~+. M~r 0?4,4~. rOMIw Mf A~~ ~py~ Of~M OC[1MfO O~ 1N MA YA M b ~M! CNeNM ft~N~ ~ M ~ CftMIEf-HyME ~nrt o~ i~w.n - M. t s~cw~ o~ A s~ O~+~+M, ti~, nu~ - Jottin D. BroK__n~g ?'II) r,. - ~ 9-2'~-?5 ~w~n~ ~ooecss-ccrnrt~ 1600 S. ~-~ift~1`. et . eT~ - Ff~07C1ds 3~50 . WbAI. C~EMA?10N. RfMO~AI lElY O! C~EMAIOtY-HAMf lOUiqy/ c.n q»~ sun ~ ~frlC+?~ ,M Re~oval Baptiat Cen?etery „ ount Ho],~y (Buoclington) N.J. DAtE ~ • ~ iUNE~AI OMf-NaiwF u+0 A00~lSS ~ s~.~n w•.~. ro., cw~ o~ io s~~n, n?~ p ~QiA Se,pt. '~i;' ~9}~j Ro r L. PSL Funoral~ Howe 851~S. Fed. }iwy. F~ Y. S. ~612 fwH~? oKKrOR-S~~ ~G+s~ nx[. r o~n eecemo ~ow ~[onnu R~v.I470 rq ~/Y ~ ~ ~ iy GcL` • u,( ~~M ~ 1 hM'~by o~rtify Ml~ fo b~ s tnN ~nd tor~~[t oopy of 1tN LOtel Fs~EC~~.• ~cC~rtttE~ y~ Rpitt~~/'s ~etotd o~+ file in fh~ Sf. luci~ Gou~~1? H~etth OvpiA• S~. LitC1~ :~JVTY FtA_ ~li IMf1f ~t fOft PiNCl. ~~M~dB. ~ ' ~ ~A$ ClfRt ~ (VYsr~iny: tvot vs~~d uniess ra~sed seal ~f th~ St. ~yi~ . a t C Ot,~~ . - ~ Cpynty Health Ospertment is sffi,c~d.) : : / : SEP 3~ L 32 PH ~ ~ , +1•i N. D. MIIIER, M. D. ~ . , . County 'Fi~ith 4ffio~~ i lntel R~qiihw ~ / . ~ ~ ~;:1~~~,~, : , . . . . oM. O.wfi? t~ou~ a.o~s~... - , ~ , , _ . ~ . 6o~K 244 f~~E 856 - - _ ~ . 318t}04 , . . ~ . ' ' . ; . ~ x- -y._ - ~ ; ~ ~ ~F_