The URL can be used to link to this page

Home My WebLink About0354 . ~T.i. rrwTi ~o~o or Mrn~~rt~ CERTIFICATE OF DEATN ~e••• • ~u~~wu or v~ru. ~rrwmn~c~ srwn ?as ~a- YL082DA A SIRT N . RtGiiTRAR•1 MO. 204 ~~~~~'2~ 1. KACt M~TM , CODt MO. t YWA~ w[MOtMC~(M~rrrYr< l/iW~~a twfww?rb~Mr~W .:•~ee.a •il~ O01"n' S. Lucie 66-025 ~ sr~rc Florida aouurr Lucie t~ ~l~e~~ f¦ ~~r- Cm. toww. oR tDaTa~ a ~S nACt 0? ourn . e. dr. 7o~es. o~ uou?~~ow e. ~s ~otwcc - ~ .•.~.t wswt tmr uMrtse r~sac cmr ur~ • r~~.. Ft Pieroe res~ ~ Ft. Pieme .o ; t ~urc or 1d••e r. b.~e.t, rtr. w«r.ra~a.) . t m~rn +~ao~css 1106?IT~L"OR '~"""i0M ~Y' 288 NaYYdT!'a Av+e 7. MAnt N ~'ba! MlfOt LYf 1. DATE ~fwr D» Yt~ i , ET~IARD A. June 26 1966 ' CAt~SELi, o~ *w ' . scx i. cololt a~ Iut[ 7. wuuto ~ ~E1rE~ wwEO a?r[ as aMTM Aii[ (h ~era w um ~ ew u~oui MR } Md Nrt1/V) M~r. O~w !~w 1fi. M• W inoowco aw~cco Oct. 24 1940 65 ~ i ai.l ~ 10~. 1lfwt otuM~~Or (Nu tt~tyvwt Me 101. KMO os M1S~rEis OR wDUS7~r 1 t. MR7H!lACi lA~k ~/~fA a~Mrl) a~ ar ~r Cou~n ; •1tY *~t- f rwlh/tl~r.~nr/~/Nrrf/ ~ •....e ~"~',~"n"~ LbnstztlCtiOC~ Vall OO~tta N.Y. U.S.A. ?l~~k l~k 1 IATIER'3 1MYE 1. MOTNEA'S MMOEM IMM[ tn~~llt~• []ULII71Q111 11 ~1Q 17~i'i~sLL'd't ~ i MAS OtCEA7Ep EYU M Y. 3. ~ItM[O t~ttSt . SOCML SfC114rt11 110. 17. t N~M~TYR OGITl • ~ t f~. r ~ Wrwl U/ r, ~ . _ . ~,,.:y . ~ 091-10-5461 nu,... 188 Na~an a v~. . eroe ot~ ~ • i ewwa ~ wn~ (a~...4..~ enw ~a a~. r. c.L c~~...t t~~.~ a~.~w ~nrcn~ a t rss m a r r~T ~ ot~TM wws uu~scu tr. a~scr aro oun~ ¦r.a ttl• WrE0N7L Wq[ (~1 ~s • ~'1 t1.~1 . t~~ s~r- taete.s. c«.~w..,.~~.n. ouc ~o a~ AdvaTtoOd Ca. UuT? ~?(Dt1Ct Oell) 8 mD. .ic. er. 1 • s • 1 ~~rt c~irr~~~ • r~~t~er~r ~t'ti/ qe rafe?- pyE t~p (s) •is~i¦ sf ~ a~ ?mtT r. onae ~ Oo~mas oorrawaws ~o ounr Wr ror wmo ro iwic mirw? oeus[ oaana~ a~a~ w~n K~1 .~ws ~~rr• st- ItOOR~Df t~~ ~~~tY ~~f~?• ~ YEf? ODBI •~~ct• ~a ~ ~uu~Y octwsco. (ELta s~rr NiVw~ 4 pw / w M I~ y1re~ ItJ i 7 Attq[ni sYKWE Mor~pOE ~1~~~~i- ? . tl~~ 1i~~. ~ mt. Tu1E Of_ Hwr ~fi~N. pI. Yqr ruu~r a n. S ~-w• ~ mf. w/Wtr OCCUMtED mr. ?twCE OF 11~J1?Ilr p. I•. 8~ r ~MYt wws, lOJ. UTl?. IOwR 0~ IOGTqII G011MT~ STA1t i 1~tL AT ~ MOT MN~.E ~ M~~. A~MI. ~dat. ~~ce MII-. s~c.) t M01lK AT 10RK - 2t- 1~tNnl~d fA~ I~o~+Md lrom Nav 1965 . ro ~ 6 ~M lyt a~~ A,i deti on ~ o..re ooow~«r ~e ?S .T mp ~ A ow ee. a.r. ~r.~.a.ao..: .,w ro rs. e.+e ot •11 f t~~• ~~T~ W 4newh/h. I~ow rM awM Kse«/ •r• 0~ 1~ (~~s ~r fYk) ?b_ AoORE~ 7tr. oATE SrG~Eo •••rl•~• . John N. Sims M.D. Ft. Pieme Fla. 29 Jur~e 66 arrat~. t3~. w~e. hunnoie ?30. o~n tk. rure os e[rcTt~r o~ e~cr~tosr 231. tOCwtpN (G7tr. M~. ~r ew~eq (~wr) B~`unia~"`~' 6-29-66 Ft. Pieroe ~Ceme Ft. Pieroe Florida s. isis t~. .wic~ o. s s~uu 901 ~f7'~1't St. a. wn.cco. r,r wrx ac_ ~cc~sr.uiY s~crn ~~sa Miltort W. Baizd Ft. Pieme Fla. ~-6-66 - . . . . _ - - - . V~.~ f.' I hereby cKtify thb to bs a true and corr~et copy of the Lou~l . a . • ~ Rs~i:trars record on fik in the St. lucie County Health Dspert. i L~EO ANU ~iEC RDE~ . ' _f m~nt N Fa~t Pierte. Florida. ~tp!',EFC~O N~s LA. _ OtfF.k :~.~~T COURT .~~~~r~' f'~'~ (Warnirp: Not wtid untess nisdd seal of ths St. lucie: ~ ' . " ~r~ _ - _ County Healih Depsrtmsnt is ~ffixed.) ' P,F~ORf YE~ ~=st0 ~ f , - -~~1°~`~~ r,' Y N. D. MILLER, M. D. ~ JUM 1~ IY 3S Iln 6 ~ : 3:`~,~ ~':~,4 CouMy Hsalth Officer a Lowi Rsyistrar < < . ~ . . 3~384 ~2 ~ ~ , - r;;, ~ ; ~ t ~e - , ~ D~puty Loca! Repistra? ~ ~ ~ E~'t PAEE s)e!~ i , ~ - _ _ . . - - - - - - - - - - - - - ¢ ~ _ ' ~ - ~ ~-.~:..o~~~ ~ ~ ~n~,~ r~ .