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HomeMy WebLinkAbout0631 ! ' .i 1 ~ ~ , . ~ ~ ~ _ _ . _ . . , ~f ~-1 6 ~ Z 5 CERTIFICATE OF DEATH %2A ~[;~o ~ . . ~~.K«~ ~ p`:~ ~..ky F L O A I D 1~ `'fir~t kftY a ~ r?(. 01 ~~INI ~N M~~++~« n.nnrs ACli1eT1~AQ~f NO ~ ?/~MAWNt INK aClASlO -H~uMf SIt UAI[ (ll UfA1N e~~, tf~~~ Sll !/~lO~OW Ip1 ~s~~~~ , De?vid w. Mericle ~ Male , Me~ 31, 1976 ~ R~?CE ~r:q, w~4W. ~W~K~N ~wp~r, - N11 w±w~ ~ nu w.o~~ MiE Of N~M ~'o'~'¦. COUNit Of O(AiN CJ ~ fMCN~ ~ H~~wY~~ . ~~~~N rOf Ms1 ~f ~aq. qu ~ _ . Nhite 6 ~ w . 8 1 1 - tm, iOWN. O~ ?OCAi~AiN Msw c....~n Nosnrn? at on~ ~+st~ IM ~10~ M ~/~M~, o~w ?~ru ww. ~ 1Mtwt ~tf W MO ~ Aoll~ood yes H Memorisl Hoepitsl - _ ~ SIAit Of Nt1M ~ r Moi w ~ f•.. w..~ p~l2EN a NMAT CpUflitll MAtMEO. NEwE! MAMIED. SUtVI~?NG S~OInE 1 M ~/f. OM ~OlM M?W 1 ~ Ohio - Qg~ ' ""O~ ~Lilliaa Z. Anstia _ usu.~ ufNMCe ~ ~ N il .•MU wcax~ SOCut SEC1iw1r MlWER VSUUI OCCU?~t~ON ~ane a:.~ w.wa w.~ ewwa •oa w ir~0 Of M/SwESS O~ w01lSiRr ~~.~o w N~tw rWa+.G ~WY M_r M NLMr / . ~ I~QI~ p~y Sears ~ Roebnck ~ fritVtw7M.6M ~t G~7G~IV~1~1 i1VYl~~ l7W~R~r ~ 1~ vo~+c~ Mw~e rs~t cwr ir~wf Si~[t .e..~ss~o.~ ~~~E-Stw/E COtMar C~T1r, tpwM, O~ l iION ~ _r~ y2..~..__ ~tntr~ Ns w MO ~f L, V'+ IM F'lorida IM ~wBR? 1« l~ii'~RO~- 111 de Ih Zw1 ~~4 ^~y iAiME~-NAME rwt ' .wa~ . uft . MOMEt-MAbFN NAME rM~f u3~ ,s Ro~ E. lleriale Ida Jenkins 1?i10RM~W1-NM~E ru?IING ADWESS ~uru o~ ~ r•.w . cw. w.o..., a•w. tr~ Lillian Z. Austin 2661S~i 64 Ne~y Miraaiar, Florids 33023 ~ Y ~nn ou?n+ wws CwsEO sn: ~~rr[~ orx r ont uus[ ~c~ u+t ra~ fel (61 wnc kM wa.~ w..~ ~ ~ Cardiac arrest COM~It1OMf. u aNr, . - ~wKM 6~~/ t~R 10 _ m~ocardial infarction I~WN~q C~YN 10~.. M1~ W. o~ •s • co«seow.~c~ a: - •1~ttM0 YM~~F . ItIM~ C~YM t~Q ~a, coronar arthero sclerosis 1 r, A~~~ ?nti ¦ OTK~ S1GN/KN1T CO1'bIT1ONS: COMMI~OMS COMIM11~M0 q M~Iw N11 w0~ ~fY~ q 4Yf1 GM« w..n ~~a MROKr li ~ES +~Y ~~MMNOf tM? \ ~ ws w..o~ a~~ nnr.wwo t~e chronic bronchial ast AO Mw~dM ~ObOEMt. ~.oMa. ~.~,.u~~ NOW IN1URt OCCYttEO ~ eun~ n.~w~e a wero w~.n ~ a r.n Mj.wr ~ ~ IIDrK~Ot: Ot II~OE1EtltM1[p _ ~ ~ ~ • Ik I~l. 2N f I IN1Uhl At wOtK MwCE Of ~+~u~tr...w. ni., snm. r~c+oa. IOC~TWN ~~~a o~ ~.r.~. ro.. c~n w w.~., v.w ~ ~ i ~ wcu~ ns o~ ..o ~ o~~ce w~c . uc ~ vtanr ~ 7~ 1M ~ ! CEtt~fKwr~OM- ..a.n. n.~ ra~M ,~u .w u~. a.. u..iwn .im a. .~riae w~ .r. or a~rN otcwnn a. w w~n. a. r~ ~ E rM•sK~wM: tO ro..+w nV w~..rw~ M.m ~„pN~ e.n. w. q wt ws~ ~ ~~rMO M p [~lOG. OY~ fN wci.s~o .w+ 1p_ ~ n_ t~~ 5 3~ 76 tt. f~~ • !M 2 P w? ~o ~.e wwa~ s•.w~. CERi~~[wTqN-MEOKwI ExwMwE~ OR CWONER- a+ nw os.s a ae won. a a.w~ rre +~u w.o ~ ft~rr.~l~ a~w! ~00~ ue/M ny viv~st~WrO~. w r~ O~wwOu. rONiw Nt nu _ M~~w OCCMMO O~ M MN ~MO OYf uD ~l C~1Mll1 f~~ilO ~ ~ m M CERt1i~ER-NAME w nw~n - A ofcae W rm! A ~nw~M. C~~,tl.~~ ~7~ ~7`~~~'!- 11 A » ~ , . 77~ ~ ~ MA~N~t~~~K~~ *i- ~ • •StMlf W~ 1 O' MO' ' C~e? WaN Su~! tU 5951 Hallandale Beach Blvd. Hsllandale Florida - W~u~. (~Ery~Tqn. ~EMpVwI fMETERY OR G~EMAiOf1-NNUf LOUiI~+ un w s~.n Bu~rial ,y 3authern 1leoorial Park Iiorth Miami ~ Florida , H. t~ ~ OATE---- ~..w~w. s.., •w, ~UNERAI NOME-NA~tE AND ~DOtfSS •»~u~ o~ ~.o•. u+• o~ ~owr, s~.n, i~r . ,y June 4~. _1__93_6__.___ n. Bo 's F A 6100 Holl ood Blvd Holl od Florida 330 wn e~EO n ioui ac~sou v. S. ~E 19 ilJNEfAI OMEC~Of-SKGnMJtl~ R( iRA!-SK.w~lIIR~ . ~ '.i: ~ • ~ nev.19~0 ~L' 111 7M ~H.: ' OC"eP. f0: R n?~ CIERK CtRCU1T ~Q ~ ~ pECOAt! YER~f~EO 34~~2 j ~ ~ ~ " 1; ~ ~~tih:RTlt 1.1:11 C()L'Y F.•a 'o 1 l~cri~l~y~~'t~l'~i,ty tl~c phnvc to b~ e truc n~~d correcC copy of thc 1,ocnl Rc~isCrar's ~ rccorQ,~~~Y1~ih,ftl~e Broward County Hcnltl~ llepartn?cnt at rort I.vJcrdale~ ~loridn. m 4 `4 '••.~'f~ , Cp - . 1 :(4~h~+tii~-ji9tr~roli"i1 ~inlene roiaed eenl of tl~e 11ror+arJ Coun~y llcaltl~ llcpC. ie nffixed.) j. ~ ; : , , A~~" ~TRG~ A~ , ~ _~Q ~+~w : " ~ ~~r ~ t:.~~i?Er- : ~~~„~~s ow ca t, yt_er nn oca cgiatrar 'r~ y'•~~ 3L0:; ~ }~E~FC~~•> jY "~•;~lJ L. , • ~ ~ ~ ' j'b~~-;~•. BRp,~iARU ~£S'tE OR ! ,t~l~t. .R . ~ . ~.r~ • c, - ~K - ~9~i;tisj~` e0 P y ca cgi~ar BOOK / PA6E . ~c~ . . _ . ~ tJ