Loading...
HomeMy WebLinkAbout0045 . ~ " _ - , s / ~ `t CERTI~'ICATE OF DEATH ~ D.M.~.~..~ .1 ik.hl R.b6~IN.~+.~ w. lYATL F~« Ka i~~e-~cx~ i~ ~fa~ u~ ~95~ F L O A I D A ~~o~rr~~~•s No. TrtE. Of ?qNl IN ~ ?ttMAtNNf INK ~~~N~ .~s ~f pAT( p pEA1N ~ ~~r, ~tu ~ ~E ~~a ~ _ Aob~aet , Fe~sls , DsceaLeor 5, 1976 ~ ~E ,wre, «wwharj~c... w~.M, ~GE-uu we~ ~.u. ww. QAn O~ ~M ~rw.. M.. COUNtt a OEntM nc._ ~wsr.~ IIC~aTA ~r ~'w~~ •wi. ~.n wwf .w. `w? • s. t? k ~~te?x~ch 2 1 r. lieu~'t,1II . O~ t T w ..rw cr. u.w~ MOS~1tAt OR OM6t NS ~r «a w ~~u. 4w f~w~..w ww~. ~ • wcr. ns a no - „ Stue?t't. yss M~leuCt.1II Me~00eLs1 Hasp~ta?lsl ~ :TA Ci M1N ~ r wol w v.s.•., ••u•~ Gr M~NnT CA1MiRtf MARMEO. MtvH MA~tO, SIJ~VNNG SIOUSE ~ r.nn. ow~ w.M.. w.w ~ M,~„o, ~.l~a~t Yaoek i0"""' U.S.A. w~oo~wco. o~o.c~ 1es ~ SOGAI i[CYr111 NIlM~ER YftiAl OKIMpA~TION ~aw aw~ o~ raa Ww~ ~w~a aoN p p0 O~ M16l~ESS O~ ItlOUiltr f toc~c~wi w~ / /y~ tM B v°rr'° ~R. AO~1~ 'a s ~ Is n~N~ ~L `^'~"vl~a~ 1~ •owswr. ~~_SiAfE COtM~R11 GIY. iOMM. aR lOCw110N ~+yw tw ~n~ r Flroaci~da ,wSt. Luaie Paact St. Lucis , o,•, p•p ,.~115 8. Arboae Are. : ~~t~[t-wwE .ra .~ewe w. MOtMdt-nwotN wwE .Mn ww w. . IL ~~i ~p~.~ K J~~ 1 IMnR1~IG AOOESS Ifrat p~.ri. Mo., ds p w.~.. W.w. s+~ _ - : ,k M~r. cb.rle. aob.att ~is /lrbovc Ave. P+ooct st. Luc~l..; F1s. 33~?s' rwn ou?n~ wr?s t~tn w: ~[r+r~ ~ a+t uust ~ u~ ~a ~ ~ _Nl vV l ~ ~GG s~ ' - r ~ ca.«aoMS. N .~w. ' - ~ $ R 0 fil/?f LA. vwcr s~w nw q M WrlM~f~ C~IIN M. M~O, y~ OOM~OMKf Oh ~ s~~nM~ rw v~~- f~ • , - tWRO VE~IFtEO ~wws c.w~ u?a M G,~h ~ . !n ~ ~ P~rt7 . MRT ~ caw~*au ~w w~ rot ww~ ~cwna r tiw ~ A1110/if • ~Ef r~M tiMMwos c ~~a a~ wo~ f~ ~+ew~+~a ~ ~-f -u ll.c-r4~ !v i- . ' C~~~ iu: . no _ Ot u~O~tUw1~ ~ wa.~, ~t~ ~ MOw INJIIlY OtCURREP ewr wro~ a wwn M~uf ~ a?.w M. wa. w 'I i 7A ~t M_ IY pu1~9 11T w0~ N1URY Mo~. ~rn. ~~twn. tOCwTON ~ s~aa o~ wo.. an w w.rw, s~ue ~ ~ wa~? m a.a ~ oww rw.. ac. aacw ~ ' s. ai. ~ . I ~j~~_ rO~N M~ ~!Y NOiMM Mt •!V ~M Yfi f~~ Mr/wM YM O~ ND/ w!r ON OtA1N OCCYM~/ nt M hKl. OM Y~ ~ M?iKUw: , ~ T~ ~ ~ ra.w~ n.t. w~+ un~ ~ux ~•wM ~ ~'in o~`pw~eep ~ ~ wm«N~ tw ~-I tN ~ (i' tk. ~ (~f' fU ~ O~ CwY'L 11! ~lGG~fH ~~Ow ~(~ATblI-M~IC~ ExAAw'~R : Ow /M M1H Or twt MOM W~4M M~ OK~~fiw w~f MO1+O~KH Ola~ tt~Y1~tOM Or Mt u0/p ay M1fROrrpw. r~ w Or~++O». rOMw M~ qu wW~ . 9 ~YM OOCYMN OM f~f O~R M1~ NM ~O AI! C~Yi~tl1 fV1N. ~ CERIIplR-MAME mre w nw+n ~ 7` . . j,~~ /cn~/w n~ ~ rw~ ~ Jose L. C ~ . 'e.~ . t .w.w ~oo~eu-c~e~~ 4 Slqline Dacive , Jsnsen ~saah Flaar°'~,da 5'T M~AL. dEMATqN. lMOyAI O~ l~MAtO~-N~ME lOCw110N 4n p prn ~ WM ~$ea~oral Hillarss~ MN. 'Gsrdens F'~. Pierce St. E~aie Co. Fla, n'~c,~ Rogac~.,~$~ ~Fnnearsl Hcers~'~516~ S; ~Fed, H~ry, g~ uc s Y. S.f612 wNdt~t - Ilt~stwt-SK.+v~ruH ow rveo n~ocwre[aaru~ R~v. I910 ~ ~ 7• ~ tN ' ~ I hereby certify thls to be a:rue and corr~ect ~ copy of~the local Registrar's record on file in -~~J~t the Martin County Health Department in Stuarrt, 1,E.~~.,,; ~ Florida. : ~ ~ y,, ~'`r' " ~Warning: Not~ yal id unless raised seal of the S.~ u~~ T, ,~y;~ Marti n Ceunty tkal th Oepartment i s aff i xed. ) % c~ : _~Fl.dRfOA,~ ~ ~ . . ; ~ : _ t:~. - - Itrchfe McCa111ster, M.D. , - x-. ~ County Health Offlcer S Local Reglstra~ ~ ,;;~~i,*S r , v' _ ~ . I ~ •~2'-'-4~~rr ~R'b'r- r` - _ • - - ' ~1l~~N1l~1~e~~ i - - f~rV~ fa~i~ ZV . . c