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HomeMy WebLinkAbout0347 ? v 1y DAUL~2 CUUN'rY ~ :Z ~ s'~ ~ ~ ` { DE.~'ARTM~NT OF ~U~i , IjIO ~~NiAL~H F~~EO ANl? REC~~DED tis~o M. w. /OYNT!!liTM ~T~ssr ~~~~5 ~ s: MIAMt D'LORIDA 88 b~~~RCUti COURT ' 1~ RECORD v~RtFlf D ~ ~ 3~55 J~W 16 IZ 35 PN' 7 ~ 3``~~V? I 1aRESY CE~!l~~,~i~i`',40 SE 11 TRUa COPY ~'14tR [.OCJ1L RT.GI3TWIR'6 RECORD U!r DEA'M. O~~ ~ (1A~~._n~v,: 8 - 1~j,rt~Qt • ~~1~i~~iZ " s ~ `jttb~:v~t~-unless the reised DEPVTY RFGISTRl1R ~'~l~ r~ ~.1ea~ ~!l;t~Sa 8ureeu of Vital VI•PAL R~C01if~ l1NIY ` L~' Qtwlt~#tic~j i~ affixed.l D~1DE c'oUt~PY ?IY.1?f.11i f~FARTMEiiT ~ , ~ . t~. -L' ' . .x • ' : ~ : 3,, . i ~ r'•. CERTIFICATE OF DEATH ' Or~...~ .1 i~~ t~ ~dw:. trwTS r~~s Mo. rzo~t~~ ~~Z~~_ . •••••r e~o~t*~~~ • Mo • ~i ~ I = s w • ..o.... ~ ALLgN JEAN HORRIS ~"1ALE ~ 11AY 28~ 1974 'j Ma •.......~r[n. .a-w~ ~ • ~ • o.n a wtn~ , ~o~... cour~r. a oun. ~ Mf AY~~ r~ MM ~OM~ w~ ~{w~ ~ , t~~d `~'I~ ~ UECE.MRER 6,191 DADE ~ ~~M {1h \ ~ ~ y b~ r ~wy\. OM ~~N~ ~Vr1~ ~ - ~ MKI~ A{ W y ~ MIA?!I h YeS w VE'tF3lA.yS ADMI!3IS'ffIATIOy ~ ; ' S 1M;...~ . ~ .+w~ cai.n: .w`wo: MM.,~RMO. wirw..c vou+i «:..~w. ~ tt.ORIDA ~ U.S.A. ~~°i"`«, „ ~RA1iC&4 8R(,~~____ ` ~ - i OCM~nOd ~ rw ..r ~r .aa w~ w~w.~ .oa r uo Or MriMN W ~AA1n y • ~ K 266-14-6857 ~~T~1 tvrniturc reF.air/uptiolatery : { ~ A COVRt Oh. ~OMM. O~ WiA110M ~ar~ cw .~w T~Z Mr -i~WiA` E ~ ~ wc~. a~ o~ ~ w FIAItIDJ1 ST. LUCIE FORT PIF.RCE YES t401 ~t. 22 ST ~ ~ ~ ~r w~~ Y/ MO~Mt~1M~~MNUM~ ry~~ ~~M~ Wt ' { ~ ~~rr~e Kosats „ x~s ~rr~?eDS ' ~ ~ ~ ~ wu?~+O ~00~3~ .rw. o~ ~ r• .s. c~. o~ ro.-. v.~. i.~ 1 E VA HOSPII'AL RECO^e.i3S 1201 N.W. 1f~Tl~ 5T. MIAHI FLA 33125 ~t a g ar?s~.tiv c.wto a: ;r..~. o... o~t uuu.n ?.w ro. Ni .~o a~ o.r......+ ~ ~ ~ ~ s i w chsonic renal failure due to chronic glomerulo nephritis ~..s~ ~ t ~ ia.c~ ww ~i M ~ pN N M • ~ ~ Y • Or. . _ . ~wM C~~M MM ~ M ' Mr! 011~ UQ~lS/~ tOl~rtq~~. a.~+M a..+w.+ r w~ ww ..w ~w.w~ » wr aw+....w ~,r iw?O~/~ Y rff s~w w,.w.~f cr+ ' ~ m ~ MuM r K~~ irM left ventriculer hypertrophy nad cardiomegaly ' 1~E~S ,~""tES , ~ ~ w.w~. w..w ~ NO~r ~r OtCWltO ~ F/H ~tiY M wM~ r~rl f M M/ l~ N~ 1~ f r .or. ~.r~. ?~n. ps~x+. tOCw/1Q~+ i a~w~ M u~. .o . cw~ o~ rv.~.. w.~ ~ QDO 1~~wIMl~~ ~K,~R. ~Mtw~ ~ w? f q ~ ~ (~'~!CA1~i~ ~Ir W tiY ~OM1 Y~ ~W r~ W~ Y~ ~fww yw~ M M!M ~+W ~f~ r1 M1M OC(11~1 u~~MO. Q.+ N ~ ~0+~ Yt AY ~p~ N~4 ~~py~~ W. rr, q r~RI ~'~~^~,~IiAY 14~ 1974 TO,~MAY 18~1974 „~MAY 18~1914 ~ DID NOT ~ 5t15~ 04~~ ti3r?sf~ Or Mr YM~ O ti .ow a w.. w.~ NcM.. w wa~a~+cw ~w • aoY~~w M Y Y~~ M/O~ M MMMM~qr, r w prwis.. ~qwr " ta~/ OOirr A M M~ M M q A~MI~M p~N . ~M! ~q» „v n ~ M n ~ !O~ ~ ~M~ ~~M. Yt, rN~/ % I~1 L_ ~ ~ ~ T MMf ~ I • MM ly ? ? ' t~ /W~ ? ~ ~l t ~ ~ ~A q ~YR 1L1~ ~ ~ ~Y~?L PDiYGd09i C~TBR? w POR? PIS$CS FLOAID~ ~IA iw. RM~ YYt ~OOP! ~ O~ ~ r~.O ~ twr M~O•r. p~N, lr ~ ~ `~~1 z~, 'a ~mor~a~.~ 1 0 ArA 9 Ft..-FierGS ~ = ..~.a.f~....~.~~~~ f ~ Mo.arar ~',s-r-- , - . . . _ r- . . s-~~ . - - ' ' - , , _ . -"--e~ - - - . . . _ , _ ~3+~T~cp~` ~'TY 'K-'~'iE%~' , .~i• _ ~ r; ' ~'L: ~ _ . . ,4 ~y~ - ~ "S ~L'_ ~ " ' _ S ~ - ~ _ _ . ~ V ..~~OJ ` ~ ' ' . ~ -.+~i1rYr.n+~a.~..ttX~ iL~fi'Filllf _ _ _ ..._..~_...~d Fe~`w..,-. :...~r..ru.~re.~+wwH.v~e.vn:f.i'+~~~x-.-r.:v~ z.. - •