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Home My WebLink About0552 ~~~~1 ~?E~u1~~~ ~~111~~~' E.'~.~ ~'~~1~ t':t3~ ~ / e r ~ ~ o s ~ a • • , . 1 • • ~ ~ , - ~ - - ~ - • . ~ - ~ ~ . - . • ~ a~• ~ ~ - - - , ~ , f ~ ~ ~ . . ~ . •'S 4' ' ~ ~ ~ . s • • s s f e - • . - • . • o - ~ e • - 1 • • • . . ~ . . ~ i , ~ . . I~ ~ ~ !1 •J , , ~ . ' ¦ ~ ~ . ~ ~ I, . ~ . . . l ` ? • at~ ~ ' . . _ "1• ~ ~ ~ - • • • • - ~ ~ ri~ ~ ~ ~ ~ ~ • ~~r , , ~ ~ _ FILED ANU fiECQRDEO ST. LtlCIE COUNTY Ft,A. ROCER FOlTR~S ~~~17t~- RECdR~ yERIF EO CQURT a7 , = FES ZI / 2 05 PM'~~ _ . ~ ~ , ` . I HFRE$Y .CER~f1FY TNE A$OVE TO BE A TRUE AND CORRECT COPY OF THE REGIST ' ~ RAR S RECORD ~ ON ~~ILE IN THLo4~0`FFICE -(Not v~1id u~ess the seal of the Palm 8each County Health Department is affixed) - _ ~ - , . , ~ _ ~ ~ 'r . Fe~r'ua?'y 15, 1977 ` C.I.. Brumback, M.D. ~ I.ocal Registrar ' ~ • BUreau of Vital Statistics - West Palm Beach, Florida i - O~. 6~; Z 6~FPt. ~'s~ ~