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HomeMy WebLinkAbout0677 sa . o0 35825~' t~ ~ state ot Ftodd~ ' CERTIFICATE OF DEATH - tra~nt oi Hedth ~ad RehaDilitati~re Serviaa F L O A I D A ~AT[ ?I<t NO. VITAL BTATI3TIC3 ~ca~aT~~~•s No 1. A~p-NM1E . •qf• ~MMt ~~f Y A1E OEAM ~ roMf~, N~, qu ~ r ~ Dorothy 6. AtBXANDSR , Fema 1 e, December 2, 1976 tACE .rm. wwo..w~Kw w~.M, ~Gt-~.i~ w~a~ ~ a.~ v.w~ CwtE Oi NtIN ~.~o~nw. C01MtY Oi OEwM . ;K. , w`"•' Wh i t e ,~~~,~U~ w` Fe b.16 , 191 1,~ ~ P i ne l l a s . TOwN. Of t wriON OEwM ~.w~ un w~f MOSMTnI Of 0111ER NStRtR - ~w w~ w. ~ure~. a~n s~e~~ .,e «r+w~ ~ wcr. .e~ a .a • Semi nol e No Lake Semi ~01 e Hospi ta 1 ~ ~f~TE Oi WM ~ r wp~ a. ~ t~, N~w C111ZfN O~ M?/IA1 COIlNi~~ MARtlEO. NEVE~ M~MEO. Suw~vNG S~OUSE ~ r.w. oM n.w» wr~ ~ Pennsylvani~"""'~ ~Uni ted StetesN1DO~a~d""'"' Paul C. SOCut iKUMir NUWER ^ YSUAI OCCIM~hON ~s~.e a.a a.~wa ~ow ~uww uou a [ND Of MlSM~ESS OR u+WlSTfv - ~O~aM6 uN. Ffw r MMM ~ • „ 198-03-4075 Housewife „ Own Home - - ~ESbENCE-S/AiE COINVri d111. TOwN. Ot lOG?110N «fw cae urnf ST~EEt ~ vecus ru o~ Mo ~yFlorida Pinellas ,~,~Seminote ~N No 111?3 57 Ave. N. r~n~ce_r~u~wE ~w~ .r.u us+ +ronltt-~urOtN wwE . .re.u , _ , u~ „ - George ~ Schaffner ~ Oora Marsha~l I -tMMf - w1lwG AOWESS ~?+ra o~ ~.r.e. .w, cmr a.o.r... s~.w. er~ Paut C. Alexander „~11123 57 Ave. N. Seminole,Florida 33542 rarr ~ otwn~ wns CwusEO ~r: ~WnR a+~r oNE uusE ?tt u~lE ro~ (eL Al •?+o kM - M~1NlM OMN~ ~M M~ ~ UyM . - N~ Occlusive corona arte disease Years corMnoM. N ,M.. . tMICN MN /0 ~a1WM~lf C~rN ~M. NN ~O. p y~ CW~MOMK~ Or: lf~tlM6 10/ YMM ~ ~nr~ tRVM att M!1 011~~ S~N~KANT CO~111ONS: ~O~M~adK COr1~y11~M6 q CI~M M 1qt YuNO t0 C~Yf~ 6M+~ w~uf ~ y~ MRCKII • 11lS •ia ~~MN¦si ca.~ - ~w~ O~ MO? qNN w NtlYUrMN t~WN - Yea w Yes ~~rIQOl, p YIO~iNrrlp ~ rorrN. •~u ~ Mpw IWVII OCCUMED ~~•m~ .u+w oI w,w~ ~w ~an ~ o~ ~.a r, we. u ~ ~MI ~ ~ ~t M. 1Y NI~Y wT Wp1I Ri ror. r~w, sn~en. ~.c.on. lOCw110N ~ a~m'o~ ~ r.~. Mo , cm w ~o.n. p~+e ~ IMK~A Af O~ MO~ Ol~~p M~f.,~K. ~YKM?~ ~ ' ~ ~ ~ • ~~I~A~~1- rOMA M~ riY rp~M O~t ~tM u0 ufr L~r ~r/wtt ~4n~ Or 1 M/01O ~Ot w!r 1M Ol~M OCCVMlO 1W ~tKl. OM ~w! ?11TlK4M: rb~M Mt 1fY WO~ Y1l~ Ol~M /MOIM~ MU. ~M. b~ M!~ . .~»K. p P ..b.~.~...r. 1fa wce.uo iw. fN ft1 tw O: 44 M ro wr cw~s~ w+w. CEtT/KATIO~~-MEOKAI EZAMMEI OR CO~OME~~ Oy aM MS~f O~ Iw! .ow a~ a.w~ ~•u Mcwe.n .u wa.ow+ce~ w.a - ~YYr~~4~ Or ~M! WO? ~?O/M M r~fltlW?~pw. w~ ~f M~+W~. ~ON~M O~7 ~~~f wW/~ °~"d'° " 8 :44 P . December 2 1976 • 8:44 P : n tEniitE~-aiwE .~m oa rwm SK.*1 Hcaft a n~u S1GNEa +roMa.. o~•, rua~ i t,, John J. Shinner, M.D. Medical I~caminer ~Dec. 4 1976 ~ MArING I10pEi5-CE~tlfiEt urr oe ~ r e cm w a... wn rN 260 Ulmerton Road Wes • Lar o Florida ~ 335 0 ~Url?l, ClEMAt10N. ~EMO~?Al EMETE~tr O! G~EMAi0~t1- tOU on w w.w su~e ~ YKrr ~ ~ ,y , Burial Woodtawn Cemeter~ ~ St. Petersburq Ftori_d_a~~ OATE fUNEfA1 NOME-PUIME ANp ADOtESS ~ ttpu o~ ~ r• No . c~r• q torw, a•n. tN ~ ~ QeE%~: Grant Funeral Home 1 144 8 Ave ' ~ ! ~~j REG~St -Srcav~ru~E own ac[~co ~ 4aWrw ~ . ~ tf? 7 ~t A.~ ` CAR$Y THE II~OSSED SEAL OF THE REGISTRAR OF VITAL STATISTICS r =Y V • ) . ' ~ : ~ • ~ I~ . ..~~~Q~r. .1 ^•;i. : i ~-;~~~1 + ertify that this is a true and correct copy of a certificate } ~ ••fil' • i . on the office of the Local Registrar o~ Vital Statietics of the ' t`~` ~ County Health Department, St. Petersburg, Florida ~ ~ r ~ , , - . _ E , ~ i:~ . ~~o ?iu( E ,Deputy Local Regiatrar j • ~ ~ ~T.~~IE ~CO~'~Y FIR. , ~OO ~ rornr~s OLtAK ~ CouRT Rt04R0 YERIi1 0 ~ FE~ 11 11 12 I1N'17. ~ ; 3:~2~'7 ~ . ~ ~ ~ f } . - j f U~ PAC~ s~ ' ~ RCD/cl S.O. 2/18/77