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HomeMy WebLinkAbout0380 Statp ot Fior:da CERTlFICATE OF ~EATH 3~~~0 I~cpartmcnt oi tlr.al:h and Rehabiietative Services sTwT[ FIL[ No. _ Vl'f~1L STATIb'1•1CS F T. O R I D A wta~ST~A~ !?+o r~q nRWT CECf~:fO--vuwf ..oa,~ ~Sti 1D~~E 01 Dt~rN ,..o..,.., u.., .e..~ ~ i ' .~~r.~T ' _------_-11.I~~~~,_'.' CC~LU112~I1S REF~~,,,JR.__ ~~NaZe Iktrch 9~ 19~7 _ 'T"'~_"___ ~CUIiNi~OtCfA:N ~ _ : i`1( ~~C '~wne. ~I4W. ~+~~~.w ~..o.~.., AG[ -..ft o.a~ ~ .e.~_ ~v..ou ~ o.. ~ CATE OI ~IlfM ~od~tr, 0~~. . 1 t~C ~ 1~fCMt 1 1 ~~\IwO~1 • ~~~~11 rpl . y~1 ~ ~q~~~ T ~M ~ ~ ~ ;:nl 2 ;,.53 i~ ~ ;.lia1 2~ 1923 Indiaf: River - - '~-t_ _ ' ~~~G/ ~i1r, I~NN, OA LOCATI~N QI a(ATN __r ~~i~ei t~n ~.~.n ?~pSMiwl Ot O1Mt~ zvST1tU1~-h~~~~ t~•.e~, c~.~ »re~, ..w~u~~+ - - ~ ~ • sNC,~r ~/s M ..o F.ach Yes ~N Indian h`iver l~em~ori.at liospitat------ ~ - y,,,ij St~Tf ~!•!tti ~.r ~o+ u s......e ~CITflEN O~ w?~~T Cd.+~Tfr i MAtnEO, t+EYER w?ltiEG. • SlMvrv~C, S~Ot~Sf ~ u+~r~. o~.~ r..w.+ «.re ~ ' ~ . ~ .........a~ i cown ~ .'5... . : :rss.... ~ . . + ?'s-nnessre U.S.A. ~~ui~riec~ i„ Lcuarenee E. NineheFter---------------- - - - , „ S~JC~~I SF ~.'~:T~ t~lr~stf ! 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