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HomeMy WebLinkAbout0576 3~~zss ~ ~ . . st~t~ o( Flor~d• CERTIFICATE OF DEATH ` Dep~rtmeet of tledth and Reh~t~ilil~tire 3et~iees F L O R I D 1l "~"T` "o. _ ` YITAL STATISTICS ~toisTwww s No 303 TvPE OR /HINT acewxo-?uw u¦ o•~e a a.~N ~ . YfRMANENT ' • ~Y MAY NEGEDLY ~ Female , Februar 15 1977 BLACK INK V~ Ntq. ~MMI~M 1y~~V, -~~N M'4~ ~ M~~ Y!r~~ 1 N• CAIf O~ W1M I~V+~~. N~, CQyN1t Q/ 0(AM at • w<r. ~ r~~.. ~qun ~oi ~oiw~ w w.~ ~ 0602 ~ White N 86 L~, May 4, 1890 St . Lucie 1 7. ~0~. O~ IOC~K~N~i Oli?~i ~.n ~~w MOSh1Y p O~NI~ MtqtY1 - ~r .a ~r~.~~. aw~ ~.~n •r +r.~n ~ VHrr ~p p w0 ~w . A Fort pierce ti Yes N Fort Pierce Memorial Hos ital • ~ ' -p---- ~ 1~~1! d WM .q~ r~ f~~ N~N CIf1IlN Qr wlyt G01I~tlY W~MIO. Kvl~ auttlt0. SUfY11I~aG S~OVS! ~r ~ii. ~w~ Mrw rr ~ tew~w~ wDOw10. p~pC10 ~ wtw. ~ ~ - New York . U.S .A. N Marr ied Georrle W. Neryedlv ' N(~~Y~ , ~ 1'_ 7 7 J " " _ " ' ' ' ' . _ r M~~ SOCIIt f(CVMf/ MJ~Ylf tlSU~t OCCi1?~NON er~f ~w M ~p~ ~ar ~rwy .ou O~ ~uMD d ~USMSS p~OIbI~T ' • occww~ w ~or.~ e~e.. ~ «..~n ~ ~..~~nM~d~, ~w~ . ~~,Mp+ JY~Y ~i Housewife !n._ nomestic _ ' - ' Msw~?Ke-SU?t CouMr (M?,'~owa. o~ ~ocwno.+ t-~••• •~ri ISi~11~ ~:io NUw~er Wtr~ ~s M ~D • ~y Florida St. Lucie Fort Pierce 1~.. No ,,.1F319 South 33rd. St. ~~~~~W~yI ~Mp ~M~ uN YO~~f-M4WMM~~ ~w~ ~ .nw~ ~.fr i Wesle Hoo er Mar Packett ' uMOMYII...N~Mf w~MG ~Op~SS n~wn o~ w. cw. o~ w.+. a•w. ~r~ . ~r. 5 rances N. McCau e ~n 3311 Avenue A. Ft . Pierce Fla . 33450 IYi 1. OlAMlMAS CMIS10 +lNfff OrAI O~t C~1/31 MI /M! /O~ HL M1L wN0 kA •~~~o~.... r.« Nf~~~w ONI~ ~N N~MI M t ^ ~d'~ 7~a~i-~" r... C i.,,-~Gt ~ L -a rT ~r~-ar--/ L • , =MM~OMA N ~w, ~IL~.,. L• F~~ ~~~1 ~~N N PI ~ - ---Z~ ' i- 1 ~aNM~ry (~~f~ h1. ' . H~nr~ ~r?M M M ij . . f~VMK~ p ~ ^ ~ ~~MN tNM N~~ ~ i / ~ - ~ ~ ~ ~ M~ ~.t tl~~-' !~-~C~.*.-~,.~Ci~~.t.i ~%.t t./t. t~. ~ ~~l!?~ ; •f~.~Z_ ?w~t ~ OMl~ 1~6rr/K~wT Cp41~d+S fP~M~f (O~w~wM 4 M~~ M NOA~ q[~~M ~w1r ~r IN~ Mrt0?Sr ~ 1~~n ••r~•••••~ co-. ~~w~ w.o~ ~N~~s Mn~.~..~~ c..w - 4 `1~1 w ~/~rr ' ~ r.~.~l~i accwv.r.- y,.t.ne 0?'- 6dt d ir~7N' :.o»:._ ~..,-.r.".~~~u+ »O~+ ~wwM~ OCCUi~tO ~~w~ n.~w w ww~. r... . e. r.« ¦.w. ~ ~ .~+uce~. a va~~wwo ' ^ 1M A. 'y ~ ~y 5 NUWi iit wt~n-~- ?~w(! 01 NM'~....~.y...~.. sM~., ..t.o~., IOC~IpN ran~r o~ • ro . t~•• e~ w~.. aaw. ~tl~Un A~ M ~01 O~KI YN.~~[ ~Wf~n~ . ~ ~ ~ (~NMI~A~Q~- ~OM1~ Mt ~I~f ~Orr M~ ~~M uY y~ w/~~ YM OM ~ M/MS MO~ M~ ~ O~~M OCfMHp h~f hM1. 0~ N ~ . 1w~/KUw~ rn+w~ Mr 4.~ Ms+ ~ti~ N~r - . ~ ~~MI~ aM ~0 . ~rOM1 NA, ~V. b V Nf~ ~ M «~..N...,. ~ _ /S ~ 1,~, ~ ~2 ~ - 7J , r~ a N tN Y~o r( s~ ~~~a~ Ct~tliKAt~-WDK~I ti~Mn~1\ Od C~~ia(i o. w~.w~ ~.r +o~~ o. M•~. M~~w». ~.s i~ w:~ •~~~r~~P~ M M I~F ~~/M bV Mq~~Y3~41M. r w O~~rO+. I S- ~r M• N~~ N~~ KCM~N M M NA ~M b M I~vV~f1 f~~A~ ~ 1~ . ) 1 Ct tiN~-~+M+1 ~w.~ •w.n ~ - - . . . . S a~~~U~! , ~'r'L' rri)T~ ,`i -1'-~ ~ ~?..N,~to~~~.w~~~~w~3Ks~+t6 ~ ~ ! ~ tH A.D. Qrr,.M.D.- - ~L`-Z~~I/~~~ -1_~~.~-~~!` ~ ~ ~~MC'.~otwii-~~~rr • G1~ ~~nYLii 7th~.M5L1^~~CL~ rOrt ~lE>rCQ~ Florida ~3~4,0 / ~ ~UM~I. C~1WIU~~. N~MO~/~l iClMtll~~ Uf C~iMAIWI--NIW IOC~~~J (.n M q~r ~~~q . 11H(M~• ?N Cremaiion ~N~ ~iecron Crem~torium_ _,~M --Wes~._P~1m__~e~ch,-E1~3~d(~----- ' OAII ..o.~+. - ~UNI/4 ~WYt ._p~u~ ~~q ~My1St • ~m~~ c~ ~r • ~O. Ob ~ bsr. 1~~N. !N~ ~ 1 w Frb. 18, 1977_1,~. ~L Picrre, ~w~erzl }lome 106 S.4th.St.,Ft.Pierce,~la V.S. #612 NW O~--Yr+~~h'/~? ~ n~.~•.~u~_ ticaurwE • o.n acu.t~ n ~a~~ ~w~snu • H~r. ~/7e /M ! f : i~ ~ ~S ~ ti~ • ~ ~ Iw . 7 ; , ' ; . + ne~eby ce~t~ty this to be a true and correct copy of the Loce~ fILEO AMlO E1ECO~UEO ~ 2egistrar's record on file in tF~e St. lucie County Nealth Dapart- $t.LUC1E COUNTY F11~. - • ment at Fo.r P;e~ce, Fiorida. ROCER POITIII~S . CLERK CIiICU~j CQUR7 . , ~ ~ . (YVarning: Not va~~d unless raised seal of Ihe S1. Luclo RfCORO YERIilEO • ; County HeaNh Oepartmero is affixed.) - ~ . Ae~ 5 ~ r o~ aH . . ~ . - = . N. D. MItIER, M. D. " ' County ealth Officer b local Rogistrar 36~1~ ' ~ . , 3 77 t .J~~- ~ ~ Od~ OePutY loui Reoist.er ~ ~ f~~ ~.W lAf~ ~ . 3 : . i t _ _ _ . ,