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HomeMy WebLinkAbout0637 CERTIFICATE OF DEATH `~~3~~ ~ ~ Ikp~rlwKn~ d Ikaltb ~ad RrL..1~J+~~~~r~ ~r~.hn fTAT[ FILt NO._.~_._-- ~M~~.,~~~K ~N.~~~~ FLOAIDA , ~•rl. O~ ?f~Nt !H rru~w.~n««.on.• RC(:16TpAR~! NO ~I~MANIN~ INII SI¦ OAII O~DiAlll Sll Ml~Q!llOl 1~1 MClASIG-N4a/ ~~u~. ~yh~ ~N~ ~ , -107273~_ : ~e ~ lACE r~ry. wl6W. ~r1~K~» Ny.~w, AGE - ~NI w.w. ~ n.~ v«a~ •I! d WM ~.~o~..». cou~+n a a.iN ex vuw. ~ ouw.. ~ ~~u~~ .of ~+•f wow~ .w nu ~ . ~ihite 30 w~ . Aug._ 8~~6 ~oHarcL_ / CO~, IOMM. OR IUCAl10M 0/ pEA1M wpN t~n ~r~q 11Q~MIAI p~ Q11Q~ MSIItU11~N- N ~M rp~ phq~, 4M \IM~~ ~N MWf~ ~ iNM~ rH O~ MO ~ Pembr~ke Pines Yes South Florids Stste Hospital ~ ~ S/~tE Oi ~MM ~ w..o~ w Y f.,~•+~ C~tU[H 01 Mnu?1 ~q~NTR~ ~ w~tlnEp. nEv(t ~+uRMED. SUavnNG SKHJSt ~r rw. awh +.oer w~.r ~ M ~ towm ~ MIIOOMR0. ~ YKr~ ~ «s«.~~ ~ Iliinois ~ U.S.A. Marrie E~ Paula S~ostedt ..«.w. - - - - - - - - - - - _ _ . ,,.~o M M~Y sou~u sccuanr wwte uwu occw:r~ors +w.Y .a• o~ .o.. ww ow,..o .a~~ a c+rm o~ wsr+ess oR n+ousnr occ~.ae w w~~c ~w, hfr M MtNN ~ 6^~ „ 344-20-4~434 „ Folice Officer Law D~forceaent ~lYOfMC~ MqM •Di1«'D"' ~ES~D[?KE-Sf~?E COiMtr dt~, tOwN. O~ lOG?T~pa Ww~ ce. ~~.m StlEEt ~ I VlCN~ O~ MO ,yFlorida Broward pom o Beach Yes 2601 N.E. 14 Street /~TNEf-?r~wE nn~ ww~ up MOTI~t-AYb[N NAME ~w~ rwKe us~ „ Gearge . Killiaa~ Ring Augusta Sunesson INfORMANI-q1u~[ ru1Rtl~i AOOKSS a~wu o~ ~.r •.w . cm o~ a.r«, s~.w. tr~ ,,,Paula A. R „~2601 N.E. 14~ Street Pom o Beach Florida-~ ~~i ~ OEwM wwS UuSEO ~r: ~ENtE~ Owlr O~ G?ui[ rN tNE f0~ pi p~ ~ kp ' " wtiren~ a. u•n~ N ~..rw - . , Bilaternl Bronchognevmonia ~ ~ . . co.N~~o«s. C! EaK CIRCUIT CO!!RT ~r~Kw 6~~f uf~ q • - • ' • •~r ~ ~.reN~n c~ra w~ a. w.~ • ea.s~owrn or: ~t~hr0 tw~ YN~~b c~_ l?~M~ C~OM UN ~t) ' ~A~T OTI~t SK~iNrKANT CO~~S~ CO~~MAOMf COM~r11~w0 q M~M M1~ MM ruR~ p C~VM GMM ?.n ~ r~ 1 1I ~fS .w n os cor 1 h~ p MO~ MN~fO w NT~~ CAYlI pr ~~tr . . ~w NO ~w ~ AGCiOENT~ib€ ~.a.d. M~, ~ MpW IWY~Y OCCUtIEC ~~~t wnrr a~ ~Mwn .n rut ~ O~ ?u~ o. ~r.~~ ~ O! 11~OEtlWMIEp ~~M 2* 7M ~ M H/ ~ ~ IN1UtY AT wOtK RACE Of NIURr.~ wo.~. ~u+. s*rt~. ~~c+w+. lOCA110N ~ ~w~a w »o.. an o~ ro..~_ u~n ~ ~ 1{MCII~ tif M MO~ pN1p ~{Op.,fK. /f/f(Mfl ~ ~ ~ ~ ~ CERTIfKwTIOM- ..ora« ew .a+w~ w. .~u ue us. s.. ..ri«e~ .un o.. ~ e~/w+.e?..nr me oe~tM octun~o nq w~n. w•.~ rw~SK~~M: ra.n. w ~o~. un~ ~.w ~ .m..~e ~ pv6 ~ ~ 1971 t° Apr11 28 ~ 1977 Apri 1 ~8 ~ ~~77 ' ~ t OOn o~ ~.~o~~o~"r.~, e:~ tb aa•see ~w. ~1D tl~ )q ?b 1A ro .w~ uvfus~ suwo ~ CE~TM~CAiIOf~!-rEDICAI fltw~wYiE~ O~ CORONER w. rw~ ~.s~s w n~ .ow a a•s ~M~ N~~pM~ ~y hOM~1~K~0 Ol~O ~i.r~..uo.. p w~oos ueiw rwt nnes~w~no.+. w• o~..w.~. rwm w, n.~ wov~ ~a~r oarwo a. ~r o.a ..w oYe a wr uvse~u s~.ao ~ }7~ M ~y ~ CE~TIiIEt-NAMF ~mt o~ rn.~n - S~GtiAT w~~ a.~r OATE SK.NEO ~..o.~a.. w~..~u~ ` _-J~~. Rozas, M n. v'~ Aoril 28, 197? rwKNG ~DO~ESS-CEtiKrtf snei. a~ r un o~ s~.n n. j 44 Rol Florida 023 ( ~1JR~Al. CREMAtqN. ~EMOYwI G~?ETEfr Of CREMAT0~1t-N~E lOUi10N c~~ w w... sun - ~ ~fMtrr. f ,,.Crepatio~ :~?Kraeer Cal-Greaatory _ Pom a~no Beach, Flarida I OATE - ~ranr, wr, n.~~ fU fn? ----?~u~?~E ~trD ~OORE S ~ s~nns~ ~ s. . cm o~ s~.u. m. ~ H• t~J? . 19?? ~ ~ ~°e ,C ' ~ . ,a ~.r ~ . 3.31'Gr ~ € S. ~612 ~UN GiSTt~l1 S~ rtc~~ n ~ot~i n~si~~~ Rev.1470 ~y~ n ~ . , . • . .i~1' +G„~`,':.~ ~rC~,'S.tit~b , - ~ - ' - . . • ' " ' ~ - t ~~~??.iP11,J!f~`:~f Jtl~"1.?~ _ ~ v.^ . • " . i....' • r ~ ~r`'~ , .y ~~~'?.y` ~r. ~ ~fi`s~~''.t{. , ~ , , . _ ~ !t :,,r ~'„v`~ 2. lf~ S' , gj(lh~' A;.'+~":i:. :5,:-:_, ~V s, ~ ! r. ty `~~~~`x' ~~I~~• C~i~l~~~~~.~~ ~\~~~Y . ?I~ " v'•.: / ril~ • : . I hereby cert~~i • tiie~ alS,o~e'' t,Q~.be a true and correct copy ot the 1.ocn1 Regietrnr's 0 C- ; Y . record on; f~le i~f ~11~~j~~~a.td~ County ltealtli vepartwent nt Fort LnuJerdale, ~loriJn. ~ ' ;Zti~19~~1 i ' ~ T ~ ~ (Warning~to~ :Walid.utt~ea$ r~i~Ied seal of tl~e llroward County llealtl~ Dept. is affixed.) D _ ~ ) ~:~;Y~ Z-i1~i~~ltL'l l._ • v r - - - RI ,l`_ f~a ~o~ . ~~ryf~ ~ - n~ , " 5-2-77 . ~ - . c, p " ' ~'~'••~'y•:••5~,~'~~_. County ileaith Offi r and Local Registrar O ' ~ ! ~ ~ IT~4~i ~ r - ~ . i ~ ~ i~~~t~ ~ ~ r ' A ~ r : ~ . ~ 3 ~ - Deputy Lo al RegistU ~ ~ # ~ eoUK 269 PACE 635 i - - ? ~ : ~ , y Arthur a. Pu~ska~no Attomey at law 440 South F~ H~S~Y Suite W•1 peerfield Beach. Florida 33441 ~