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HomeMy WebLinkAbout0766 t ~ ~ V/ Yr/v~o . . O ~ ~I~~~ t . hCCaRp"y~~~/ ~ QCT ~J ~I 0$ dM ~IrI S~e ot Fioreda CERTIFICATE OF DEATH ~ ~ ~ast ot Health aad Rehsbiiitatire Senices F L O R I D A s~rwTC R~~s No._ VITAL STA7'ISTICS RCQILT11A11•f NO _.w~yE •~n• rrM1 ~~f SEx ~Al( a{ OfAM ~ rOw~r. ~a~, ~N~ ~ ~ Yillia~ R. NAGER , lble , August 25,1977 ~ACt ..w. .rw. wuc... .~w~. sGE - us. wa~ ~ nu w~o~~ CAtE d MRM ~«o~+N. u., ~OVNtY Of OEwIa Yhits ~ h 24 1904 Piaellas . ~ Omr. ~pwl O~ t OI OE4M w~ cw uws ~l O~ OTMER MSi - ~ u•w~ w u~r~. an~ ~~ro a.~ nwn ~ snc+. nf w.a ~ w S+esinole ti No D.O.,A. Iake 3e~inole Hospitsl SU1E O~ w~ r~ s.,•.w C111ZEN Oi WMA1 COIINT~11 MARR~EO. NEVEf MAlyED. SUtVNl1G SI'OUSf ~ r.+~. arw ..ww ww ~ • _ . Yest Yi~inis`'°""~" . v.s.A. ~;1D~~COint°'~ Aosales Utter~ohlen ' SOU~I SK~~r ~aiwE~~- uwnt aCUrf~nO~+ ,a~ aw a.wa ww w~~.o .os~ a K1W O~ MJS~nEU dt wWKt~r 1~O~IWG ~O! N M M ~ „ 23~-03-0131 „ 9e~ ~p~o~ed „ Neger,Woolf Printing Co. ~ES~O(~~Q-S1~R COIJN~r CRt?. tOM~M. W tOCAiION ~sw ce? ~was iT~fEi ~ WtM~ ~N M w0 w F'laariRla Pinell~sa llo. Hedington Beach Yes ~4 3 I~o. Bsth C~ub Blvd fATE!-WY[ .r~~ pp~ Mpil~R-MADEN NAIME trff r~~ uf+ n MthoN J. NeiBe'r Ant~s Ae? or ~+i~law-~MME w?aNG /?DO~ESS ~sw~~ a~.~.~. .a . cmr w www. u.w. ir~~,~8 .yrj~ • .lJI w Mrs Aosalee ~n o Bath u [ Ofw~M w~?S i~11SE~ ~[ritE~ O+R~ O~E C~us[ rN t~+E 10~ Nl IsL ~+D kN NMlw OMMf ~M M~n~ ~ ~ Hypertensive cardiovascular disease undeterminec s.na.o.+~. r wK~ t~r! wM ~O ~ a~lM~4 f~H~ 1~. ~t ~O. O~ s! ~ tOMKONKf O~: 1tMN M ~~r N~~ ~~M/ MF w • IMt ~ OO~t fiC'+r rrKa~t tONDKtONS: COM~*W! COMY~Mw10 q M~tw W1 MOt Mtwtt~ q t~Y9 GMw w~ nut ~ w~ ~OKr 11 rEf +~ue ~~Mwros ca• ~ nf «o~ MM~N wnn.'ww~ ~wM ~p a ~~~rr w ~w eY~~ ~ ~~tw. w. ru~ ~ MOW INJWY OCCY!!EO ~~Mw~ w~nw w~MWl~ IM ?Y1 1 M I~M N, na q t ~r ~ ~ ~ w'iRRf wt wO~t Oi NJUl~•~ •o.r. ~.u. s~. r.oa.. tOCAi10N ~ s~un o~ .w.. an o~ ~o.a. sr.w ~ ~ MO~~ q! O~ ~O~ Y6 ~ h[. ~ VKYf 1 ~a ~ „1 ~A1~i- M~ • TlY ~~M M~ ~ta~ ~M 4ft LM M1r/M~ ~tM O'1 ~ M/Or NO* ri!w 11! p[AM OCCVMfO ~t rMf hK~. Ow M ~~Y~ rp~1w M~ . 1!Y ~OM UR~ p~M. ~r01M1 ~M~. ~M. b M M!~ ~ ~R~y~ r! M ~t t~~OGl. 0111 Iti ~ece.an wo•. 1q !4 ft~ tM r? ~o w~ uwsta~ sr.no ~if~T~t-~KAI EZAMf'rt~ O~.COAONE! O~+ 4q Nf~f p M wow w o~a~. r.n eectee/n r.a rw~o~n.uo w.~ ww. o~rw a. ~t s.~ r.~ we a w~ uvseai w+e~ ° ~ ~ ~ ~ p~. Approx. 3 :00 ~ ~ Augus t 25 ;~1977 4'z°Yb P. M Ul~t-NM~ .nwe o~ N.+n A p nn~ OAiE SI(',NEO ~ • ~ ~ Joan E. i~iood, M. D. 4',u} Ihp; ;:Ass oc .Me~ .~cam. ~ Augus t~~,1~'~ 7 ~ ~~AOO~u-°""`~260 Ulmerton Roa~;~~ est~' ~~argo Flor"i°da 33540 R~AI. [tfMA1~OM. ~1rOYAt p dEMAT0~1f-N~E IOCAflON cn. w ~o.... s~.n / .~..c... ~.~~=-4Y°y ~+s_ . Buctlsl - nit~ Cardena Isrgo, F'~ori.ds _ r QwR ..o.~ ' ~ . _ - - w a.~n_~.a..-ax• o~~o~rn. st~te. nr ~ "i B~rH ~/~{QJt~ a100 S~eloob Bird. fib P~brs6ur Fls. 3~~0 s-- REC.~ i ~ru~E owa fo u iow nas~u~ - - ~ ~ 977 ,.i.. . tt~_~c_--~-,.:a.~; _ - - - - A CER?IFf~ COPY°l~tT•_~~,;,TftE E!~(BOSSED SF11L OF THE REGISTRAR OF VITAL STATISTICS ~ ~SP'~ • f. . J •.Qi ~ i ~ : .~1 / •-.,~,~,y~ . 'I-.. ~ ~ .:2. . . . t,r:` i ~a ;...,~•,h~reby ~~r that thia is a true and correct copy of a certificate ,~,~c8ar .aY~~~r'office of the Local Registrar of Vital Stati~tics of the `~i~~:l,~i~ji`~lealth Depetrtment, St. Petersburg, Florida ` ~~?#,i~~~ , s Aog 30, 1977 = ,Deputy Local Registrar / ~ . ~2'15 ~ ~ ~ ~v. - _ _