Loading...
HomeMy WebLinkAbout0597 ~e~s~o / . ~ Stale ot Flodd~ CERTIFICATE OF DEATH Dep~rtment ot Heailh and RehaWlitati~e Benices F L O A I D A ~T~*t ~i~s N~. . VI7'AL8TAT18T1C8 - ~cmat~~~ s wo 310 TYPE OR Pii1NT fA1l0-NMY rw~ ~a Sf¦ OA d Ol~M ~ ro«n. ~u~~ IN ~ t 1 PERMANENT - BIACK INK RAC! ..n. r~~w. •r~.c•r w.wr. •GE-~•ti wa~ . q.~ +.~N~ ~ M. CA d MM ~•w~¦. ( r Otl1 ~K. 1 VS(M~~ N~by~~ ~Ot Y~~ ~~1 ~Y+ M1~1 6602 ~~-y~ 83 * 23 1893 S~a~int i ,OwN. A I ~ M1»~ ~M~ lrM~ IbS~~ W OII~~ 1M MD~ M II~M~. OM f~M~/ MIMN ~ wc+. .n o~ +o - w Fblt Piez'Oe Yes r. Fbrt Pfet~oe lrlerorial HOSpltal____,-------- SfAt! d M~M ~r wc+ r~ r~~, r~r~ C1111EN O~ MIM11/ GOtIN1~~ MAtM[Q N[~E~ ruM~lO. ~HNO S1'OVSE ir .o~. e~~ ...r~r w.r ~ • , cow~. ~ wIDOwEO. ~ wcMn Y1Y~t M~NM(~ ~ Sct~~ectady.N.Y. ~ USA » Marr~ u Wilbur W._ Sine ..~N ~ecar~ - - - - - - - - - - - - - - - - ..n~ r w•~w SO[ul SIC~Mttr ?1YWIt ttSUwl OCCU?AT~Oa ~va a..~ a.ou w~w wa..o .oa a R~O d N1S~+ESS O~ ~IAttt OCC11Nf~ M ~O~w6 trf. MM ~ qMl~ ~ . ~ u 579-12-3991 ~s Clerk United States Treasu~y_-- nvw..a uar rrw aw u.+? ~fiili iN6 ?~ii W-iE-i •w+~» tls~otuct-s~~r[ coui+ti rn.. rown. o~ ?ouno.+ .wi...~. o..o ,y Florida Saint Lucie P~art Saint Lucie Yes w 135 Solaz Avenue ~AtNE~-Mru~E ~NA ryM~ ua MO~NE~-MADt?~ MUNt ~+f~ r»w~ N+` ~f EY'ilI1 1 E11Z~~I Stdl ItrOAMANt- . MAING AOMti3 ~smn o~ MD .(R~ O~ M~w, i~~N. ~r~ Wilbur W. Sine ,n 135 Sol,az Av~e. Pt. St. Lu~Cie Florida - . 0[AM Nn?3 CAYStD ~1: (M?E! ONI~ Or! t~u6t ~N t~ !p hl. Al ~ kl! wr.~ oru~ ur w~~w M , [ ~ ~ 7 ' ~ . ~OwNhOM1 ~I ~M-~f ~[~y~~Z~~- ~ ~N~O /IN w ~ ~ ~y./t r1"_~.- ~ I~YN~n t~ll~~ ~M. ~ , tl ~ d, {~~~W~ tM ~NM ~N~N ~~~M U~p ~ _ ? . ~ ~ t'1 `L- l. l - Mfi ~ OhR~ S~N~KANi COWR~~> COM~~1 COMM116w q MM~ M11 MW ~fu~M M C~tM ~a~/M r~Mt ~~N ~WtdSr • tES .u~ ~~•.N«o~ co+- INf O~ MO~ W N ~ NpMUwN tMIN A M ~.ows. r•. ~a~ ~ 110w IN11N~ OCCYMEO ~~•+r~ r.~ a as r r•n . w••M s. .w. ~ e~M~~ O~ 1MO~fltlyll~ - 7 M IM M. iY IMIIN~ At u woW. ar, v~N~. ut~o~?. IOCAl10M ~ fNNt W~~•. r0 . Cw~ O~ q~. Y~M . ~ MKM~ Nf O~ .a ~ owK~ ON . ~R ~ sNt~ r ~ ~ _ ~Ef~/KA1~I~ Y~ ~W ~O+M M~ . t~M W uft Y~ ww/M~ M~! ON • M/N MM ~M~ w OIAM OCC11M~0 ~t M~M[~. O~ ~ ~111SICMM: O ~O~M M~ ~!Y W~~ YM~ M~M IMOM~ MA. R1 M MY ~ ~~MMH ~M ~ Or ~~~~~W. W~ iN Ntl~M~ ~ ~ 1 i= t: ~ !M ' M ~o wq t.oYM~ N.N~ • . ~ CE~IMKA?~d~-~~ a~ ~ OM aM p p~~~? ~ ~ NU ~~~~f0~ d M~OY~ ~M M~n~Ha~~. ~w w O~ Gj M ~1~~ ~or~ v M~~ OttMM~ O+ r Mq YN NR q ~R U111f~lt f~~N~ M. ~ f~ M ' ~__fiNl[~~/ ~~-,y-WIfwf W_~wrn . ~ ~ a t.M~ s~Ep ~+~o~~T~ s , ~ M Q ~ ~ i ~ - - ty ~ ~ ? 7 ~ ~ wG S!-tt~TO[R ~ / ~ vrn w ~ r • ~ n ' r ~ . I ~ ~ ~ C _ ~ i Ml/IAI. C~E TION. ~EMO~AI fMEI[It4 O~ C~fbMTO~-~uMt flON o•• a~~ i~•n . . i ~ YKw~ ~ n. BuY'~ r? Hf1lCrest 1_~i~DY'~l_ " ~ nrt PiE.rrn ----~'~qrirla OA~- ~.~o~ww. n.~ ~ tuNE~M MO+~[ -w~ME ~v~0 wOM[SS ~ s~n~~ w~ i s.w . cs~ or ro~... sr ry. !N ~ F`l. 33450 w Nja 23, 1977 n. Yates Fluieral Hane. Inc. P.O.B. 777. Fort Pierce, ~ V.S. ~~Z ~u~ ~~'M lIG1S( AIV~E O~ flCUr O~t ~OCM ~lG~St~~~ Nw.7/7d ri, ,o~ tM 24 1977 ~ . ~ ~3 . - s. ; 6 ~fi f 1 hsreby osrtify fhf~ fo be s true snd oorrect copy o~f the Loca~ ~ ~ANO EOIIDE . Repistrers record on file in the St. lucie County Heelth Oepart- f m~nf at Fort Pierce. Florida. ST.1.1lCiE C~fIT~ Fl~~ _ ROCER P41TAA5 ' ,~'j,,;``' ' i ; . ~1A/uni~g: No1 valid unloss raised seal oF the Sf. l~ci~ CIERK CIACWt COt1Rj ' _ r= : COUnfy Heshh Dsparlment it affixed.) ~c^^4"~ vf~~~~ED - . N. D. MILIER, M. D. OCT ~J IZ SS , . f~ .w.ti,` County ealth OFficer locet Registrer - ~ ~ • . ; ~3 ~.0,~- ~38'',~S,Zp ~ O~N Dsputy loul Rea~~•,~r Q ~ so~,z76 P~~ 596 ~ ~ ~ ` f ~ ~ _ ; i . ~ ~ ~ _ . - ~ ~:;~.a-~^.~_