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HomeMy WebLinkAbout0809 . - • ~ i i :I~~) _ . . ...~t - _ - _ • w s4a or r~o.~. CL- RTlRICA7 ~ uF DEATH ~ D~Nl~M~ Ot IM~IV ~M RfM~kY{~IM 8~t~lON ~ STAT~ /II.t NO. • VRAL ATAT18l1(~ r i o ~e t a~ T1f~E 011 MI M • IN ~ JON~1 ~flik Y2'~1 ~~1~ ~ 1S~M 1~ ~KAAiK INK •~w. .~MO. ••wc.r .~w~, ~0! --..a Mw. ~ cw1! a MM . w~w~ w. tOYMt+I a OfAfM «e. ~wcw~ a.~r.j• ~•w., .e. ..n .e..? Jw. S 1912 n Mt1'~1o : v~ ~ cw w~ nl ~r .a r nrM. Mw wn rwrM ~ t vKN N? M w~ . . w S~vart ~ yes N Ma~ctlu Mqws'ial tal ~ . . . ~ r r~1 ...M w~Mt GOtIrMt wMA~NweO~.~ •N~!~v!! YAIRIlO. ~+.w. «w ~r~Ir ww ~ ~ ~~w uw+w ~ Y 0/Za~i arra s~ A• l1i~'1~ ~ wtw ~ 1~rtNl ~L1Q~AS~tI ~ ~~Iw u a11+nON ~.•w «.e....r ww .eM « ue a MN~ta a wll~m ~ w~.~ w~» ~ ~rrw ? 1 : y 3ab-10-1013 ~aintenano~ 9upsrrisor 14?tlaaal it~? ~.b. _ , ~s~osiae- ca~. an..o~wK w.ouea+ •w a. ~.M. ~ ~wc..... ~ ,.,~lo~id,a ,.8t. Luoi~ -Po~t St. Lucie w no w 430 uil r ..r ro1~e.-a.onr.wm .rw. w~ ~ y ~t'l~ ~Z1~2 y w1~1~~~ri Vl10~i • : ( IML~A AOO~i~ IMrw M a1~. N. ~lw M~Ow4 M~A. N~ . Mrs. ~hsl ~rall 430 'hce?nquil , P~os~t 3t. Luaie !laa~ids 33~?5~ ~ ~ ~w~ wns tN~ee s*. 1e~ aar o.~ u~ wr w~ ai 1~t ~ K~ w ~ M • ~ ~Z~~?lb~' i ! ~.~t~ YM ~i M ' • / wrwM u~w ~w ~ ~w • • ' w~ aw wi~ e~~~ ~ M MM a OiM~ f10~l~LM~ GOM01110M. o~.rwrr c~ww~ ~ w.~ w » crw ~ww. ,,...r . r . w~ ~ n1 '~'w~~ ~~w ~ w~wa r.•. - NOw wul~~ OCQIrt~ ~ MN r..w « rrw. w~.r . M.rw S A. qi ~ *t IIL ~ _ ~NJIRY MiO~ Ma+. wa s~w. Nwsw. tOCw110N ~ ww a ar.~ r-. m w ww~. w ~ ~MO~~~pMM~ «K,K. ~MrCwl _ • ' ~ ~ ~ h1~M~dMk~•• ~~I i~~ A~f ~P~ W ~W ~ MN ~M rM M~ N/w1 Oa~~ M~ hMl. Or M a10~~ s wY M~ I~rp Y~. r1. O r ~2~ - - - ~.~~as ~a: ~ _~r ~r ww a.r nsM « M.r Mcwrw .r ws.o~~ wr ~ ~~..wr. a r ~a..N/M ...M~..or. r.. o...OM, ~y • M~~ ~011/~~ M/r W~ M~Y r twMM ~N• ~ / • IIIq O~ MMA ~~~1.r ' _ + V ~ r~`ws~ ~OO~tri-CNIrC rr • ~C68t1 ~1R1. ~ ~ ~02`~di + ~1~A1. ~~At . -~MME l ow w Aw~ t~ •~"`"~~ite~o~ral - „~Iillcreet Mea. GardsYUS I't. Pieros(9t. Luoie Co. lrla. { ~ _ ,r Jtme 2}~1~?~' ~o~~ei~. B d~u .P1an'era~ ••Ho~s' ~5~. MFed. H~p. z~t c~ ~ vs. ~a~: ' - - -sw..,n,~[ IMr. ~/7~ ~ I hereby certify this to be : true and correct . copy of the Local Registrar's record on file :a. the Martin County Health Department in Stuart, - a Florida. . - (warninq: Not valid unlesg rafsed seal of the . 1rlartin County Health Department is affixed.) Archie McCallister, M.D. : - County Bealth Officer i Local Reqiatrat , _ - - , . f - ; ~ •F~~ . - . " ` 1 ~ ! Date Deputy •~.oca Req ~trar i _ ~ . - - _ - ~~~5 . ~ RO~E~ CLER1t CIRCU cauRr brra=~ Y~F.ti~E~ 3~~8 Noy 16 9 26 ~'i? ~ . 500~~~ PACE ~~V~7 EXHIBIT A ~ ~