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HomeMy WebLinkAbout0107 ~9~.9s9 ~ ~ su~• o~ GERT{FIC/1TE O(' [~F/1T11 btpartmeel nt 1iF: :ts s.~! R=~a~rN1.11e~ Aenkts Rr• n~ R~:o ViTA6 BTATl8Tl(~ F i.0 ii I D li Ar r.1R\I~wp ! No 9R.'1 TYPE OA ?RINT OKfI~SID-~a •w• 11? (iatf ~ OI~n~ ..e..... ~N ~ J!?ME5 HEtiHY REESE ~ N/1LE , AUGUST ZZ~ 1977 •fRMANENf _ _ RtACM INK ...w .y~w..w~.w ~w.~r. ~Ot-~•a .+e.~ ~ w.~ ~r~~ ~ P~t/ d pM.wrr (OlM?~ d MuN ~~t ~M~t•n{ MM~~t ~R~?\` rO~ NN ~eM\ ~ M N~~ ~,~~~2 , NEGRO w 66 ~ l L , October 31~ 2~0 5AINT U1CI6 l~. f0~++. Oi l ~T,~-,~r bfjRf ~.rw i« .rn M03?'n~l O~ Ony'€~t ~0?~-- ~r ~»r~. ~M awn ar .w~N ~ FORT ~IERCB "•w•" w YES N EASTER MIINOR t1URSIN(', FlOHF, ~ • , y- - • - ft4tt O~ WM...e~ r~~~..w ~~il tl~ wwi cOll~ln yM4o. +Itvf~ MAM~O. SUMtiMC: SRM1Sf ~r ~w~ uyw+::wr tw++• ~ w40+rlO. W~'UKlO ~ Mt~. ~ ~ £L~CIRIbA ~ USA NIDONED NUNE - - - - ------'--,-r"~--"_'-- ' ~....«.nw - r M~r SOCIY YtNM~ I~RY1~f-' YSW~ OCCY~a1~Oq ~rw ~.w e~ ~er ~aA wrtrs aeM O~ ~lND d MISMlSS O~ f411SMt . oft ~ rl~UI~R ai. M+ w N~M s „ 715-10-2302 RETIR~D , ~ . ~~«....~..~•a. •~'~~e• MS4l?Kt-fi~Q CdMt ~ tR~, rOrw~. p IOC~T~O?~~ i~i i.:: irw ttAii -iiid ~Q/ F[ARZOii SAI?i? U1CI FOR'C PIERCE ""`TL'S°"'° 2800~ Ave J u~ ~u ~a /AM --N~~ ~rM ~rw ~~M ~iMl~-YaMNN~Yf rwN ~.M~~ ~~P ~t UNAH1?II.ABL.E y UNflVflII~?FII.f: 1 -MM~ M1lNf1 ~[+t~NS1 .N..~. n~ «e, t~•. rr.n..., N•r. ~r~ ~w MtS. CEMLDIIIE DOli.SbT!' 2FiOf3 Avo J i'c. Fierce~ Fla. rut ~ ~e~M rns twsh w~ ~n~~ o.~? a.~ uvs~ n~ t•+r ~cr ML I~L 4O k11 Nti~Ir ~MNI ~r~ M~til Z~ / - - ~ C~ I~~Qid ~~s~/?•a ~pr ~i /'I'11 ~l' ~ ~ i:~i: «ti~+~ M 't n1 1 G Ai/~ «/ji d~ ~/p ~K- t rra~n c~tw ~ i~T7i.~ifA• ~ - . - - ~i~«~+~iri.i i u~ b C'G~-.~ wt o~' /~Cl~~dtv ~ O~~ ~KA/R C~" ~OMM td~MN b M~~ M i0~ M~~M~ M/~~N'~«~r +r ~~1~ r M ~~dsf r 1~1 ~f~1 ~rr~~~~~ f/Y~ ~ ~ M~ M~D! wNN~ w Mq~+~+~+A f~tN _ M /~~~r - _ ~~~C~ rw ~10~1,~~-- ~~s+. isi,:3ii:'fiWi" -'-~-}Mf1V INIIHr (1CCII~~iD ~Iw~ wM~ O~ ~rM~ ~ r~N ~ M ~~N+, rh. r~i ' ~ ~ ~ L~ M~~ • N~Or. MY. MR~~. ~~[4M~. l(7(11Kr1 I~M~Ir M~~ I +D . t~ M M+~, M~M I tYKw M~ .y~ r~.~R 1YRw~ ' ~ ~ ~ C!tl/K~14M- ew• M. wM .a.r w. n•~ .a•. ~.iq. ..~w e~+ . .c~. ~~t M~M octv„~• w w~.••• 1~1K~~M~ Mr+~r MN . ~~A~~ ~~7. ft V M~~ ~ ~~f~{ ~ ' d ~t ~r~NMM. MI~ N. e~.~.ai...o. ~N~ -~l ~ ~S1V /ti ~.t ,4 ~'~i I % n. n. / Y ~.~....u...». ' ~ " ' 'I'---' ttm~Und+-rib~Lt i~I-ii~i~0ibi~__a» +~'awi i~.i_~__:e» e. M... w N.M... ~y.q~~NN •~w.~wer O~ ~ ~M~ M~O~ ~~fYi~•4~. r w l~~O•. ~ /pq A~ ~M e[t~~M P~ r/ N~ ry N ti~(NM4 P~~ V~~ ~ M 1~ I~C~6 ~ Z I I• I , i~...~r r: «wi - 6~IE ~j+lb ::.i.:+~w.: :~:ii tl~~ri1~-~~iM~ .ww e~ iw~n - - ~aiah~N ,,i ' ~ ' ~ . n. L ~',r•Y.~Anl6, n~rJ l„ ,(t~,~/.:~~~.-,.~+ ..,-.~-------,t*__~.,M't .?~!GI~~ M~A~~ L~~ - ~I f t~_ ' _ 1rM~i !~I ~ ~ w . ' ' _ . H. •N ~w.r ~ ty O ~ S~J ' i~'. ~ ~ r._ ~ ~~!A J) f!s t~ /UMM. C1lMA~4N. 4rOrM ~~~'I O~ CRK?~~~ - HtM1 ~ 11!f ~tlrM! c~ r.n ~~w[~?. r. Bl]RIAG w PINE GROVE Cf.i1tTERY tt)R'P FIF.RC~,_ FL~RIQA a~"' ~~O/'~ NQ.AM•"" ~{MRIY ~MA~I-- HI~r ~Mrltt ~ r.~~r n~ .n. ro~r f.~n P~• - . ~ ST 1977 ti. SARA11'A H['.14C)ttlAt. C~iAi~l:~. 7~8 hve D Ft. ri~CC~jFin ~ V.S. ~1Z i-- ~(?01 Nu Y r~~ryN ~1,' ~ - o~hA H~I~QS 1VC~t Nn~/1~ wlr.~n~ ~I ~ ' . _1~L.~-Lt,l/ I~I!/H ~ I\U~u~l ~Z~ ~:I! ~ ~~rrr~ F ~EO l~M~ RECOit0~0 . ~ S~.WCIE COUMTr FIA. ; : : POGER PQITR~S ~ ; = ~ CtE"x CtACU~T COUR~ . ; • ,~~cp •i ; .cs - ~ ...r:3 . t,*'~; 'S't.:.*.~I~ ~ Me~by artifY fhls b bs a M~s and twrott oopr ot the l,oeai ~a. ~-~r X~~`,4 ~ Rspfstrsr's record on ffie i~ the Sf. LtK~ COVnty Heelfh Deperf- 11 "~9 'j,~r : 11wM d FoN Pie.ce, Fb?id~. ~ (VU~rrting: Not valid unlets reissrd teal of the S~. luc1~ -~t,~ _ , ~I: ` COUnty Hrshh Dspertmenf is affixed.) ~~~`9 r , ~ ~ ~ ~ i.~.- 3 r j ` t~ ~ 4...' ~ N. .;t'' - : .-r ; ~.r-a=.. D. M1itER, M. D. `y GOU~tp H~slth Offica~ b Loul RegisRSr X~`r- Z 1 ~ . , ~ - ~ 'i. ~t ~t~.C~.,~, ~ ~ ~iOCi~ ~ldiNrM _ sa~ 281?~ 108 ~