Loading...
HomeMy WebLinkAbout0601 ~ 39~2'7, i ~~r;«. , 3 ~occR ?o~r~~s ~ !':Fr^K ~G aC~lZ C~URI `t~' 0 ..r...~~.. ~AN 31 45 ~H ~~8 ; _ ~ CERTiFICATE OF DEATH ~ • FLOAIDA RATt t11.t M4. _ ' • NO. R[~i1StpAR~s_NO;_1,o ' , 9--.__. t. PLAC~Ty„OIr Coot No. t. USUAL RESIDENCE ~ww.~....Mn..d n~..titrw.~.«u.wn.r... I ~OUnn STATf COUN11 ~~M~~~ ~ 66- _Flflrid~~___. 3t. Lucie . CI17 1 wuW wq.ew n.1u, s~n. 1V~wL? c. lEN6TH Oi t. CItY It! ..aN~ .ww.a n.~u. iifR~~~ ~ O~ fTAr 1r w~ M«r1 O~ ~ TOMIN Q~ TOWN ~a.__P~~Z'(~i~__. - ~ , Wtt NAYE p/ ttf..e r lrnu w/ruatu~. Kew.atw w reuh~i d, StRfEt ut ewd. w.~?~i ifOSIf1Al O~ AOD~FSf ~NSntut~oN ~ D~ ~o ~ ~t+..u w iu a~ae~.~ i~.~Qf~~ 6 ohf -~~e.ui'~ii:.,i~ ~r...~ - ~ e y K ~I3ell_~_ _.__~:l.lingtnn °fATN_ _._2 19>3 ' L fEJ! COIOI OR RACi 1. 11AtR1E0, MEYER MARRIEO, DATE OF ~I~iH 1. AGE ~.u N t~n~ ~ nu • ~ w~oowEa, aro~cEO ,...~,n, ~.a .~wd..? ~..w a.„ n~... M~ ~ an_ 2 19-Q2----- 5~_ _ _ IM. UfUAL OCCIf?AilON~@Nr !lM~wr~ IM. KINO OF ~US1NESf DUSi T fIRiN~CE ~lha~~ ~r fwNr~ ~u~1 11. CITIZEN Of WItAi M~'Arrt w! d~ 1W? ~w Y CVUNTRri ~rvs~nville~_ Fla. - - 11. ATNEI'f II-NOfNERY MAIDEN lIAA1E ~ liarriett~-_------- _ - li. MAS OEGEASEO t IN U. t.A~itEO FORCESI 1{. SOClAI SECUtIIY 17. INFOR?IAN/'S SI6NAIURE . T-- ~w. e»....w..r.~.~.~ _Art~ur_ L~~ih ,ton a r ~v ~ ADORESS ' e„,~ o y~~ ~ t..s~7---~-,r 4 J9 N. CAYf! Of OEA1H ME'DICAL CER?'1FICA ION ~wrewv~~ ~fTM?~M c.e.~ e.a asust oa co~omon ,M«, ~„s a„~ ~ r.~ n.. a. t,~. . ol~tcnr iuo~na ro orwnr=.1~cute myoc , ~ t.1 . i ~ ANitpOH11 C.J1Uf!! ` . ' ` - - - - ~ •T~b ~a wM ~w DUi TO (?1 • i tb Mte N 1~t*R Yr.W w~1t4w~ It w.~~ ..e# .r ~a.t 1.ti..+. 'W tl1. ~~wb.l~nl.~ t..t. atAN4. da lf ww~ pUE ~O t ~ t4~ N«+a~ Mlw~ N - S ~r~ ~ ~ 1~* 11. OT}li~ flCMtfICANi COHOMON! - C~wNt1w~~ e~wtHhtiw~ t• r~ 4~tA iaf +wt ~ ; U~ 1(~ar ew~iWw e~y1~ iNt~ ~ H~. 0 ~lfT~017 AUtOKt7 ' ru ? wo ~ , ' ~ IR.WIrI I~s/ I?. CE OF NlllRY Iwo. f~ u~ww Itc, (CITY OR iOWM (COUNTt) /SiA~E~ # ~ ZI~. ~CCIOtMT M'r. t~. ~rMef. MeM. ~i~ NiL. ~ta 1 1/ ehl. ~tN~ ttTRlLi ~ ~4KIOf ~ ~ q .¦u , - - j 1. tIME u~..u? ~ ~ >:i.. ~ u~r occu~eEo i ~ r~~ar ~T ~ea ~~a?~ ~ ' ~ INlUi~ ~ t~~t ? n te~[ ? ~ ~ u. I 1~ereb~ certi/~ iJbe l e~c.rasd tw• a~~:~.3 ~ ~ 2`~r l9-- . lo ~ ~A_. fAnl 1 Inaf aav (he d~~~a•~d ~ aliiti nw lY otid IAaf deoth occurrcd at e f~l Jmm IAe rnua~a and nw (hr dnfr tfeltd ahnr~~. _ ~ ~ ~ i ID.r*a K t1U~1 J7)a. ADD~E~~ IIe. DAiE f16NED ~ ' J o b ~ ' iOtl, tF.L10YAI ~C~~- L?I DAfE llc. NAIRE OF CE1dETERr OR CREMfATO~~ Nd. l0 At10N ~CH~. 4+ww, er eeanb 1 S • ° - - Palat Palatkas _F1e. i ~ DA ~EC'o ~Y LOCA[ ~~GtliRAR'! lIGMATU~F tS. iUNElAL Ol4ECTOR'S St6MATURf ADD~ESS~ ~ i Rii' V { . , ~Ft~__Piorce. Fl~. t ~ i ~ ~ ~ ~ ; ( ~ i ~ ~ - ~ . ~ ~ ~ t,sr~se~r os.r~ty ?nk ro be a r.~,e snd co..ec+ ~y ot n+s t,oc.~ ~ ~ ~ Rspishs~'s re~cord o~ file in the St, lucis County Heeith pepa?t• In~eM ~t Fort Piarc~, Fbrid~. - " ; (WKnin~: Not valid unle:s raised ses! oi the St. Lucl~ ` N~elth ' ; Cotrnfp Ospartment t~ affixtd.) ; • . - . z j ; N. 0: MILLfR, M. D. ~ . =i• ~ + County 11h Offker 6 Local Rsgishsr ~ ~ ~ ~ ~ "`"'~~t kf '~i~~ 4/~ i Orpuf~ Louf Reo~~+•~r ~ i ~ ~ , ~ ; ~ ' ` ~ ~ ' 281 PACE fi00 ~ • ao~K 1~ ' : ~