The URL can be used to link to this page

Home My WebLink About0516 ~78 23a se.t. or Fa,.~~, . CERTir ICATE OF DEn~1 H . tkp~rtment oT H.dth ~nd R~hsWlit~11.~ 9enlces ~rRr~ •u.i No. , , ' VITAi.81'ATI3CIC9 - F LO R ID A A~p~s*~Aw ~ wo 37G ~ -'TVPE OR MINT O!Cl~i~O-n~+W •~n• .w.~ y~~ D~1~ U~ MatM.•~pr~•, PER~1APiEHT ' 8~e4~. .L•---4D6~~~ ~ ~ ~ ~d ~u[a~71'7 • HIACK If~IK uC! .~w. w~sb. ~•~Mw ~+M?~, •G!-uN .w. 1 q~ ` Vy~~ ~ Y1 C~Il W M~M ~+or~. M~•. COIIMtI d OlMM ~K f 1M[.n ~ pN.~~t 1~~N1. w~ ' M~1 ~~f .M. N•~ ~ . 1 66b2 . ~ • ~ . wt~~te N a4 w . ~~.~e.nt: 2 r lit~; lOw~? . O~~iOZii~lbi+ ? +~w ~~+s W O n!~ Nfi y _ r ~..~w~, a.~ w+w• ~ ~ : wt+~ •H w w ~ ~ ~ Ft. ~ P.~ehce yee P.Lc~ dt mo~i.a~a si.~~ a w~» . ~ w0~ r ~ ~ , M•N CI i N a ..w~ ~ow~~. :w:~eo. w~n:.uuao~ ~u~•.•a ~ .p~,~ ~ . ` ~..M.., - woow.o, oNq,cEO ~+..c«~ ~ . ~ N~co Y~nk , U.S.A. » ~ku~t.c.ed tv_i.i.e.i~ Hs66~ •n N.~. SOCi~I 3K'~w~i MYrit~ ~ USV4l O'CCW~~rOri .r'a iw w.s~ sw ~w~y .os~ M t~0 a iYS~MSS W w011lur OC<YM~~ M ~OA~~ ~M. ~MO M NA~N ~ . ..,.,.,.,~.a.. „ 262-ao-2ar~ Ho~,s~ w~ ~ c~,~ N~~?e--- 1~ f N+t~ b~ON - i~voe?.ie`~r.n cana. rn.. ~o.+.., w ~«.nw ~r.i ~.....+i ~i«e~ ~?a ~T"--_"_""_'"" ~ yKr~ N .~O ~w F~On.~dQ ~w $.t ~ .t P!. • ~a NO ~M 2 2 f'l~n Q ~ n ~wr~~_~+~.f •w. r~w~ ~ ur rO~NE~--rapwi+wl ~+r . .w.~ . - wv ~ . C~t~th,~e6 PQItlLC?tS ~I{!t? ~ fc?tLl,bt t ~uWwu+1_qMM - , wR~O AoO~lS! .sw~~~ e~ ~.r• ws. cn. w~e«. M.y. n~ - E , W.i.Ce.iarn Ha man ~~?.7202 P~ur?kraa I.ane ~.t. ~~,e~tc FP.c~.. 33d 54 ' { /41~ ~~~11 MA1 ~~k01/~ '(N/~1 aR~ dK ~M1K n~ A~. Y4 NA NA~/~ OrN~ ~y MW y K ~ ~ ` t t ~'T' . ~ ^ ~ COrMti~wf. N ~.w ~ . ~ • . ~ w~ . ?r~. at~ ~ ~ M . ...~t~ al'!t-s~--~.~ ~ ~ [i-' Q ...w~un~~~~~.~.. tii~h: ~w. ~ ~w~ or~N .e( ~wN t~~M ~ap ~ • " ?Atl OfMf~ SD~~'KYI? COM01f10MS. tM~~F~ tir~~M~.M Mw. M M~ ~O ~NM ~~M w, NM AYtC1~3~ d rf 3 qH wrn.~N ts? p . ~ w~ e~ ~.e• ?M~I~ ~r Nq~rr~ tn~M ~r s~.~. ti t~ ~w ~..~.S~ $tX`i~i~$t"a~ll~ ~ ~.e+r. M•, Nprr IN/1N~ ~CCVMN ~~"'n r+w a.+.1r~ w r.« i e~ s.M « wr ~s~ . M{~~u,.r~~~!d~. O~ VO~IIN+R~ ~ - . . . 70~ x M IY /r. 7M a+Aptw~ wqi q~ p ~a N~Oy. 1~M, pMN. ~K~~. lOtwnO~~ ~ MN~t M~.~ •~Y . dA N qw~ MM ~ ~wc~ w w~ e~~ wM.rac ~~nc+~~ s. 7r ~ ' Clt11nCA/ON- ~d~ M~ NY ~b.r Mr •~Y M uY f~ w!~ M.N a. ~"M/M ~p ~.pr M N~M p((MM~ M r~~r~, p.r ~ ' ' /Mt~C~IM- ro ./~l ~ N~ AN M~~ ~~M M~~ ~~O1P~ e ~N. ~r~. b M MH ~~Mwf~ M ~j / M r~ frww~~ei. M ~ ~ h~ N~~~M~ nOr ,Y~ IN - I• Th - ?11 ~ "~~j~_ Y ~O ~N tI~1nH WM . C~It/l(~110H~rfOKµ~~M~~O~_C_ MMrA O~ tillK~M HhO~011`CM N , a~~w~~O+ d h p~ N/M ^~t/4 w.. rP~. N~ M~~ ~q~ ~ . 17i'~ aRMM Oi M My ~~N M~O M f~rM~M Yi~N . ~ f / / ~,r~. . A_~+ : C~~M~lt- M i~r~ 1~i MM~~ py~u A ~.eM~ti. M~~ ~M~ ~ 1b ~ ' ' ~I IU ~ v / lM -~U'~ i - ~ rA7~~+0 q V.~~. a • • ro .~L~'_ . v . ~ iM " - ~ ~ • Y L, L_.. , - ~ WM~I. GIEaM?~Or1. ~lMO?M !M! !~t O~ C~t~M10~T-~+wt 1 QO~~ ~ c•n w suw ~ swcw ~ :w ~w Hl.«ChCb~_ ~f1nOh.(.Q.C F.t ~,~PhCe POh.(dR ~ 6A1~ ..o.~. aw ~v~+ti~l MOr[-iunt ~+o ~oirlSS ?.an o~ s+n c•~. a w••i. s~..r, a.• - . ,N hcCy 2,_ 1971 Ba,ihd funeJrn.C N Me 901 N. 7,th ~S#. F.t. P.cehce. ~ta. 33~lSO V8. #812 WMt~lCi -~C.+~~~f~ / tlGS ~-~~?yK ~ ~~n un••~e n ~otM ~w~s.~w . a.,. t~~s ~ ~ _•t Cl L ~L ~w ~ .,~at ,L' ~N Jul 1, 1977 ~T ~acE~ G oU~T~ ILA . II . rP~ C".~UIT C9 . _ c:r~ _ . 21 12 i u PN'~~ 1 hereby oertify Mis to be a true and c.orrect topy of tfie (qpt • - R~gi~fror s ~ecoid on file in the S!, lucis Coun?y Hesllh Dapsrt. . ~ m~nt at Fort Pierce, Fbrida. ' • • - ~ ' (YVsrning: Not valid unless raised seal of the St. luti~ Caunty Heslth Department is affixed.) N. D. M~IIER, M. D. Gounty H e(!h Officer b lota( Reqistrar H.~ - . Os~uh lataf ~Rrv~•+•wr ~ ~ . ~ ~ . . ao~2,8g ~ 5i~ ~ : . . ~ ~ _ . . ~ "~''~~s~s..~?, : ~ w ~ ~ ~ i. - n:~ ~ ~ n'~ . rr ~ ~ °-~s- :~°r r. _ `l ~ - . . ,..~.i'~'< .