Loading...
HomeMy WebLinkAbout0296 / 4~~1'78 8ut~ ot FI.?~id. CER'fIFICATE OF DE/1TH Ilepartmr~~ nf Hedth ~nd RehRhilel~lise R~?~iry ~r~~c t~~c No « VITAI. BTATIATICB F 1.0 R I D!l pr~~s~w~.~ s uo 105 ' , TYPE OR MINT ~qAf10- •.a• .w~ S/t O~tE O~ Of~~w •.o•..., •t.~. ~FRMwNENT ~ C~ML~ R~.ckn~d TllCkQA i~~([(Q. ~ F¢fvtun.hl 12, ~9y~ ~ t~t! •fw. ~w~M. u~K~~ w~~r, •G[ -~•N vr..~ vr~~~ .~e.. C-Titf Qf WM ~.9.w.. N•. 6lACK INK -`T cow+. a a.~N ~K • ~Ml~~ ~ M~~N~• • ~~N~• Mf N~1 +O~~t ~r MN ~ . GG02 ~ Wit.t,t¢ N 47 .-1-----~,, ~ ~._I~h!L3 193 C 4~~4r ~ _ ,I~ tii~t;10~. O-i l~~iibi+ ai ' `-r- a ..:..T t+05?~i~l W Otiq~ rifneuiP+-. •r ~~w ~•rn ~y ~wrrN ~ ~•~t.• o~ re ~ ~ Ft. P.iQl~ce Vice ln~~~~mo~l Al~d.icrtL C~rtfch ~ • i~.~e o~i`~w?N ..s. f~ii~N bi cow,.; - w~nNO-w~n. M~..~io. - su.~k..n iran~ .:r: ~ . . t~pw~ O. WvM(/p .~~~t~•~ w+..N+e~w 1 LOU~YQ/1R • U.S.I~. NCVC/i I~[V11UP1~ u NO?tC ~HNM(I~M~ ' ' " ' . .1 " ~~•~r . Na~ SOCUi ~C'~Mtti iqlWt~ ~ VSY~1 OCCV?~t~(»i ~e•.. •.r~ o• .o.. eor e..~? ~n• M ¦Nb Or NKM1~ M r-0USnf OteMw~ r ~Owti tM. M•. w ~ „43a-32-02fS ~ asw..~~«.o~ R~PbmAn ~w ' ~hf~r~~lCC Miql~iCt_llip Cpypt~ ~-1(iti. +Ow?~. M InC~iK~+ t~ ~.~~n rSt~t11 iN0 rN1i~~f1 - - - ' - . . 1 '.f~Nr~ A\ M r0 ~~O~I.1(~A ~t. tUC~I.C ~4 r.t. j'{ PR1'C ~u ~lf? ar. r t'N?z 9a ~~r~ -+urt r.a~ .wi iw~~w~ _ u.~r~. ~~uv ur ~i A~tch.i.e U. TuCk~l~ I„ i'•r ~rn i cd K~a y ~~MO~W~~114~ ~MA\OK AMt~SS ~{~N~~ W~~• ~n. f•ti N M~w, ~~~N. Judy Hud~ene 304 rH~t'~~l~n R7. (dv~# fk~~vcoc [aui.s<mrrt ~u l ~t~M MAf C~YSfO /r, pNrt~ ONt r O?t Cavft ~t~ ~~+t ~W N~ l~t ~?+O k A ..ti.... o»... a..~ ifyil- ' ~ r/`~~',~/G'R~ ~ P~R r c/Py /7/i'~'td T . (0~~~~~pM~ rI ~w . ."tw 2..i ~.u ~~1f~ f~lACl/lE ~ ~OX/~ ij/ji) !~•1 ~i C~'/ C!•i~li~rql ~~/l~d X/n % ~~w• ~if Ur1/t- ~~~rfO+N~ rt10~~.--._._"_~~'~ _~'l. _ IMr~ t~~N ~~~1 ~ ki.SL%C/D.h~ u~,y-. ? , ~ . ~ ~--e.'~~' ~ :.'1i`:~Y~! ~_VI~~L'/?~ !•~.rl~r .i.T,4lr^~ !~•'.~~i f'/ ~ .~i . ~ fbMMS~M~ CO~~~I• ~OMMAM (b~MA~ r N~r M AO~ M~~M~ ~O (~~N ~Mr r . w I5 ~~~t • fw 1 1 ~ ~N~ ~AUTfV~r , ~ ~w~ • w ~1~~'r..~n f~~N e. ro. r e• ~r~r. -I~w : ~~w i~•,~,,~3,~ -7T27MN1'y~ ~'IN~"' 3 ~77~/"' i .,a•~. '-'tV•~------------- - ~ - ~ , - - w~rK~ii. O~ 1I4~t1~MrA~ ro' -~d1 pr MpM w~ut OCCUnID ~~•v ..aw.+ e» ..n.. ..r ~,M /i/bvG~NG _11_0 ~ .i~.uFS~i ,.,•~••..no ~.~~'?a:r•~iii,~~.:~- i ~-i~ .Sv/G DF » - ~ . J . _ ~c.~__.~~.1_.z._[~Jr'_.J~.l:.. 1._~~~ . .il~lrik•~.r tNAM~ A~ ~NWt ~t ~t , 4N_ f~Yb, ~KbM. ?OCA ON r ~m1• M~~~ +o . t•~. e~ W.r. p•y . rI%!'/ f~/ Jl . ~NK•~rN)MSe~ O~d~~.It ~fMt~n~ ~ w. ~ ) ~ .7fI / L /N~Y~tIw/i: G/7 % i- Jr,.i••- ,r ~ M~ i. t~~.Y.t• ~ CI~tA1CA/Q!1- ~w~ M~ nN ~Owr M. •p~ Uft rIN~ N~t Or r M/K ~r ..r w:~ ?~~rr p~n~~s M hN~~ /MtfK1~M~ 'O N~ ~ wY ~/IM ~h1~ M~~w rw v ~ ~w~Wf~ tif M ~~~rtwo~ tM M~ Nr~n~? ~W+ i fq be IU ~y r.we • ~~.~.K.;~- L-- - - ~ n~~~ _ l'-~I1J:. ~O M (~frY• " MIOKlI [t~~~I~ O'~ ~tt ~~?H O~ H N M~M M N~ ~Mw iF'?~+.~+~~ ~1~~ I~~~r~~v1r N ~I ~[V~ ~~N/p~ r/ ~1?r6~~M. w w p~~wpr. ~0+~ ~rfr~ q~i~r»~e ~•w ~ ~ M M ~yy f~•w• Lh ~ ~ SSI~_~'1L-/'l.t~l.`~L`/~~~t //1'~J_~__ ~ ~ !1~!'/!*"!~ ___'~J~""_ ' 7!" ' / ~ ~ _ M CI~t~ R~-?~MM ~ M/WM 3K~~~~~-_ M~.M~ M~..~~ IfAi~ S~J.iND IH ~ ~ ~ ll~~X__~v~_i1GL=.V~ Z' l~~ ~,[.t~, . ~ ty.a. ~~.~.1 . Z~~f!'. r ~J . / ~ulrM. ~Ot»!~S-Cf1tM~i 1 f~ o~ ~ : ~ «o e.n ~..y . 1H j i ~ r• /'r ~~~•f-r i-/.!j 2 11 ~i1 ~1NIII. C~EM~IKIq. ~MQr~I ~M~I~~t (,H Cf~y/~1(NI_ NI/V IIK ~III1N e~~. M...w ,~,~R~novn.C-ftuh.fitC ,pFoAhe6t Pn.tH (uv~t et~t~vcj~~~tit, f_ar~itiimin _ OA~~ ~Yiywr. N4 ~IM~ IV~'K~RI~No~.t MIdI IUt ~n !:t ~ n. • • ~ . c• n.•.. 1 R4dItA ~unfRnl~ I~~rnP °!?1 ti'. 7f;~~ C f. f t, ~i'~v~tc~~ Fin, 33•1 ~A V.8.~61'l IWI~~1 IOO~j~ f1C~IT ~ tIG~Sf~~? 5'r•u~n~ ~ ~ . ~n~a ~::r..in ~~rn ~n.~1n.• 1~ev. ~/7~ ' /t ~t i. • ~ . a. 1~~•hn~:l~•y 13, 1!17R ftLED AMD R~COA~Et, ~ 1 herebr c~er?ify mb to be s??us ar,d corren copY o} ths l,oc,i ST. LUt~E COVN1r FL;c " ~ ~ Registrers record on file fn the St. lucis County Health DepaA- p0:= n F~~17R45 • ~ - ° m~nt •t Fort Pierce, Florida. ~ 4~ -~{1~T ~^+;p { ~ . ~ (1A1~?nin9: Not valid unle:s raiscd seal oF the St. Luci~ ` • Couniy Health Dspenmenf i~ sffixed. ' ~ : i ~ ~ ,1J~ 16 2 26 PM'~~ - : ~ ~ ; N. D. MlUER, M. 0. ~ County Nesl~h Offecsr 8~ toul Rsgishs~ ~ s • l. . . ~ -~8" c~ ~O 4111'78 ~r ~oc.~ Reo=...~. ~ . ~ ~ B~GK ~i7~ PA~E ~~V • ,R _ ~ ~w ~ - - - ~ Y. v~wX-s.." y,3,xw%". `>r . ~ ~ ~ b ~-'^~Y~ •Y,~.e `3+22-.E d"y S, • ~ , N- :Y ~ ~e ~ - ' ~ '>~+Y~--~a".,• ~ ~i': _