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HomeMy WebLinkAbout0597 • s•----~--~-----_ _ . . _ _ . _ . . _ . _ ~ STATE OF FI.ORIDA y~ ~ 4i13~1 ~ DEPARTMEIVT OF Rtv~in O'D Aakew, Govs~nw Health & Rehabilitative Services DISTRICT ELEVET4 DADE COtiNTY DEPARTMENT OF I HSRBBY CBRTIFY ~4iIS TO H8 !1 TEtUE COPY PUBLiC HEALTH - - IDC~1L RSGISTRJ?R' S RECORD OF 1350 N. W. 14TH ST. g ~~,D~~~+~, , MIAM1. FLORIDA 33123 .~AttaIING: J _ s7 ~,,~`~L~ ' ~ ~va~lid unless the raised ~t~r~ ~ ;i[etI of the Sureau of Vital DEPVfY RBGISTR1~R y • ' ~C3 ~ :T ~a: ca • , i ; ~tistics is atfixed. ) VITAL RFCORD6 UNIT .+i : ~ `i'1 .~r~ , i . ~ ~ r`~ . . . . r8ta6t o. enda ;3 . ~ '~i ` CERTIFICATE OF DEATH partment ot ~~.~p~et~s ~~Y~ ~~~~s F L O R I D A sTwrE Fi~c Ko. ~ ~pq"' ~ . `y/ ~ 2 ~ REGI6TRAq S NO ~ ' - ~ NT OECEASfD-N , r.x~~ ~~7~ SEy OAtE Of OEATM . ~Gwt., o.._ • ' ;T + _ M, ~ JAMES SCHENCK ' ~ Male JULY 21 1978 ~ - ~ ( 4CE rM~1t. w~G\J. ~WUC?M ~wp.•r, wGE-..s• u..a~ ~~u~ u«au ~ w. tAIE Of pi'iH ~.o+~+, a.., ~COUNt11 Oi I~FAIN vc ~ sncn. ~ ~,~.ww. .~.~s ~ ..o~ w.~ : »a+~• ~ n.~ . I ~ _White _ _ _ ~ b8 ~ ~ x ' 6 ~ ' DADE . ~ C7~1, IO1MP1. O~ lIXAi1CH (~i pEfiTM ~wtq~ (n* ?r.q ~MAt pR O~Mtt NitltUt ~--H~ ~ ~.e. ~.*w~, c~i ~~~e~~ .w »u..~e~ ~ . a?ecu. .u a Mo „ MIAMI YRS „ yETERANS ADNINISfRATION HOSPITAL • - - : STAtE Of WM .~o~ .M v t~,.1~.t C1112EN WM111 COUN«11 MARl1E0. N['~E~ titwrt~'t0. .Si+fvnw~; SPO(~SE /NI. Gt~l YW~N wW! ~ ~ cwn,.. ~ w~DOwFO. OtvOKEO vu... I : , e~Iea_:ork 9- II.~.A~--- ~i~d Fr~n~e: ItQSior.ek_ - SOCIAI SEC'J~t1Y Nll~E~ U.UwI OCCUtwT10N ~tM a«.o o~ .oaa oo.n au.K. w.s~ w~RM~W 01 WSwE51 OU 1NOUSTt~ ~W/~~6 ~~N. I~fN Y ~In~p 1 ~ ~ . ~ 051 10 417 1 ¦ES~DENCE,SI~ff ~~.n+TY - ,~_~s tv ~ar~__ , ' w> tI~rts ~ P~icir_.?~~ HuM~i.--- - [ r. tOww. Ot tOCwnOr~ - 1--- r ~.t<<.. o. .~.I _ Spanish ts.a r d ~~o ..S I,ll t~c 1 ~a~ j~]p f~_~2` tj ..T1v TA~CP.r /ATME~-HdIME ~,n .•x.e i.s~ YQTME~-AfA J~?~ NA~nt ms• .•oo.~ ..u +s Fredrick Sclienek te Ur.o t i eNfORM~N1-~rAMF ~wwRwG wDLlESS ~s~na ~ ~ e .w . cn~ w ~o.~, iun, ~r~ ~~a I~[rs. Frar_ces Sehenck +~s Tu~.ad2•id Lar.e Port St Lu~i oridu 2 ~,ur i otwn~ wws twusto ~1 .n ~M ` ?[Nru awr .~ri[ c~us[ n~ :.rt ~at p~. Isr. nno a Nti~~M pwHt ~M 0[~M ~s ~.neMwcws~ fIlEO AND RECO~Ot~ RECENT PUI.MipNARY EMgp;,,[~ IUCIE COUNTY F~n , • NLOW ~ • ~_l}~~ ~i~.~iL' _ :M",~: o: : : b w~ CAKCINOMA OF PANCREAS ' ~ ' - ~ urlN~l~ C~Yf~ ~~t, NM q. O~ ~i i(OalfOYlKf M^ ~ ~I~~IMO tM~ Yw~~4 ~ lf~M~ C~YM ~~N ~i~ ' ~ ~ I ~ ~ ~ AH 1 _ J~_ 28 ' ~ ~nRt N OTM[t SIGNYIGwI ~p~i~p~ls (pr~bpq3 COM~MYtuK b O/~M ~fll rpT 41aR0 ~O (wtt c: q~+ ~.n V ~ES .~n~ ~~MOIMGS COti• ~ N1 p M~/ MM~?O ~M N~/~WNIM6 UYy~ 19a YES ~o'•"YES O~t~tAO1iNMM~[O A ~ ro«m, ~c~, n•~ ~ MOw 11~1~~~ OCCUttEO ~~w,u .~unw~ a~rwa ~r r.n ~ w r.n u, eu ~ 211D 20C M 10Q IN1NR1r wl wCRB M~CE Of NIUt~' .w.~, s~~n. ~~non. tOCwnON , so~~~ w~• o ~o . bR O~ IOVM. N~~I ~ - ~~nun n~ a..oi o~+n ruc., nt ~ vaw. ~ ]oe 7p 7op CE~IIf1G?TfOH- rou~w tiu rww~ w~ .w o us. yw wrr~~ o.. ~ ae/ao w~ .r. wy qwM Otwf~to ~w ?ua. o.. w lN1fK!/1N. TO ~Oh~w O~? t~Y W~t ~I~1~ M~IM ~wOli~i C~7f. ~MO. q 4f M1t ~ .mM~e~ ~»e A w .w..~ou. ow t~YAw~~•wo ~w. ,1U~NE 27 1978 ?ro JULY 21,1978 r~JULY 21 1978 ?+aLLD NOR' r• L1 t 15M +o ~w ~.~w~s~ i~.n~. CEtiMICAT10r+-r~Epl~Al E~O! CO~IOKE~ a+ nw w~s a w .ow p w.n, au`~o~«...u rw~w~.cw a~.o l~~a~+~tqw W M ~00~ W/b M~n~1nG~•pM. .w re p~wH., I ~q~~w r~~~ .Ov~ M~w~ OCC~MMQ OM 1A O~h ~M OM q Mf C~vN~1~ fr~NO n1 M Y20 CEtt~iHR-Pt~IMt ~~+r~ w rn~r~ ' - - M ~ ` Mu1t O~ ~~M 7~A_~~ S~IC,rNfO ~+Or~'M, O~r. rfur n. FELIPE KNOPKA, M.Ds` r,o Zf %~1~ Irx JULY 21,1978 "W`~ ~0°~u~`~~~''~RANS ADMINISTRA'1~~ IT 120~. ~N;~~bTH ST. MIAMI~'~~IA.3312~'~ ~ • ~wn~. c~w?i~or+. ~eMovw? fMEtEtr W UEMAiWr-Hiu~E ~oc•noa ~(~g'lm BeaehCd'."') s ~ wcr.. Cremation- Ho Narcon Crematory___ ~k~fest P~1~Bg~~__~___ O~T ~..p..rw. WNERAI MOM(--Nlbt( t~/~ ,~QpR(SS s~.a. o~ ~ r o.o . a+. w to.¦, s.u~. t~~ ~ ~b Ju2 21~ 1 a neral Home 8516 Fe3. H .~or~3'~~? Lucie ruN i n tcr N G~ uu_S~G++~ruK o. .ec • « i r~o,s~... - . ~ K ~~E y~t ~ ~ ~a^~ r lb ~ ~ ~ , ~ . ~ . ~ T~.~-s~ E . . . . ' x * _ _ _ .isr' *~n~ ::'-4 ~ i