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HomeMy WebLinkAbout0349 ~ ~s,~~o8 ~ 414984 ~ Palm Beach County ~iealth I)epartment ~ ; , _ state o[ Florids CERTIFICATE OF DEATH txpartment of Health and Rehabilitative Services sTwTE FILE Ho.__ _ _ v~Tn~ srATtsrics . F L O A I D A p~G~gTRAR S NO O TYPE OR PRINT ~~E~SEO-~µE . r'~~ ~~ft ~T OAIE Or DEATN ~ ~o.+tw, o~~. •e~~ ~ iN ~ William C. Ross ~ Male ~ July 2, 1977 P~RMANEMT - BLACK INK ~CE ~MN~. w~G~J. ~rt~K~r ~wOuw. •GI-- ~~f~ u~.01~ ~ q~~ uwOH ~ M~ ~CA1E W~1~1N . ~M++w, 0~~. COUNiY DI OEATN ~~C 1 wCM~I ~ ~~\IYO~• ~~~~l~ ~1 W~! MON~{ ~IM ~l~~l ~ White ~ 69 ~ ~ £eb. 2, 1908 "Palm Beach - - CIT1I. 10MM. OR lOCw110N p DEwIN ».sw~ un w~n HQS?ITAL OR OTHE~ r'1511!{/TlON-N ~n ..o. ~M ~nwt~, 4M f1y~~ ~w0 wWyf~ ~ / e O I ' Wc~1~ qf M MO - . V V Yes Boca Raton Coa~nunity Hospital „~oca Raton _ _ . . - S~AiE O~ WM ~u wot ~ s.,«..~ CITI2EN Or WMAT COIMJit11 MA~RIED. NEVER NUfR1EC. SU~YIVN('s Sr'OIJSE ~n ~.N~. on.~ u.~~oew wre ~ . cou«n. ~ w1DOwE0. WvORCEO v~ . ~ - - ~ Ohio , USA Never marr~e~ a.tM OK~~lt~ ' . _ _ _ _ _ . _ . _ ,~~~o M 0(~M s«~~?l SE~~R(T11 NUM6E~ USUAL OCCU?A1qN ~c~ti a..s a`.o~¦ oow ou~~..c +os~ a KWp Oi WSINESS O~ ~NDl1STt~ eccuulC w ~~~MG ~W. NIN a Hn~~p ~ ~~,•~~~~p», d~• Accountant Wholesale Meats «b.. ~~88-O1-4537 ,L , ------7~ u~a N~K~t1/V~ wua cm irm~ST~EE1 ~NO HU+~ER a. ~ ::'~.~v`.i:~:-i:~.'• ~vv.:.. .:v... , v_.v~._..v._ I]~lCN~ t1! O~.rO - 2167 NE 62 CT. ,yFlorida ,N Broward Ft. Lauderdale Yes /AIMER-MU~f .us~ ~roa~ i•u MOi11E~-1MdbEN NAME nne wa~ uv „ Ruthven Rpy Ross Olive ~ Griffith 1id~ORM~?NT-NAME MAqMJG AOO~ESS an~u w~~ o ..o . ur. d a..., ar•w. tr~ . Clara R. Thompson ~n 22 E.Collins, Oxford, Ohio 45056 . • \I~M IN rK ~Afi 1 pEAM WAS CAUSEO ~Y: (EN?[f OH(? OI~K C4USE IE~ lM~ fOf (o~ (6~ AI~ (~N ~erruw OMt~~ ~r~ N~M 1~ _ a..eoun vs~ a~ ANO REC ROEO ? • f . ' ~l ROCER i0~j COURT j ~(.'~a . - COM~I/10Mf. I~ ~M~. rw~tr o~w ~~ti~ w (~I ~J`'"~ r.~ fRK Cj~C~~ - l~~i~tflM~6 ~M/ VM~f\. M1~ ~O. O~ ~1 ~ C S~OV~~Kf Or t~F+r:,L1 'fE _ ~tIMO C~YM t~l1 _ - . . ' . ?A!i M OtHE~ SIGNIIKAMi CONWTqHS ca.ano.~s cdn~w~.w ~o ~e~n. ~v~ ro~ ~ewm ro uuu a ~~o~ ~ M ~ES ars~..~s eo«- - ~ qt p~ MO~ YN~fO W1Hr~w~wG C~YM . QI ~f~tM IA N~ p,.~w.t ~ ACUDEMT, SU!CME ~O~ A lUIJ~ ~ rp+tw. e~~, ~eu ~ NW1R NOW INIUR• OCCURRED ~~nrU wryy_ d~wwti ~r rur ~ w r~n m. u~ ~ ~pt: p~ wp[ttwwt~ ad. M tw - u~ ~r ~ IN1UR1f AT wOd( ?IACE O~ t1MV «o..~. r.~., vnn, ~~cw~.. lOCwiION . f~nn o~ s.w . cm o~ ro... s~.n ~ ~ 1Mt~n t~f O~ .w ~ a+Kt woG .~~c ~ wt~n r ~ ,J ~ ~ ~ ' ~ ~ CEtT~iKJ?T~ON- ..wn. w. ri.~ ..o..n. a. .~u •..e ~.s~ s.v .r~r~~ .~~+e o.. ~ aoioro w..N. ~ ot~tN oeeunto m~ .uc~. a. ~ iO ro..n. e~~ n.a ~oo~ un~ a~m <.ou1~r O~A. ~~0. q M NS~ ~NTSKI~N: lO:LC p r~ i.p~10W. OM .~rn.roto ~Me ~ 7 7 ! 7 Z 7 7 71/ ! a N•/ ~ 4wse n~ aa.«o no.. 7 t~? JIIl~/ 2~ 1977 Zt~ t~~ J ro na n~ sa.ee ' _ _L'._'_- ~w OK/qM ~~f ~~OV«Cf O~~O CERTM1CAi1pN-1M[DKwt ExuMN~ER UR CO~ONE~ o.. rre ~•s~s a ny .a~~ a w.M ~iur~~tqr~ O~ ~f ~DO~ ~MO/O~ ~M wv~ll~G~rpw. ~w rt Mw+W~. ~Own~ O~• r~~~ wOW ~ p~~M OCCV~MD O~ r! O~~f ~..C pYf b M C~uS1~S~ Sr~ttO ' ; t~ M 7t~ _ _ - M - - ~ ~ CEtilfiE~-HM~F ~~n w rn..r~ S~G?~~TUtE /f o~ o~ on~ OwiE S~W~EO ~..o~+n:, o..,.~u~ I 7~. f f D~ K. t K ~ / G" 3 G t/z ' J-.~--~~--~- ~~n. 7~ J I~~• ~ - _ .w~iUIING wOD~ESS- CEItM~ER J +n r o~ Sr o w -i~ri o~ .o~.. u.n c.r , 3?G L. ~r: . i1d I.t~..~! ~~nn.~ ~ ~ . 31Y~~ ~ j ' NJRIAI, CffMAT1pN, lEMpVAI CEMCTfl~ O~ CREMATORt-NUW LOCAf1pN c~~ e~ ro~+.. st•rt ~ ~ vt: m ~ : Burial ,~~Lauderdale t+lemorial Park Ft. Lauderdale, Florida , - - - - - D~TE ..w.r.., r... fur+ER~I HOME-- ~+~MI +nt0 wp6efSS su~n o~ ~ r o ~o . c~~. o~ .o~.+, sr.r~, i.r • ~ ,y July 6, 1977 ,~ICalis Funeral Home 25Q5 N•Dixe Hwy, Ft. I;auderdale. F1 33305 ~ f1~1EfA~ pitECTOR-S~G~'~ANH tEG1ST R- Sf IA ~ ~ ~ ^ ~ O~tf ~[CE~vfD IOCAI ~[G~St~~f v_S. ~bt2 ] fi~v. 7/76 ~ w ) ~ ~'B > t aJ, ~l lr . . ) .'~c_: •i ~ yr . / i 7 % ~ ~ ~ ~ - - - - - - - - ~ ~ - ~ i ~ _ ~ I HEREBY CERTIFY~THE~ABOVE TO BE A TRUE AND CORRECT COPY OF THE REGISTRAR'S RECORD = ON FILE IN THIS DFFICE (Not valid pnless the seal of:the Palm Beach County Health Department is affixed) - . , F? x ~ C.L. Brumback, M.D. ~ July 11, 1977 " Local Registrar ; Bureau of Vital Statistics v . {~Teat Palm Beach, Florida y ~ ~ ~ ~ ~ . , 293 ~ - 3tiU~ FAG~ ~ ` ' 349 ~ ~ . ~%S ~ . " _ _ ~ l T . . - . " ..~iF. t_ . . _ rr I ~ _ M~~.Ye ~ ~~,1.f w:'~~~'~~.m~YF~ ~`~A , 's~S"~~`~~~:~s