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HomeMy WebLinkAbout0014 . . . , ~ ~ 418454 ~ . ~ /tI I~.~I~ ( ~.:1 ' ~ I li . I<~uhu~l)'ll/?~A~N,Gu~i~u~~~t • ~ { Heaitf~~ F~~cf~abili~~:~ r~ . : ~~?c~s . ~ DISTRICT FUUtt Vi~1 + ? ~ ~ , t; ,l Y 11EALTH DEPARTMENT = . ; ~ 01 S o. C 1 v d~~ I~1 u r r i;: I; l v d. I~AVTpNA BEACN, iLUR10A 32015 P.O. BOX 2329 ~ State of Flurida CERTIFICATE Ui' DE ATN Ueputment of Health and Reh~bilitativc Servic~s trwTC r~~c ao. VITAL STATISTICS - F L O A I D I? REGIETRAR'! NO ~ " ~ ' V PE OR PRINT ~ClASEO-NAMf • n: ~ !.t i DAIE ~i pfAlM • ~o.+. o~.. .eu ~ • PE RMANENT ' (3eraldine Il. Fleuren~ Female Jul 24 1 BLACK INK uC! ~n. «~~w...a.K.» INUM. AGE-~~1~ ~••a.. ,.e.. ~w~. ~ o.. ~K ~ wc». ~ ~j~~a Cw~[ W~uiN ~ rO~+~w, 0~~, COl71If~ W DlATM ¦[LL YB ~ ~~~,f ~ ~Of ~ M~f ~W~i ~w • ~ s~ x x e~C• 23 1909 VO~.U8~.8 . tOwM. O~ l 110N 01 Ew N ..ue~ cm ~.Nn NpSMM O! OTME! MISTIT!!I -N ~ r,.o~ uuy~. ane s~~n .w .ww~~ ~ ~ Daytona Beach ,~~~~~~yes Halifax Hospital Medical Center S/ATE d 4~M ~ r wot ~w y~~,..u~ CITI2EH Oi WMAT C01JN1lY MAtRlfp. ~V[! MlAtb[D Sl1~VIVlKi SI~OUSE ~r ~W. 6w~ r~pr w~w ~ CowMS ~ W~~~p ~ wcr. ~ j ~ . •~....K~ , ~ U.S.A . w _ j„ Joseph RobeTt F7eureAt ..er~ acu.u~ KMrO O~ M!SlESS O~ MOIJSTRII ,.~c r N~w SOCU~t SEC• MW~i! USUAI CKCtJ~wi~Oi+ ~an ...e a.oe¦ ww swo.c ~os~ o. oCCU~ffO r ~18-6163 ,w• r „~N 1 ~ yr~rv~~.6M .~vw~.c~ ~eror tt.?~ ~a~ Ci010 f.@2 rBt.OP ue Ford Motor Co . c.~~uo.. lES~OENCE-StAIE COUNfr tnr, iOwq. Ot tOtwT~O?+ wwt c.n .o.as itfE[i M~O ~v~a~. a w Florida Volusia ,k Da tona Beach es 4 Bradd Av MT1~R-NAME ~w~ rwae uf. MOTNE~-nurotr~ Nu~E ~rs~ r.wu u~~ „ Glean l+,ansfield ,6 es pa I~M'ORM~M-NAME rur~G w00~[SS ~s.u~~ o+ w. cw. o. w.n.. p.w. i+~ Joseph R. Fleurent 314 Braddock Ave. Da na Beach Fla. 018 I, r~ut i oE~nr wws uus[o ~r ~ IEMEf ONIr OrE UUS[ ?[f t/i ?Ot p~, p~ Adp (~n i ~w Nti~fM OrNt ~w N~M i a~ ~ ~s~t~~ ~ ~c.r.:: ..c r ~s y~. >rti; y:~~c[.~~z~- ~ . . ; LOMMIOMI. ~r un, f;~, •t ~r i~: - l-i/ti t T Lt1T ~ i i~ i ~~I~Cw 04t~ ~IN 10 hI ~ ~ l ~ C ' l ~rr~N~q C~YH Nr, M p. O~ ~ CWq~WfKf O~. - i ~t~t1A0 l~~ YM~~F ; ~nM~ C~YM l~t~ ~ ~ ! ki S f{t~ C X ~?CV-! ~~~7' - Y a/ CL /~2~ € ~~1 ¦ OTMEf S~G~+~fK~wT CONOrflOttS co.ano.n co.wMw»w a«.w. wr .qr runo ~o c.~s~ ann.. ....u~ . w~ M ~ES .~n /~MNMG~ COM• ~Af O~ MO~ YN~fO ~w Mt~W~r~, Vy~ ' ~ : ) Or ~UtM ~ . ~b[ A ~ rOri~w. Ms, p~~ ~ ~9~ t9O py~, O! u~Of~EWwlO NOw ~NIUe~ OCCURRE~ ~ twn~ .rwr p~«iw. .r r.n ~ o~ ~.n ~n. ~ ~ ~ ~ 20D . 20[ M 1'00 - 1MJU~~ wT wO~lc RAtE d lUU~Y ..o.e. s?~+. ~.cwn. lOCA110M ~~n~a o~ .w , cm a w..w, s~.w ~ ~wwnn~a.a~ ow~n~uc,~~c ~wcr.~ a . ~g 70~ 701. 2pp - g CM~KA~~'1- rOMA Mt t/Y ~d~1~ Mr tfY ~N Yft L~ wr/~N uM OM 1 N/M ~Ot ~t~ 1R OlAl11 OCCYNlO ~M! hK~. d~ M e t~nsKUM: 1O J .o»s w' ~w ~w. un~ M~w. ~ww~~ i'.w. ~ww, w. a r w~. ~gg zt• ~ec~.u ~iw~.. - - Y~ T~o 1~ L~ / 7' hc 7-~~ 7p ?ie. ~L! ?u 3•~~~M ~o w~ s~ suwMi S CtRi~1UT~OM-MEDKAI EiAMNER O~ CORONER o.. ...r ~.sn a rw wow a w.w. ~M NC~pM ~Y hOM011rCl~ M~~ ~ ¢ ~uY~~wp~ O~ 7M ~W~ ~1~/O~ ~M ~n~t7KNrpM, w r~ Mw~W. ~ M~ r~y +py~ ~ ~1~ OCC11rb O~+ M MA ~M NI! q M C~IIIl:t~ lt~ryC ' C[~T1/1[~-NAMf ~nM p /r.~q ~ ~ M . ~eua o~ rnu A O~ w~. w~, ~w. s ~ ~ v-' ~ K~ t]c 7 ~ Mi?fll1G AOpESS-Cff1/rt! frru w~.~.• ro. tm p s~.a i,~ ~ g ~aS fone 51t, ~ u3s ~9n. (11? NJ~IAI. C~EMATION, ~wOvAt t[tV OR CfEMATO~t-NA+NE tOU?TIOM ~ uo a w.r ar.n :.iac~~ O?CYi ~1tiC~n~ ~ ~ F /•n vSril'J) ?y. B~1~i 2a~ ; ~ y A ~aon*w. RYI fU?~f~Al MOME-N~aM[ ~?A ADORI sn~n w~ ~ o.w . cn• w~o.., ~*•n. ~ 2~A. ~ 2 1~ 2S~ i ' . 2~ ~ ~E ' s+Grvar~ H ~.l.l . .S j! n ) ~pt ~ cnrw ~ ~ we hereby~ta'ertify,t}~~ a~bove to be a true and exact copy of the Death ~ Certificate f~}.{e41 in.;iT~is office. ~ ; ; f_ r, • ~ ~ (NOT ~V~L'~~~ UU~$$S'`'S~AL OF COUNT EALTH DE ~IE T~ AFFIXED.) ~ ".r . • 1~~~t~~OU~frfll~ ~'r~• ~ : a c=. ~ r:,~jRns n Q cp ~r~Rl ` 500x~~ i7„r - - - ~ 0 L COUNTY REG TRAR ' ~ auc s~97e ~P 28 9 t a AH'T8 ~ ~ ;~NTE : J` ` - 41f34~4 C IEF DFP1iTY RE(;TSTRAR - ~ ~ * _ e,. ~ ~ ~~-~.--t. ~ ~ ~ ~ 3 - : ~ _