Loading...
HomeMy WebLinkAbout0551 '~l 420609 < ~~~Ni~y~ F'1~~ O~,ANGE ~COUNTY HEALTH DEPAR~'1VIENT • 4~M~ q! MIE1T CENTRA/ ~OtKEV/1Rp •?OfTOFfICE WX ~Ip •TE~:4~~5 • ORLANDO. RORIOA if~0! ~ CERTIFICATE OF DEATH ~ ~ D~P.n~ .f Ik.U~ .~J Re6.b6~•u.r Se..ke. fTATt ~~~s No. ~ rn.~~s+oav c~ inw~.ne F L O R I D A ' N ~r~wirrw~te~e R[GIrT11AR•f ~o. 73 2 OlCtAS~D~t+AMt ~wa ..rw ua ~a Owlt Ot OEwiM ~~o«~., u.~~ ! i , FAIIL 1. SALKINO t R~a,te ~ Ju,C 22 1973 . RACE ~n. r~~w. uunc.n w~w, AGE-ua vMw~ ~ h•• wa~ DwfE W N[11~ ~.wr.. ~.r. C01Mf1t Oi OEATN ~K. ~ V~tIq1 ~~~MN ~t4\\1 n01. Mp ~OY~~ rM. ~ . Wh~i.te 6 0 w ~ Jan . 12 1913 Oucn e ~ CrtY. TOw1~, Ot IOGi~ DEwTN Ms~ c~. ~rns ?1~S/IIA~ Q! OtM[R HSIRVIION- ~M M01 w ~.tW~, 6M 1~M~~ ~M ww~~~l MlCrt n~ p MO . ' n On,Cando e,a Flon.i.da Hoe ' ~ SiwTE OF ~tiM ~ r ro~ w Y.1.~-. M~+~ G112EN QF M~M~?T CO~Mitll MA~R~EO. H[VE! MARbEO, SVRNIVlKi S~pUS[ ~r ww~, cM r~etr w~ ~ co~~.i wIDOwED, D1vQ O~ vur~ ~ . Pen?~ Lvan,i.a. . tlSA~ Ma~v~.ce~ Jea,ie,tte Uav.i,a SOCtAI SECUR~Ttt raM~[R USUAI OGCU?ATIOfa ~wn asN w.ou oow w~wa rw~ w [IN~ Of WSwtSS OR 1?~DUSi4~ ' rpa/p lMf. Mr O~IMl~ 1 „ 083-IO-5446 U.ia ena.in 0 „ 0' a.t Svw.i.ce . tES1OENCE-S1ATE COU1itY CRt, TOWN, OR LOCAT1pfJ w+w ~T ~~n S1ttET O NW+~E ~ wtw .~s o~ ro - Flnn,i,da O~car?ge O~r.Gando uea ~w 3004 N. Hcwu,~on Avenue fwt~R-N~E r~n~ ~ae ' ua MOTMEt-MAICiN N~ME ~m~ .~oau w~ ~s C1w~c~Cea Sa.Ck.ind ' I~~an,tha Goldman . INfOUMANT-NAME ' MAllK' AOGRESS , LLMIt W~.~>. MO.. t~Tt p Wwy W~. frl ~ Mn.a. JeanQ.t,te Sa,~k.ind 3409 N. Hcwuaon Avenue. On.Cando, ~ton,i.cfa /wRi 1. •~i~~a.. ~ OlwiM w~ tw1?SED ~r. ~ENfE~ Onlr pi UYSE 1ER tr+E ?d NL AL k/l ~~tiur p.~~~ ~r M~~s 1~. WWOrR • C:'!l~-:!%~'~ ~'C~~l-~ C/-~'-t~~ ~ . ti ~r.r~,c_.. ~~s. COM~ITIOM~. ~~~~t ( VM1CM G~t~ .o n~ Gc.~.7F`'lhLGO - ~..~e~..~ c.as~ a~, ew ro, o~ •s • cwxow.~u w: ftp11M0 tw~ rM~~~. ~ ~ t IT~Mp C~VY 1~11 - • ' ~ " kl Q [vw ~ (L~ ~EC~C ~st-P ~ ~.E ~LLS! t~ M[I OTME! SK~NVKANT ~ONp1TqHS~ co.ian f CO~A~NwM10 p O~~p ~yt MQI „4tf~ 10 VWl GMM •.n ~ y~ ~~dSr . YES .~a ~...M..os cor J . . ~ ~t~f 1 1iN~~~ u/ pn~r~rWp (~,vN ' - T Iti N~ ~~~tM ~ ~S Ir..b.~1~r1 K ~ A U ~ rw, o~~, n~~ ~ MpW INIUtr OCCUttED ~~•nu w~vM w«wn ~w ~•n ~ w~. ~ w~r NprKWy Ot WO~tE~MINtD • ~ M ~ f1r 71~. • M. 7M INIURT At M~ORK rIACE Of YiJURY ror, ~.a.~ ar~n. ~~cw~•. 10CAilON ~ uiu~ p~r.w .a.. un o~ w.r, s~.~e ~ ~ I t?~417 111 M MOI OM1G MM-. f14 ~ VKI/~ ~ . 7!~ !M. ~l ~ j CE~TIiKAT~ON- .~Owrw w~ tW ~W+M Mr ~W wM t~ls L~ rr/M~ 4M Or ~rl~y Wt at~ w~1 OlA1M OCCVtttO M~uQ. Or M /M/31CIaM: MO~ib iw~ qy ~OO~ Ol~M. Iw01M1 O~R. ~r0, ~O ~ YF ; ~.nt..o~~ tq TO ~f • I o+ .~s :..r.-.:sce. we ` tt~ ace.s~e ~~o. 73' lt~. ! Z Z 7~ t~~- ~ ZD 7~ ~N. ~ Itr .~~~K ~O nw ~f+.a~ fun~. ~ GERiuKwiq?~-MEDKwt ExMUNEt Ot ~ORONER: w nu wn p a[ pw p M.e, iM NClpM ~ry Mpwpyw~~~ ~y~ fa.rw•t.p.. p~ ny qof ~..s/q t~e rrvtltw~nOr. .w w p~wpu, rO.i~w Lr sy.a wpM Of~tw OCCWtl00' M Y~! u~~ Ou~ ~O ~ 4YilW W~l~. . ! m ~ M f}~ K CttTlllEt_NAM[ m • n~rn q• o~u DA SiGMtO ~~M, e?~,~W~ I t~.~~C ~ ~ ~ ~ C s[ ~t - ? 3 - 7 3- ~ /~Yt+G ~DO~~$S-Cfll!!uR ~ o~ ~ • C~ • s~•R tr ~L ~ s c l c ~ ~~fG ~ 7 P ~Utiwl, CREMATION, REMOvAI G[Mt1ERr OR CtEruTOtr-HwME tOUt~On un w p.. s~.a ~ ~antur~ ~ - ~ ~u Cnem F' ' d ChQ,?,r,f~n c On.Lando Fton,i.da D~iE ~ ~.w~ o.~, n.~. iUNERAI MOME-NAME I1IJ~ ApOf[SS ~n~n w~.~.• «o., t~h M~0~~, fr•~f. ~N ~ ,w ~•,7 Fa,i~cch,i,ed Fun~~ Nome 301 N. Iva~ihoe BPvd. , O~r.~nndo, ~.Ga. ~ f11N[RA? t/.K1pR GN~;~~IV~)E ~ REGISIRA~-S~r•~atUR[ O~t! ~IC/.rt9fp ~OC•~ rt!3~~f~~~~~ ~ . )S~ ~•'~i~'%•y~~"~ii.t.c o 7h ~~w ~ ~Y ?N ~U`. 2 ~ ~77.) r. ~ - CERTIFIED COPY ~ ~ ; _ ~ ~ = ' ~ i~~ ~ I hereby certify the above to be a true and csrrect copy oE~~the I,qcal Itegiatrer's ~ record on file in the Orange County Health Department, Ot~¢ndo, Fl~tida.,:_, ~ ' ~ ~ _ . . r _ ~7n County Hea Director and Local 8 is ra~~-~. i, ~y~1~`~ ~ , , ~ ~ <-:; . , . ~j~' ~ .~IGCQ, ~Q~f'f = " ~ ~ Date Isaued Chief Deputy flegistrar . ~ uARNING: Not valid unlesa raiaed aeal of the Orange County Health Department is affixed. ~ ~ ~ ~ ~ ~ ~ . F~~E~ ~NL• NECCk~cU ~ 4` 'O9 ST tU~~. ,_~,U~T^ F~a. ~ ' ~1IitA5 ~ s r',~ . - .iJIT ~OUA : ec~M+~ Pa6E 5~9 - . - ~ OcT 11 3 27 PM'1~ ~ - - - - - ~ = ~ ~z:~~ ~~:-f~ ~ _ . ~ _ . o.. ~