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HomeMy WebLinkAbout1235 . CERTIFICATE ~F DEATH ~ . DtrArewl J 1 k.hlt tttd ReL.WL1•tM Settrltu [TTATE; liLE; 110. UIYfS10N a isAI.TM FLORIDA ~ TY?E, OR t[IMf ME ••rr•wnaw.nwt• fiE:OlHTftARi•E~ NO. jr . ?lRMANlNT INK -NAME trtt rMtt t•. t DATE Of OEATN t rerrw, M . tt.t 1 ~~.s~i> ~ ~ CLAUDIA L. RENEAU ~ ,Female ,July 16, 19?2 RAC[ ww, clap, ArttKMt war, AGE-wt twlwtt t n•r wt¦ OaA~ir[ q RIRM two.rM, •A.. COUNTY a DEIUM ttt. t ltKrr t larMw.l I a.ll/ rO< MM wOlal rMt. 1rtTite 59 •Jan. 26 1915 Desoto , TOwN, OR l . rlN Crt trq NOSfITAI TNER FIST - tr !Ot w lwtrl, Oct loan W rMMlp t O wcw. al a .10 a. Arcadia h Yea DeSoto ?temorial Aoa ital ' STATE p RIRiN r r rpt r •.1..., rut or wtuT COUNT[r MARRtfO, NEVER MAtl1ED, 511RV1V•1G SPOUSE t r Mlrl, avt r?Mtt Mwrl t I . ~,•,,,„.tt,o, 1. Arkanans 00W"tt U. S• A• „1Sarria d ~t~~t ti.Hanmond Reneau .r1rt~ SOCULL SECIlRTIY NtMtlER USUAI OCMATgN ttMa ¦wt. as roK t+011e .tlt11r0 rOlt M RIA OF RVS,+ESS OR NiOUSi[T urn. r our oe^cMnl. rola.lo ?rl. ear w awta t - ,O t:.354-OS-5118 Home Maker None - •M"'~1• RESWENCE-SUTE COUt+t11 (7TT, TOwN. OR IOCATION Mtll.t crr trrl S j. t,,ttcr. as a ro ta. Florida ,N.DeSoto Arcadia ,t, No ,M. Girl Soout Camp Road fATItER-NAME tan raMt wr MOTMEt-MARTEN NAME tilt rMt! Mst Charles iReaeon t._ On]aao~ru - ts INfORWWT-NAME MAR.NG ADDRESS tfrtttr w l.t... r0., an a gttr, scut, lrt ,p l~l•. Hammond Reneau ?n. Rt. 2, Box ?16, Arcadia, Florida 33821 TART L DEAM WAS CAUSED RTt (EMEf p14T' Ott GInE /ER l1NE /OR f•1. Al AND kll utvrttr o t...+ wMr j' ; 11. rww i E•1 r i ll.Cct~(/ ~ • Irrt•tArl cAMtt twl, •M q, Ol U • rG Ot1 ' 'lt.tlr0 tM Yr•!l. ~ titre CA•1l l.lt kl - ?ARf R. OTf1ER 11GNVKANT CONOITIONSI Sel~•••s t•MM•Mr• t• •4•t ••t t10t ~a• l°YM OMr w ¦Alt . tM /WTOIST' r ?ES trla wrrr.s cat• II tat a rot a ieNai Mnt.w.we wrtE ~ t corr. lrt, aAl t C - pr~aM OR 1RO~ItRSSWED ~ NOW INJURY' OCCVRRED t lrRl turtal ar trwn w r•n t a r.lt M1 wht n t ~ INJURY AT WORK NJURT' wort. cur, snen, noon. - IOCATtON t scan a ro., tar w twr, p.q t i. i r atttcrtt as of tt0 t owls lw., tie. t snot t ~ t. Jft. ~ Tit. i. ~ CERTIfICI?TION- rortw_ .?l au rylfr ws .e.s w wr s.. rr/wtl MM Or r w/¦+ rot vttr w11 OIwM OCCVI¦EO •r r tua, err t .or w a.. lo•. aR. taiw twoMlt t~L t,.n,..r, a rsea t .rerwttr twl !v Z TO 7 ~6 ~ Z ~ ' ~Z a r. swwtea, Mw } !Il Ntt.ft• ttor TK Tk. ,1.. TM. M. t0 r cwstw WrN. CERTtltUTtON-MED t OR C R1 ttr t.1t s•sn a r Howl a et.r rq attgrr .u t10110MKlM btY f ttulr.w0+1 M r u1w/et r MIirIWrOr, r .a. O?MwOlt, rent Mt pu MOM •t.r OCCYY!• Or wr MV 1111• •Ilt q r UMltrl lt.At1, • M. TT? CERTIfKR-NAME rrla Ol tort tkt:lte Ol try - D tr0ltr, tt.t aAft MARNG ADDRESS-cE,n R scan p l.t.•. ra « t•1+r MlRIAI, CREMATION; REMOVAL ~ - EMETE OR p1EMATORT-fiAINE - IOCAT1pN cml M Wr! - - rt+etrr? . - ,a. Cremation ~ T.?Ft. era Cremato rt. Myers, Florida ~ GATE trerr, ¦+t. M.11 fNNERAI NOME-NAME AND ADWESS 1 Nan O. l.r.•. r0., Cttt W qrr, Wq, t111 Tt1. Jul 19 1972 ,,.Van Patten Funeral Home, 206 E. Oak Street, Arcadin, Fla. 83821 - ~ Y. 5.,61? fUNERAI WRECTOR- TUBE ~ REGISTRAR-SIGMA overt ttcEnto n tOCA? a[e1stRAR - ~ - R~v.1470 TA ~e l--' •f ~ / ib 7W _ I - CERTIFIED COPY - Ihereby certif~r tho above to be a true at~d corr©ct copy of the Local Registrar's _ record on file in the Health Department at (`warning: Not ~~`s1 seal of the ~a~'~~~ • • Imo/ s~'~:i~. :_1~-• ~ t HAa1L,n 1~e`bartmAnt ~ / . • a ~ ~ Date ' .r = ~ ~ ,.•y'~ Deput~r Local Registrar . ~ - _ i ~ + k • g;,.~r L>~(~ 1:~.:c 1235 ~ - _ _