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HomeMy WebLinkAbout0305 _ " _ _ ~ s . ~ . . - . '..i . 4:3..~6~Z1 ( ~ / `1 State oi Floriaa CERTIFICATE OF DEATH Dtputnxpt of Health aad Rehabilitatine Services ~ • ~rwT~ ?~tc No. - vt,reL s,rwTtsr[cs F L O a I D A A~~y~STRAR ! NO 726 ewseo-N.we .w~~ y~a o•re a a•n~ , .o.~.. ~ vpE ON N11NT j~Q~r 24 ~78 ~ERMANENT ~ E• ~~@ ~ a ~ BL/1CK INK ~••~w. wow. ••~~K••• ••w.., wGE-~.a w.ee~ ~ a.~ w~w~ C~tE OF f~N ~.~o~.~¦. C01k+11r Of OEwTM .K. , w.~~•~,~..~, ""Oct. 18,1892 St. ?~ucie - . - aa ~ w x 6602 . Tow~+. ~ laAl a~f~TM r+MN Cw~ ~rM 11~/11AL «~1?~ MS ~ ~w wW ~w ~~t~t~. GM ft~t~t ~r~ wwN~ ~ 1MCM+ tH Ot MO - - ' „ Pb~rt Pi~eroe Yes „?~od Medical Qent,~er ~ STA?E Of Ml~M ~ w Mo~ ~w v~~,~+~~~ C~n2Et~ O~ ww?~ C01J~tTRr MARf1ED, NEwE~ M11~ME0. SUlVNf~K' S~ONSE ~ a~~. G~e r~yt« rr~ ~ u=yj cou~.w. ~ ~ ~ w~o . wc.. ~ u,.f~` w.. wf~t..ta / 17~.~ii~1 to ~w tl. \7. ri..[~L~ ~.~a NCN~l~ y«I~l SK')RITY MMNE~ YSUAt OCCY~At10N ~GM a.~o O~ w0la ~o.~f ~+~w r0lt M R!n OF MJSl~SS d N~NSTlY , . t0 M M~M JC<V~~ M ~O~WG ?W Mr Y MM ~ VAii t1~il~. ~•.~.a..•«• „ 265-#9-2900 Hot~e ife • e ?a.Kt M~O~! . o..~s.o... ~tS~OENCE-S/~tE C011Nt1 C1ir. tOvrN, OR lOC/U10N r~t un ...w~ StlEEt . L"""~ ~a F'Lp~'~8 St. ?~l]C~ ,k FfO~t P1E'~' ~'~'n o..~o ,w ~l ~~1~ I~D~d twTME~-ruiwE r~ .~wu u~ riOtNEf-nuiDEN nA+wE ~wsr wa~ us~ ~s '~'~"".Z GCa{YD~OI.I~. Q~ZS~ riitiYUG . II~II~OMu~M- w??wG AOOIIESS ~swe~ w ~ ~ ~..o . cM. o~ a.,., a.w. trr . ~ot~ G. l~fee 501 H~aowley Iioa~i, F~o~t Pieroe, Florirda 33450 ~~tt ~ oEwm wws GuSEO sr_ ~H+r[~ p+tr O~+t aus[ rE~ u+E ?w NL Pl~ RN .e..nw o..w+.~.. M.,. ~i "'"~a' ' NI • COwMf~OMI. M Yw. ~1M1(~ ~~N ~IN /0 M ~a~/M~M t~Ytl NM q. ~f ~ C~MOMK! O~: N~ttM~ tN •r~~ ~ ~e~w~ e•w us~ kl - ~ Mtt ¦ OTNER SKd+iF1UwT CONDrf~O ca.~wa.s cawara.w w w~. ryyw~~ ~n.~ w c.vM ewe.•~.•.n ~ wr ~WIOrSr rES .e~r r.~~~res co.F I~ff O~ MO~ O. M: Mt~W~w10 C~1LL E "r~. . f 9l 1lD. € ~.~1~ ~.o«~.. seu~ IWW ~N1W OCGURtED ~~••n~ .~.iwe o~ .M~w. w~.n ~ o~ ~.n w. w~. n~ IOM~00l: O~ IMOfitM~MO - ~ ~pp 20c. M. 200. INAAt AT wO~R ~lwC! d~+11J~+~.~ wow. ~u.. s~. ~.non. 1O~~1WN ~s+wn w~.i.~ ..o.. c~n w ro.u. s~.a ~ ~ ww. ws a w~ a.~a ~w., ~s ~ rncr. ~ - ~a ~a ~ C~K.A1~1- rOM~w M• n~ rp~w~ M. r~u uy uft Yr w~/1~ uM On ~ /M .b~ .M~ M OlA1M OCtYrlo wf hKl. Or. w MRf1CMM: ~O~ti Mt 1!Y W~'~ ~/M M~M ~wOY~~ M4. ~M. 10 M ~fst , .~..w. T~ 8. 4~.. ~.~....o.. r• NU~N~ ~qr Z+e tu t+e. t+~. • w c.wn~ u.w C~~1GT~'!-MEOKA~ EIAMR~R ~ C ~ OM 1r! Yf~f Or Mf wOM Or M~w~ . ~N NCfM ~~i MOrOWKlO My ~YY~~~q~ p M! ~M/W h! ~nlfT~WtOr~. a+ r~ OIM~Ow. ~0~+1M M~ t~~~ wOY~ N~M OCC11~Y~ OM M Mq wM OM ~O ~f C~VN~ ft~R• ~ M 2~ ?2a ~ ~11f1[~-NAMf ~f~ O~ Mwq . MGM~ O~ h4! A ~~rd~~, M~, qYr T,. M. F. Watkina , M. D. ~ ~ SS Aflfrtf siwn o~ ~~•.a cm w w. suq [ ~ "~°L~. ~ox 26 Fort P e ~ ~ry 1pi. 111? M~IAI. G~~YMTIO~~. ~MOrAI - Eft C~EMA10~~-N~ME . lOG?i10N un O~ w~r N~~~ j pi~c~~ O?GVf ~srKw}~~ ~~j.~~ ~ Fa~w~ 1qN1ll jM saW VaZ~D~iL J.A1 I~ 2~C. 1~:Xl.~TA[1 ~ M1C~11c~11 DAtE ~..o.~+¦. w.. nu~ WNE~nt HO~E-/~uMf ~NO AODRfiS . snu~ o~ ~ r•..o . a~. o~ ro.«, uan. z~r ~ Dec. 2 1978 ~s. ~lmeral Hane Inc. P.O.Booc 777 Ibrt Pierae. FL 33450 ~ -yG~u ~EGK1R S~Gt+ArurE. ow ~ece~•eo ~oeu ae~uu~ . ~ ,~,~L° ~ December 29 1978 y ~+~rb'f? artih ~hb b b~ •~~+d aana oop~? of th~ lac~~t~-E~,. E!J R~ENOROF ~qlstrar's noo~id on fil~ In th~ St. Luci~ County H~aith Op~K ' ` ~ ~ n ; = 4= ; = ! . ~ ~t at fat Pi~roe. Flaids. . 1,~~ . ~ (W~~nirp: Not vaJid unless rsi~d Nil p~f fh~ Sf. Lyd~ 4`~ . ~ Gounty HMhh O~pirtm~nt b affix~d.) • ~Z9 f E~ ~ 2 QM 3~ , t~~~ N. D. MtLLER. M. D. : s - . co~n,t~r f+..ltl, oH~o.r a Loa~ ~pt.n.~ . , _ r~ =1~L~' i. ~~i:~ ,~o~ 9- 7~ ~ G ,c~ ~ . ~ OrA~ ' O~qAY I~ool ~0 ~C'(1!! W~J ~Ar.r ~ / ~ ~ _ - - . _ _ _ - . - ~ ~ ~ r~' - _ ~ ,