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Home My WebLink About0633 .4:3'7580 ~ ~ CERTIFICA7E QF DEATH y- ~ , D~Iwad ~1 New11~ u~ Re1wWIhMw See~foN RATt llLt NO. ~ :-<i. o: .t~?,T ~N a•~+o"as~.4TM FLOBIDR ~ Nt01iTRAR•! HO. ~ ~ r t_ACktilNi INK ~~SED-H~f ruft ~~t SEX DA1E OF OfATN ~ rowtr, o~~, ~t~a ~ , S'i l~iDi~10[ fW ~srr~aars D cco FeMa1 e M~ 23, 1974 RI.CE nac~. w~ow, uuucu~ wowr. AGE-?~s~ w~a~ ~ ~t~~ ' u~a~ ~ wr DATE Qf ~1RM ~.wrw, o~~. CWNfY Of OEATN nt. ~ t+ecru ~una~r ~ ru~u ros. wn wans .ra. ? . Nhite 67 ~ s~ ~Dec. 2 9 5 Brnuzr.d _ CItY, iOMM. 01 lOCwf10N Of DEAtH M?w cm ~W:e~ NOSMTAI OR O:MEt NSTITUllVi7-NAME ~u wp~ w enMe~, cm frni~ w:o rwae~ ~ ' sreC~ hf o~ a0 ~~:y~' ` n Tau@er.daie Y.akes r.. es ~ Lau~icrda e akes Gene at Nos~ita~_ ~ STAIE Of Wif1 ~ N Mo~ ~N u ti... NW~ UtiTW OF W1tAT COt~1TRY MARdE0. NEVER ~+~wtRtEO. SUIVrv~Kr S~OIISE ~+.~w. ene .u~oea ..we ~ ~ cw~+~n ~ wIDOwEO, a~URCEO ~ int+. ~ H3~~~ ~ Ieaty_ U.S.A. N Hiciowed Deceased A_ c~ce.ue ~tURijr ?au~~.:ER USUAI OCNIATION ~w+e a~+e o? vro~[ oow~ ow~wa rosi or K1NO Oi WSwESS OR iNDtlSTtY u oe~s~ ;~...~o u+ v+o~ara un, ae~ u imca ~ _ ; ; ~ ~ „ 339-Q9--~~901A NouseHife Own Nome RESWfNCF-SUif CWNf~ UTY, TOMN, OR IOCATION wswt cm urrn SIREET u:D NVµlER ~ ~vK~n nf W Mo ~a F~oriti~. ~a Tii'Gi+idit~ T.auderdate j,a~:CS ~s~. VCS iM 24~~ H• ~IVt:t :~~'::":t+:: , fA1NER-NMAE ~~n~ rwae u~si MOiMEN-MAIDfN NAM! ~~es~ ~ woa[ + us~ «y y y` ~s JZCk Marzul~o Unobtainable ? INiORMN~I-NM~E MAUl1Cs ApDRE55 nneer oe i.~.o. No., C~ G~ IOVN, ~1~7~~ ir~ p; ; 63'4 S. ?_?_nd C~urt - Mir1r=s^r Fin:'~~ P~T DEAIH WAS CAUSfG 6Y: ~ ~ENlfR ON!Y Oxf CAUSf IER l4NE FCM a, ) f 1 t51. A~ k) ~:~rer.. o~•it ~.«e :;.iM : It. rwl~uR cwust i r ~ te) Cs~-~-c'L~.~ac L~vLC~ c.,~~ ..~`..`L , w ? Ox . cowou~oNS. u w..~. .L ~ ~wR-L Lo~.~ ~-s~_ /~-jr .w~cw c.~[ t~~t w ldl~ ,C.~ ~jC~p~( G ~ t~ - ~rr~D~~tf Uvst ~o,, ~ ~O, W ~s ~ Cd+StOV[•K! d: . - ~T~IING IM~ UND(~- I~IMG CAyH lAll I ' ~_.a_. t - ?ARi 0. OtHER SIGNtfICANi CONORIONS: co.+ana.s towuHUr•..~ p ourn w~ wm nurto ro uust cnu. rc+ru~ ~ wi AUTOtS~ !f YES a+ur n..on~os :~w ~9~ i~es o~ .+o~ s~oiero u. c:iu..~~~~e e•:,ss , t~f-{e~~c;- r' oGQ.~ e...t~,-e-, ~l~`..~ if.ItO te.tn ~~T~~~- _ _ p,~~1~~ KC~fIi ~+t. ~:aoE OE A ~~Y ~~a+Tr, w~, ~e~~ i HOUR HOW INJURY OCCU~iEO ~~NT(~ WIV~I O~ ~N1V~~ IM /~U 1 O~ n, r.tr ~ NW?MaDE: OR 4"Dctftu~hiD . ~V~c~~t! ap 7~ 2h M !91 INIilR`/ A1 WOeK tIACE Of ~NIURY .:~.+e, rru., sneei, ~~c.wr, ~p~Anp.~ ~ snrt~ o~ ~ r.o. wo., em o~ ~o`n+, s~.~e ~ ~ ~ne~n ~i~ oe «o~ pNK! MDG .lK I S?K?t 1 te. 201 m1 Ctt1.FKAl~Or+- rowiw o~• u.~ +u~+m o.• •t.e 4s* s.~ K:.:.o •u.~ v. ~ er oro .r~`.oe.+ our~ u.cuneo at r..t r>-~, c- ~MrSK~wra: ra.rr o•r ~!u ~GO* ~'w. t~.~+ J, o.-e, •.o, to ?~s' ~~ni~oeo rrt / t~ ` 1 L= Z~il or r»~..~:...e. c•,z )te otte•~ton~. ,L, ~17Y ~lt~ 5/?3J74 !ta ~ 7~ 1i/. Jl~ M t[+.'~i v~.:; . . _ " ' CEfil11G?TIpN-•NF~K Ex~~?tfY OR C(XGt~fR w n[ us~s o• ~Ke iaw o~ a.iw rMe eecrww• w•s r.p..w~ceo cun ~ ~ lurw~7~ O~ u~~ ?.rr 11N'3~0~ 'M! n+rls!K.~*~Gw, ew r~ C?wp.~. rp~in W~ fl~~ ~.GV~ u " ee.n. oeew~eo a+ mF onn ...o ow ~o na e.use+s~ s~.no. ; . , . fta M 7ti -~A- ~ CERTtHER-NAMf ~n.t o~ n~..a S1Gt~^I>~Yt'^ o~e~et w i n~ DAIE iG~=": o.i. ,oi " ~~'w~iLs_~-D .~c{,~--~~!'~'~_ ~.~'t~~Q ~'n~'~ I».S~z~~7•+ i -~'_Qt~^r~.L«~ ~ - - - ' w?t~WG ADGfESS-<t,~:itft s»cr. e~ o..o. un o~ •F s~.re n. ~ : i1 ~ 4~ n1 ~c~_tth "~s-~it1~1 1)r_ . P1 ~t::r..~tion, 1 a. - - ~ ~URUL. CIiMAl~Ot1, 4E~+lpYAi Cf.witERY,O++ CGieUiG"r.r'-t1~ME ICY~.t7iDN On o~ tor« i*~~t ~ 1 yKus r i Entor:t=.,ent K? Ht~.d. PiP:~:nrial Ga~-d~,.ia No?lyuo~d F1or~aa _ f ~ - - - - - 7; OAIE t.0*.M, O••, ~tu ~ FUNEQAL MON.E - ~~•A AL:.i_ SS ~ 3'n+~ ~0., t~tt O~ ro.+w, SbTt, t~~ ~ ~ x~ ~av 75i _~c'?[~ :s. P~trlciE'Ta I'~!"`~t"2:ti Nt>- _--!~?~:~~.3 !i ~ard. Bi~d.-F:o't~y~:ood, F~~ 3'~!"I_1 ~ . ' . • Je~~~ ; S. ib]T f~1ER/~ t4KTO~t-S~Gti~i~•R~ ,-=3 ~ i::afSi ~~Gr.~i~q~~~_ ~ ~ G~R ~[Ctivfa ti IOC~~ R:~~1~:~ i ! ~ . i~ZCI j' i~ ~C:~C~?"•~-.~ _a~ / ~ - li? ~"1 ~ ~ . r.~~~'t~-,_. r~ i % / ~ ~ ~ ~f ~ I t' r ~r.1'~ - u ! ~ _ . j~--•-r , ; - ~ ' : - • -Vt~F. . ~ , _ _ , ~y\~ ~ ~~`~'j;~y,,~~~: CER'P1 P1 I:ll CUPY 4~C~Q ~ ~ - `.,,::.,,i_ f~~ . ~ I hereby ~~~,tt~~jt- t~ p~~~ti~e Lo b~ a ~iuc ~ nd cvri-cct co~:y of c ca 6 Qp 12~ Yt~ . T ~ . ~ Re~;i str~ti's ~q~d in t~~c 13rb-:~ard CouiiLy ilca I t.L 1)e ~.a a r Fort LaAti~r~alc Florid~,.~~ ~ ~ ~tr 9. ~ - ~ ~ ~ (tdariiin~?,~49~~fi~ic~?~t~s rai scal of thc I>ro•~~~~rd Cc~:~~ity }jc•~).th' . ~ i~c~cQq~C`.# s~~af f i:: c c~ ~ ' _ ...i~`~~'4~~ ~ ' ' ~r~"fTtsj. ~+1~~- - r~''~1 ~ <~~f .C.;~°-~fi - . ~ A / /j~/. G ~ Lr - - Gcuniy ltc•<cl ? h O: f`"i~cr , n~_~ l.vc<~1 Pr~~• _.:tr~cr ~ r> i ~ ~ h r. / ~ f J~,? / ~ % ~ ~-C~ ~--~.~r.'./' j < ~'~-,:;.G-~%~+ ~ I ~:r ~ ~ Deputy Lel Kegist r~r ~ - ~ . . . ~ ~ ~ ~ . ~;~"a 3CGr a~v : : ~ 4 ~`"'s.k~ i~ ~ '