Loading...
HomeMy WebLinkAbout1081 L~~~~~ ~ ~ 43'7bi3~ pp j r ' tiralr• I.r Fh1ri11:1 CE•RTiI' KATE OF DEATH Ih•tfarUu••1,t of Hc:111h and Itch;+irlitalicr• ticn•ic(•c ErTwre itLE [:o ~'rr~~t. ~ rJ~-rt~rtE ti F L O R I D A - - • ' r't +'iEl('J1 `'I l+..fU ~r rct~r ,.a• ~ ~~.a ,t , a ~t r ~ti;nE.1N[NE' ~ _ _ lJlr:l.lA''i +U~IIKG:~ 1<llltl ~•I;lir_ i~1tCh lrrr 1~J7t? i'Li1CKIN [/•1 ._.•r • ..rr~w ..D ~~(.t ,a.- '-jer.. .1..- ~ T.. - - - K 1 1~ .r. t+. a a A'f CJt ~(/'~fH . ~~-•C.'~. •T. of CEAT.( 1•, y.1(~/., •r.ry •1 rOt ~ C..t .'bH I ~ 9..~ • `•:Ilitc ~S, 6'2 e _ F~'h. 9, 191h i .Erc::•ard ICK•11CN IV pr!!i. y\•fd (.n 1Y.'!y ~1105t~1At OR Ot11f[ lactiT_••1:?N .lN•( n . w rir»I• W. 1 1'.11• v.».,. / •11 a.+tr. •If O. r r ]T. PeEwrvlte Finis f ;-1'es - ~ • . Pei'~rof:e Pi r.e:- iicsp - - StA•f ~f t?IRTH w (y . ..,.rt~it ,[rJ pi vrr.A+ - 1 ltal w CO+_,ralcr ~MARYtED hEYFt ~u•cc'fP •5'!t~,.ra : Sp'OC'>E ~~•1 c~.! a(.. ~.rr ' . d i:e~ar Yorl: ~ li.S.A. ;icErri~El `fart' i;rolzk ~ cu•.. SLC'•: SF C'/R,Tr rJilos(R ~ i USJAI fsCCUOAnQN .:..D o .c.. cc-.,1 r1~..S rcr c• 'urJ. - ...rD ,.c....,.. ~ , p C•r It•,~paESS Cr •r.DvSicr 1.p. . 11 •..1D . ' •:1•;r•ao.r t2 1)71_1?-947 i+la }tell i'rO~lrt:' ShlC1a1.1Sf_~ t~t'71 1'.St3Ce cES~CE•aCE-SiAi(- r - - - - - - - - - a~ ~COUNir '(;IT Y- fO+b N. Gc ICC AIIfjN •+i:r nr !Sl r(ft ••.D NUa.6Es s.1.... .n rn i:C:J York •JI, :11ban' !+.c IAUtiOEI~'l1~C !4•; ~•E':; 1.1. 73 naUl 1.:1aE' lAil!f f .-NAM E r~.1• r!(D,I l.t~ I..~tr.f ri- Mal; fN V141f r..\r .:',I y. Gcor e ii. Kuth ~.5 ~f.~ri,• I3i;:~r i NrC~iMANr-NAM[ iMwu..M..(.tsI SS r - Pfar ~ Ruth 23 A i:naui i ane, i.cudnuv t 1 Ly , `-~rl; 1 ?210 ?Ail 1 rv1 .r•n... D[AiN WAS CAUSED .f Ni(R ONI r ON[ (AVSE rER l!'+[ rUC ,'o,. br, ANJ ;(;y .1•.11.+ Oryfr •wo 6.. ~e _ ._-aril D••I! C•Vfl - le; Acute Coronary Insufficiency i fitT !3.~~ (o..iF ~Iwli e. ----1 +..~i. a..i nn~•o ! Isr ArteYlOSC12rOt1C }iAdrt t)1&r?aSC ' • -IDU,f c. ,t'1 o!. - - - - - - ~•.rr•.e rrf uroe.. ~ oui ie. w •i • ertivoar.ce o• ` - 1•x•.4 C.Vif sl t() 1 _ _ _ - _ _ _ _ _ .._-1_____ ~Ait n Qlrf[R SIf.NI/tCANl CONDI/IONS ee~e~••,:~s cur. v+.»: ro Dr.•. f_• ..er Ir..•1D •o (.use ;••w .D ' AU'C>•Sr ~ !1 r E S ~n1 ••.D:vef r .It G. y~D11fD ~ .111. ~....r: 1. 1 1 C• D1.+. t ~ ~r.;y.-• { ~r~ip[•.r p`:?rCE Of pAEE of IN1UiY ~ - ~ Ia'i.r .Dt: OR 4`nfTlce;hED D. n... I•.C ui rtO+r Ui 1;:Rr uRrFO • r~•rr ...,n or .n o. ..r „rr a.; j •pa •a 1 1- ~ ~ ~ y j I 1Nlca+ a xOrr ?(ACf Or .!.aiJRY s•n1•, i-- - - FfRC.•• Is O. `•01 `n.rr .,p ; , r•( ,.1C ~ • (OCAYON r Yuc J. D - :~r. C. •.1 v..t . 1 t: i Cp•np_AtpN- ..0...» r.. .u. ! r, D.. • t.... . _n ...r : - rNr!•'~.v r » , .ru ~ o•-..... ..1 !.r~Dl •tr. Utf~I1 t[O . .a.r 1. O~ .n1..DrD r»r T(' ~ ~ ' Io. ••n D1.,» D~•1 ..n. •O . CEs'.!.C/, 710N...•[L{AI EaAMU1f+t O7 GCCOr+[: •»r ..ry a• •n n~~. n.•. , .»r D1; ar-. +.t ..c,.c. ..;rr:;r.c-.-'- E /ur~•.. •~Ow Or ..•1 ?-.D. • •+•r. r»r '...I1•! .•r).. ~ . ~f.r.... C... - r"... » • C.. .Oa.. E Dr.•. ntcuum c~ +r c.-1 wo evr •c (.~.tLy! ~..,'rD ~ : 04 a M ` :•,arch 17 1578 : 04 a ~A ~ C[ni' [R_NUNf '••1 c..n..,~ Deputy i:edl.~a1-~----~S,.r~~iUR[ _t. rrc.n c.....r 'p•-E SI=.r(D z.r~ o...-•r.., ! •lbdullah Fatteh~ti.D.f%xaEainer i- E - L t ~ t ~ ! .arch 17, 197• . MAt!•: ; AODcE55-C(cn(,fr--- - v rr~ c.~ . s. :.o-_. r-. 1--- i S \ • 1 ~ 5301 5.~. 31st iyvenue t'or~• ~aucierdal~• C''_critla 3331:' e ( ~I+t Wcl.t. !RE NAr10N R[MO~AI CEMfI[rr OR (t(MAiOtY-h•M! ~r•n~-iN t'..,1 1 ' a•J Rcnova l _ _ I:rt Our i,aUC n( :U~;~r~l s Ccrr. r\l ~l.m~• ,~ci. York qa G~Tf ~ r.. .r... tl,•NER?I +rps.[._r.•a•f •t.U • c _ v - -FEE) 11U Tf:1Z -L'R t. Ii~ i•.' _ . ~ i r ,.,.•lrch 17,» 19713 ~Sa 1 , tr A ,ti "'G'UI ?;•:li: hR Fi ','~.1.'1)i:it[)'~LE Fl.~~ f,Plf~•%~f!'ipv_„k.ra~•U~^^ - REG~Si? i. Sr(,..•ru%t 'O.r ~r ~ .~,y~-. . _ _ - Pggg • - 5 • = 1 herel`,y•,certify the above to be a title and correct ccln~; I•, the i,c~cal ?:e~,istrar's ~ record on file~fn the Brow~+rcf Crnlnty ile.rltil Dena[-tmrnt at fort Latulr:-d;~1e, i~lnritla. ' (War ing-Not'va2id,knless raised seal of the f3rn and Cr nt•: 1' alth ;:a••it. is affixfad.) _ f _ 3-22-78 _ ' County Ilcalth E?.ficcr and Local r•.ef;istrar • - _ ~ J • Chief. epttC~' i.ocal ".t'_t;1 trar i •t - - - 0 r i~.~l~