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Registrar's record txl flN in the St. Ludo County HNhh Dapsxt- ~ ; ~ ~
g rrlent at Fora Pierce, Florida. ~ .'~~.r.+.;trst~} .•a.'. ;i.<..,.<.~. - ,t-±-~• .
(1Naming: Not valid unless raised seal of the St. Lugs . _ ; . _
County Health Department is affixed.) , ~ ~ - , t
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N. D. MILLER, M. D. ~
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County Ith Officer 3 Local Repistr« -
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