Loading...
HomeMy WebLinkAbout1326 43'79'74 ~ state of Florida CERTIFICATE OF DEATH Department of Health and Rehabilitative Services FLORIDA trATfE ru.t No. _ . VITAL S'TAT15'TICS RECSIRTRAR • HO " t PE OR PRINT OfCfwlfO- NMIF .•oou 1•fr Sf>< OA/E CN (xAT« • ror+r.• o....s•• • IN LEUNA GRENIER ~ Fema.Ee ~ 'Aaltch 25, 1978 PE RMANENT - -r---~-----~-- - !tLACK INK RACE a,r•rn. wwo..rf~uc?.//« rwo•.r.. ~ AGE - .fr u..of• r•.• +ulroff : o.. I CA/E Of HIRIN •..O..rw, e••, COUNTr Or DfAln PG flfUf• . G!h•cte f.uwp.i • •••.U r01 ~ D.rf +OUq ~ ~ •f . r _ 6Z _ , _ _ lH _ ~ _ _ _ , _~phi,E 5, 1915 j„ Indium Riven CITt, TOWN, OR IOCAl1pN OI OE A1N ~ - --rwfro• Un rrraf NOSMIAI OR OInfR lf1i11U/ION-NAME .u .Ipr w,pwf uq frNfr •r4 .+urNf r - . „ Vero Beach. _ 1,.•'~e~5' « ~ p I rtdcttn R•i.ven Memohiae Hoy p.ctute. S/ATE Of IIRTn . n ror u f . , +•+fiCIT11'[N Of WffA1 CCUUNrrv ~HARbEO. NfvEt HARRIED ~SURWVfNG SOUSE r....q, a:.f r.qf« w..f , ~ cown. r ~ wfpO O. DIVURCF ~ f.u r. r frfwf«cf R Pe?tney~varti.a _ (ISA _I0 ~fc~c-c-ec~ Geon.ge A. Gnen~.en Sn. • ..ue cf~e.vo - - - ~ p,•n, SOCIAL SEC '[Ilr fl11H0(R USUAL C7000f~1K7N ,4••f awo or .rof. cr>•.1 ou•.•.c, rofr orRIND Of WSwESS OR INDUSIR'I :•110 "ti .f>?l ua(. /.rf, f•f •r « •I r.•!O r, 085-16-941.4 ;,,of, Home blaken i,,, Own Home _ ' - " tESfOFf•fGE - SIAIt COUNTr Cllr. •OwN, OR tOCwhON ~MSwf an ;I..,rf lgrt[ET ~rlp ~lUHsEi L"'~ FQa~c,ida . f.f~.f.. f a. «a r! S.t. Luei.e 14 F.t. P~.enee des 1605 Sunhiae R~vd• _ ~rf•rr~~ fA1MFf--NANf hHl rwOaf lafr iHOTffER-MAIDEN NAME nyf - _ • • 's I,,^ O y- ~ ~{a,P_.onob fu, Ea.te~e Mankot+~ k~ INFORMANT.-NAME HAWING: AODRF SS .fnnr o• • ro ao, Ur• o. ro:.r., flf tf, !«1 Geonge A. Gnen.ieh, Jn. ,n Canme.~, N, y. 10512 (Cowithoube~ • ?ART 1 OEATM WAS CAUSED 1Y °fNlFf ONl? ONE CAUlf ?Ef lfHf iGM jo). Ib), wN0 (f )j • n ur• f r•1 _ ~fflrffrl Orafff •rp Of•111 ,R 1.111Or•If Cuff / , / ~ • a ~«uarf~ o-f__ _ CO«Nt10 «f• U ~ ~ ~ ~ .«rclf c.•r nf! a itl__ . ' ~ r . i j ~ C ~ ~ . ~ ~ ~ erYf Ol•1f C•Yf! 101• - i_ !1•fr«a 1Mf V«Rf•• OYf /0, « Af • CO«ffWf«(! Of, jaj _ _ 1. IAN M OTMEf SIGNq KAM CONDITfON1 co..ano«f Co«rfrfun•w 10 q•wr wr ror qu!fc ro Uulf ar•t« ••n r Ior AUTO~ST' M 1(ES ~U! n«flr«Gf CO«- f.ff f>• rlOr YNno r« f)fn¦rr«.«a urrse a oul« _ _ _ _ _ _ _ _ _ _ IUf__ I„ 1~••lnpp11~~1 •CUDlNT, 3Ulftpt d OA1E OE RNIURY r.0«rw, o•• •r••r )HOUR 1--~- r f«rtf whiff Or r«IUf• rw r.•r . o• ?•p n ..er 1fpHICrOf, p UffDFTERMfNlD InOw INlUR1l OCCURRED Isc+u?rl i - . ]uo _ _ _1780 .701 _ _ M ~ ]d tN1URr At WORT: ?IACE Of MIAIRY ar wow, r•fr, frfefr, rk•p••, ~ sOCAT10N , f.fefr of . r o «o . crn of r0.«, sere r . fffC.f• •ff Of rrO~pr:Cf MOG , fK riff( r•• r _ Jb ,7M ,':Oy . • _~.~.T C[RT IIKATKNf- ro«Iw o•1 n•f .owrw w. .f•• ..ro us. f. ww'.ru .Irrf o« row: ow nor nfw rru DtwTN OCWtftO •r err! rule, O« rl« )«\SIC IAN ~ r(+nM O•• R•f ~ faGr •Irlf Df•M I . •n1 w0lO rwf : _ f.t ~ T(1 - / ? -r ~ '•buf' D•rf, •w0, r0 rlrf NS• n• ofcf.ffo .for _ f - ~ - - ~ r- , - '1~ ? ~ of r• aw..rewf. oJf _ ,:'1 . Jh i flf i i,b J ,h H /a •wf u~fenr s•.no CE41NK•I,UH__w/fOKAI fxAHiNFR OR CORONER ow rrf •.~.f o• ...r ~fucv..r ~ - f...u...r W.. Y •q f00• .»D; O• rq w•Ifrlf.•r•p+, Mrw O•• • W LI•rw +•f ••u•W(IDGUO ..o..,» o•. ..o.. •~"",~j of.•~ ouw/o ar. n.e o.y u.o ouf r~ ...f cuff .fr v..ro CERTIf 1ER-NAME mf o• n ~ - `CIC.NrRillRf ' r / afuf~W~n1~ ~ ~l)ATE SIC:NED .,pr.rw,c. ~.f.n ~ L T /f.1/ ` vtAQfNG AOCRESS-CER7NrEI - e~.;e~ n•: ;,r r:o cm O• row.. _s ~ sr.rf ,.f ` tuR1Al. CRt.w.11C)N• REMpvAI 'Cftiffrfllr OR CTrEM~I•,~r - Na.Mf cOCATIGN can a• +o+.. sr.cr Yt U•• . Rem-Buni.a.P i 7,f H.c.LQehed-t Hem. Gandervs. 7.r F~• P~,ence FPo~ci.da k " •_~T-.~ pAIF r.y..w. o • .f f ~ •rUNICAI ~C•nf '..a a.c a•;~~ _ _ - - - - Ba.ilcd FunQlca.Q~me, 90f1 ~N• ~7.th~ $t , ~ Ft. ~ P~,enee, F.~. 33450 _ -612 ~ IUNIFA/~:1!1!!~GR ~SIGN•/VRt/ _ `9[l.-.if~lq r.A,i(~• v C O•rf ff~,r.fD t•~OC•1 tlG.SH , ~ F ~ r~_ ~ - !-:EREBY CERTIFY THE ABOVE TO ~E A TRJE ADD CORRECT COPY OF THE LOCAL REGISTRAR'S '~COE2D Oa FILE IfV THE IRDIAN RIVER COUNTY HEALT4 UtiIT AT VERO BEACH, FLOZIDA." ~~;IS IS NOT VALID.~I~WLESS. TFI~ RAISEQ SEAL Q ,.Ir tiE INDIAN RIFLER COUsYTY HEA4.Tti J1IT r" ~ . .S AFFIXED. County realth Director. Registrar a ~ - ~~puty Registrar - +t _ _ 4:3'9'74 ' Z` ~ 8 Z9 ~ R~ _ g~~~~ 3U5 ~aC~ 1324 - ' : - - - . - F:- 3