HomeMy WebLinkAbout1602 . 4:38155 ~
- CERTIFICATE OF DEATH -L
D.w....1.E [beM..~ ee1r~MEaYw sfarUle F ~ O R I D A louE HU MO. 36 .
rn•t n•1•ereca
• • 1 {lECE1ENT-J.w1,F i1LSl MIODaE IAS/ EEX OAT[ Of p[wrM 1 Y. , ln.
,l .a.•.I
H. _ C~i.ffith Male ,Jan. 21, 19?~
fiEY•NlM r•
e..'-c r - 1wC[ O . Med. wGE-Leal M..'dwr 111aE1 1 rtwt 1?p! 1 OAt DATE d MtitN /M,. Oe,. r../ C01Iifr d DEAM
- ,es....•<1laE~.,•,/ 1 Ir•./ aEOt-T OaT~" IEDUlf MI,EL
G6n? Wt>lite ___~1s_•_ 69~ 6.--- - Jtily 2,1909 r.. St. _ Lucie_ -
_1?r, TC~lei. OE :lJf/.ilpN d Dfwrel Ii06e1rA1 Ot OI11E! le?111M WfJ-~,~we /f1 ,r w wE~. M. r•.w M reM) If 11061 CV T*6f . ^.r.we MY
Fort Pierce _ _ r~- Lalwnwoocl Medical Qent~er 'd Inpatient
a s•wT[ Of E:1M 111 eeM r ClrizfN Os 1MNAr CONNr[r a,AEElEO, NMt MAlfIfD. A1E'1[1rINTi 61'OIRE 11l eJe. /,e Wr easel
l'S,1 , .re rw,av/ W1O01MED. pWlCtD f Jrs./,/
•.+:.FL2I•dE + Tllims- to. Married II. QOtter
.-.,[;t.l.`.1~ - uwoE~u•tirssoel.aalsifr
• we:•e s[t11t•tr Nw?ue tlSU•E pC(A1tArKYf w el.a.E Ie1e
~ of Deferiis_
a
- 1`57__8-24-8275 qe. ZI~~C~7Qr Depta
y JES:OENC[ S1At[ COtriry Urv, TOWM Ol [OCATION ttfET AEO NUIY[t
. 1~ Florida T+ St. Lucie Part St. Lucie lad. 418 Oleandex Ave. ,N.E. Yes
f•1•Rl--lMM! hifT Y10ME EAS1 1[~!-YAIOEN WWE hRfT M10DEE UST
1,- H, C~•iffith Maude ~
••JO[M•\!--nAMt IT.Ee ee In•rl 1uNC ADOtESt SiXE[i Ol ! E.D. ND. Utr Ot 101,IN 6!AtE zn
1,. .Griffith 418 Oleander Ave. N.E. Port St. Lucie FL 33452
s~e.•1, U[AUtKM/, EEa10YAi• Or1e[t /S~.ryl CEIMETEty O! CtEMATOIY--NAPE iOCA110N ptr Ot tOYN irwtE
1M 1. All Saints Tom- J1 Bead.__F~r~da
tV.[Ul [cTO! ~ 11N[EAL 110YE
Ira. ~ .1.. IE? -
' i • ar amuwd M ewa rle. Ow M Mr eA esee>•wo•+w a•d~'M .w.a,~ Aw. ••7 .O'r'1 Beer.
~•e ar i emewd ~ M ere, ere awe elaee we ~ 1e r•e ceselel M.'.e.
~ e ~ fs.oe..e. ~ 1.W7 ? ~ j, s IJ•ar++•+ e,1 tale), -
~ a - - - OE o[wtN DEtt srowED /r.. ILI. r•.l 1Q~ of pEATN
~ ~ PATE 51G1:ED /Y.. fb ~ r
I j rUl11F Of •trE.pltla EMSKTAN lE OMEE r11wN CEtr1T1EE f rrle ?w+1! j ~ EfOf10V+CEO ()EAD (Me-. Ow. T.J : A"'!
•
]la. AT M
i t3 ace „0.1Y2
MME AED ADOeESSd CEtTloft in1IS1C1wN, MEDKAI EXA•ITNE4 rr1s+~?e:r1
1
~ n Melvin Wolkowsk 8 Fort -
iEa/sTw DwTE f#CEIYED sr eEG[S"I1/1a.. r• /
_ ~s- Janua 2.3, 197__=__
. , •r., ' d ~ 1.1w,a1 bweer awd de•+-
e W.[ 7a. IMMED:Ar[ , !`/v iLM~OrLR flCf[ ?A fJtt I0>t f.l. ft/. 1110 /rI.1 ' ~ /
~ WE r0. AS A OR ' lrerwl b.wr ver erd drew
a /I S / Y-t 1Yr
DuE lb, a w Cd6Ept1ENCE OE: 1w..1,.1 bNraee ee,re W s..•
kl l
• - ..-li OrME.- •G[.1EKA COfAI w+.4wM ~ dw~ .r wlsad~
e.wea l.ww •w.Afr AUiOES?,J - ~ ! AWN~EE Jrt ,
"
p[6Ct1lE NO'MI ltiw/ir
T?•eEellel ACCIO[M. WK10E r OATS d r?wrr /Y•. i1q• rr./ u011e d
~ ND1•KIOE. v 1?.rpElEfM1NED ffi.e•hl
t~ - D~. Ef rld
~ IIWn' A/ YY07XR lflerJT to ?T/IC[ d 1NwRr-Ae Ere. fw~, ee•er, 4ca•r- etlw EOdIT10N S"EET Ot 1./.O. Na. UTr W iMvJ, fTA:1
.ra . y.., , I J. r Ae/ ew:- (fKH,1 ,
a'f .Je-
;•;e„ c,/rvs fie. af. ~ -
1,•.e v1r.17f
~i
~U f.: RECORDED
1 Hereby certEty this to be s tt•us end correct Dopy o~ the -fit! ~ . _ ~ U.'JTY. FL .
Registrar's record on file in the St. Lucie County Heshh aPe~" ~ : ^ v . .
mast at Fort Pierce, Florida.4aX71SS ~ .
. r, a ,
(Warning: Not valid unless raised seal of the St. loch
County Health Department is affixed.) X79 ~•,:<< 22 QM (U • .~y
N. D. MIII~R. M. D. - ' :a~.•r~ , c ,
County Health Off;cer d1 local R~~t~ ~tRyU;? +.~vRi •b ° .
/ a-.3
D~ Deputy focal R~ieE.71. -
% 54~K~ ~~6E~5~