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• RANGE C~UNTY HEALTH DEPARTMENT
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- - - _ CERTIFIED COPY - - - - 1
I hereby certify the above to be a true ~~ep~ tp~c i~ct copy of the Local Registrar's ;
record on file in the~6range County iie~j~ert; Orlando, Florida.
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.1 U L 1 1 1917 Cou al Dit~ctot and c~tl Re istrar '
Date Issued
y!a'~8~~-~ `y ~ Chief Deputy Registr r -
NARKING: Not valid unless raf~lQ~`~`eal of the
Orange County Health Department is affixed.
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