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LtlCiE ~CUNTY.:FLA.
. 4~~15
DEATH CERTIFICATE •~9 ~Y ~ AM a S9
Re: Ruth A. Magee, deceased
CLERK CIRCUIT COURT
4
State of Florida CERTIFICATE OF DEATH
[k•partment of lieallh and Rehabilitative Services srrwTe FILE No. . ,
VITAL STATISTICS FLORIDA REGI6TRAR S No 6A'1
i ~ vE OR PRIINT OECEwSED-NOME rloor• l•s' SE1< DATE OF DEAIH ~ +oN.+. o•r, •eu
?N faith ~ A. Magee zFemale ,November 19, 1978 °
PERMANENT ~ -
BLACK INK RACE ..In. Nlcu. •w•Ic•N L.e..N, wGE-us, YN_w. 1 nu vNwe r o•. _ LATE OF HtiH IroNrN. o•r, COUNTY OF DEATH
IrC 1 f•f<N• . l.arw0•r •et 1 r01 D••f NOY•s rw •t•• r
, Mite ~ x R Feb. 5, 1901 ,,St. Lucie ,
6602 (Iri, IOwN. OR EOCAIICNi OF DEA/H NrlOf un lYrrrS HCKPITAI OII OTHEt INSTITUTION-NAME IN Nor w Urrt a, 4rlrt rraU •NO rYrN• r
s.e<N..ts o..ro '
,p Fort Pierce _ Yes ,d Iawra?aood Medical Center _ _ _ _ -
S/ATE OF BIRTH . u Nur .r Y s • . CITIZEN CM WHAT COUFrilY MARRIED. NEVER MARrdfO. ---TSIMvlvrtG SPOUSE r Ir orl. 41r! r•NIeN N•r! .
Per~nsylvai,;a~~„N...1 USA WINrt/ v9~Ci01),t(N.r ~ Burton A. Magee
- i,,.r HsloeNc! ~ 9 _ _ _ r0 _~l_~1_ _ _ Lt1---- - - _ .
-.l el cvu.uo SCKIwt SEC'/brr NUMBER - - - VSUAI OCCUPATION Iw.e ¦+•o of r0ee ooN! o1MrNG rosy w KWD OF WSINESS C)R INDUSTRY
•.ID .r O!•rw
L!JrefO W rQe•rM(, lrr tYlN N el r+t 1
„_169-03-2010B I~ous~~e Own Home
rr lor..(r NrOa _ _ - -
•n.'rs'o" tESIDENtE-SLATE COUNTY CRY, TOWN. CUR IOCAl1ON rNSloe trrr lwrq STREET AND NUMRE!
~ r'~eC~•rI~« Ner 2023 St.Lucie B1vd.Lo
,u Florida ,.e St. Lucie Flan Pierce ,b t4
FAIRER--NAME ne1r rreea! lest MOTNER-AIAIOEN NAME rreSr rreMt usr
~ Riley L. Ashbaugh 16 F71tt>a book
INFORMANT -NAME . MAItNG ADDRESS rsnur w . r o rq . urr oe rpt.N, sr•n, trr 1
Burton A. Magee 1e 2023 St.Lucie Blvd., Int 124, Fort Pierce,FL
?ART I DEATH WAS CAUSED RT. ~ENrER ONIr OFrt CAUSE PER tNE FOR (e). 1bL AND (q1 ~ eetite« oNStr •N:
• 1e rrlleule cyst
. ow
coromoNs, a •.n,
IrNIcN e•a trse ro tel _
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tO, M •f • CONfeOWNce Of
•1•rria0 Twt YNete-
lrrNO c•Yte l•tr
,
PAfI R OTNER SIGFFIFKANi CONOI1gNS CoNOrrrorrf CONrMWrNG ro o!•rN Wr rpr aureo a() C•yae prW w .•er r /er AIFTOISY • TES rte! rrNe1NG
r rtS w r•o tretae rr anerlNrrl
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1 ! AtC1OENT, 5471CtOE tX A 1 rONrN, O•t, tfu 1 F1OUR MOW tN1uRY OCCURRED 1 lNn. N•rvtl OF IN,yn IN ?ur r q .•tt N, net r. .
IgMKI -/OR IINDEIERMWEO
tIV•rtIM
70a 700 70c M 200
IN1UlY AT wptet PLACE CM Ri11MY •r wO.N. rut. sr•!p, r.eroe., LOCATION .arms Oe . • a Np . an o. ro.N. sere r
r shun ns o¦ Nor orate uoa ,!K rsrxrn r
70t 701 709 `
f CEfrNICATKN~- +oNrw w. .ru roNw o.• •e•. ulo usr s•~~7 .lm o« r ao/oro Nor •~e. M oEArH OCCYIefO •r O.t n•e!. c.
I ~lrrSKuN: TO rONrN 9•• .tY e00. •/r!. p•rN INOW r e•/t, •NO, r0
• •nlNefe M! 1 y !'~f l W r• [NQIVIl1•
.'ra oue•aw r.or_'~i u ~ I Z- 2tp r s'T.~ 2i 7 / ~ 21d 2te ~ 7~ M r0 sNt ewsers~
CERiIiK.stpN-MEDKwt Ei NER OR CORONER oN a s.srs a rNe~ a oe•nr a oeceaN+ y rsorroY o a•o _
t a•r..•r.oN or try e0e• •NO rM wVtfrlG•npN, IN r. trrwlpN, •rQrlrN • Te•e rrOYt
ot•rrr ocwaeo oN w o•n ow ro rrl! c•vstlsr sr•no ~ ~ k~~
72a _ _
CERtIHER-?vAiwE n •uNr~l/ - 1 y SIGNATURE of ee! une ~ O E SK,NED
1~w~
7Ja _ ~ N / r 7b t/~ , Zk ~ r v .
MAIERVG -CERlusft srau oe . r o N4.- ~ u .p. sr•y trr
..a5 cam Sr2. 7>' - - - .L .'W ~tr -
va/ 1977. IW RURIAt. CRE MATIpN, REMOVAL EMETERY OR CREMATORT-NAME t ATKRt Un W qr.N Surt
i - a•eV~P~vS 7UKrnr 7.e Hi1lCrest MemDrlal Fort Pierce Florida
I r;-
OATS 1 rONrN, o•r• q•e 1 FUNERAL HOME -NAME AND ADDRESS 1 Scalp Oe . r o NO . Urr O. rO.N, Sure, Lt r
7w 2 978 7s~
111?+ERAI E - N REGISr A?uRE - o•re etctr.to e. lot Al e[wsnu
.Hereby certify thb to bES a true end ooEnet Dopy of the Lour
x Registrar's record on file in the St. Lucie County Heekh DepeA-
:-,ent at Fort Pierce, Florida.
(Warning: Not valid unless raised seal of the St. Lucb
County Hsalth Oepsrtment is affixed.)
a
N. D. MILLER, M. D.
County He tfi Officer 8 Local Regist?al
~ ~
Date Deputy Loaf Realst*nr
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