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=i'~L~~ ORANGE COUNTY HEALTH DEPARTMENT
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•CERTIFICATE OF DEATH
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N iw CEDAR HIL R~lATORY It/. DAYI~ONA BEACH FLORIDA
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March 11 1976 SEl+IORAN FUME HOLD; 622 W SEI~RAN BLVD ALTAI~DNTE.SPGS FL 3271
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I hereby certify the above to be a~~x~'..Ia~~c>< copy of the Local Registrar's
I record on file in the Orange Coun ~t~~ bnkat, Orlando, Florida.
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Co y Health _ cal Registrar
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FE8161979 -
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Date Issued .Chief Deputy Regis ar
tiARNINGt Not valid unless raised seal of the Orange County Health Department is affixed.
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POCiRA~A
Y CLERK CIRCUIT COU
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~ 443996
900!! 30~ ?ACE 1?55