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Palm Beach Couiit•y ~-Iealtli Department I
CERTIFICATE OF DEATH "D
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' I HEREBY CERTIFY THE AaOVE TO BE A TRU
E AND CORRECT
~ Y~ ~ 1 :.'-'i, COPY OF THE REGISTRAR'S RECORD ON FILE IN THIS OFFICE
~ ~ (Not valid unless the seal of the Palm Beach County
¢ - _ ~ • Health Department i s affixed)
~
~ ` C. B mback, M.D. ~
~ Local Re istrar
t ~ 9 {
SEAL Bureau of Vital Statistics
May 16~ 1979 ~ West Palm Beach, Florida
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'44f 334
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ROGER
POITRA~A•
CLERK CIRCUIT COUkT
RECORO YER{fIEO_ -
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