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FILED ANO FECORDEO
ST.LUCiE COUNTY.FLA.
ROGER POITRAS.
CLERK CIRCUIT COU(tT
^ I f [TAT[ woAwo or NuLTN CERTIFICATE OF DEATH RECORD VFRIFIEQ
o.et • [IURUY OR VITAL eTATIfT1C[I RAT[ ?LLLS NO.
,,x,l r«_ FLORIDA RcDISTwAR•s No. 520
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.nd .tlt Saint Lucie 66-025 Florida Saint Lucie
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!n;nM;,l,,, :Jill ie 3mmet Iiolmes ouTr Decemher 16 1968
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d = wwrwr OCCYRwtO >Dr rIAC[ Or rtuwr p. / . b M tA•M MM. 20J CITT. TOtlw. 011 IOCwT1011 OOIIwTT STAT[
MNN.[ AT MOT >r.. /r./. faa/r/. Mrlfi. Mrt Mq-. Hr.l ~ .
„o„K O AT t,a, r , P' a St .Lucie Fla 1
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Bur~a~ 12-22-68 Pine rove Cemeter Fort Pierce Florida i
T . ~ f ~ 21. [ wAl [ ofl S SIGIUTYRt Aowtss r~~ ~f~ ZS pAT[ 11[CO. 1T t.OCAI AEC. ti- GKTIUt'S T~ -
e. • . t oe• 20 1968 !ll~lil![~ti . ~~~EQ,~;~.. ~•X° '
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I hereby certify this to be a true and correct copy of tM t.oui
Registrars record on file in the St. Lucie County Health Depart- '
msnt at Fort Pierce, Florida. '
(1Maming: Not valid unless raised seal of the St. Lucie - 4
County Health Department is affixed.) g ,
County Fieatth Officer 3 Lou) ReGJstrar , 'r_ ~
~ ~T. - .
Qate Deputy Local ar t l1 , •~S^ - i
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_ ~ dUn~ JV~ YacE 2782
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