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• - : State of Florida CERTIFICATE OF DEATH
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Vl1'AL STA'rIS'r1C5 FLORIDA 70t~
REGI6TRAR'S NO
r'HINT DECEASED--NAME +.'oc'r ••si ,SEx ~WTE Oi QEATw • +c«+. Y•. .,.f .
,•.;:,;:vEyr -JONN_-- - IVORY iTMALE___-_', DECEMBER 19 1978
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:;C K INK f4it ~+•'n ww..., .wt.~ .«o••~ .AGE . - ,r~lt + r_u._ ~_~+cn . m• Cw,f Or tcttiN •~«•w n••. .CQ„NTY Or DEATH
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NEGRO ;k w ~ ;sr it June 15 190 . SAINT LUCIE
1 _ _ 78 -
11r~, TOW?a Ot cOC A.:C?J OF Q, AI.• ; vvcr c.n t+..n NOS?ITwi OR OInER WSTIfUT10P1--NAME +•r •Ar flr«t/ :•I•f sltft• •wo wYrsff .
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FORT PIERCE YES „f LAWNWOOD MEDICAL CENTER
STwIE Ot t+RM wor s • - •••••tiClTrrEN t.M WHAi COUNTRY ;MARRrtD. NEVER MARR,EO. ~SUtVTVt4G SOUSE e.r .nf, ma .•rot« waif I ~ - -
.puwa• - ! !WIDOWED. OIVOtCED + s/ecw l ~
' GEORGIA USA - - . MARRIEA ~t1 MIRREOLA . _ MARSHALL.- . - -
+ u.•w s~l:Al SEi r•n• N~a.Etti I USUwt OCCU?AT1pN .a:f .+«o o. wOf¦ o4«e nYt:rr...w» or 1RN:0 os WSwESS a. TNEWSttr
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oar „ unavailable- ley LABORER
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ttSID[NCE-STArE ICOUNTr CITr.tOwN.ORtOCAhON
L•-t FLARIDA ,!„SAINT LUCIE /„t[~YES 1202 N. 12th St.
14 FORT PIERCE l
/AtNtR--NAME /Its! rgrprl usr MOTHER -MAIDEN NAME roar rltl0lf w•
STEVE IVORY SARAH MILLER
INN)RMANT--NA7Itf /AAMI?ICi wOGRE SS arue* of t r o ao . art a •owr, sr•n, w.
„f MRS. MIRREOLA IVORY 1202 N. 12th St. Ft. Pierce Fla.
~wtt 1 REAM WAS CAUSED tr jENTER ONir ONE CAUSE IER ttNE rOR (o), (!,t wNp terwur o ur •wo[
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~ rARt n OTHER :IGNIrICU+T CONOrTIONS co«ano«s co..rtnwl•w ro wan. tlrr r•or nwrt r0 cwsf 4ntr Ir rut • w/ wUTOKr M TES w+ftf .Iwolwcs
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n. 1~ ~_~$3J_?C"C_C _~_N~L'_~i-_Iv~~I? 1n~ _ C ~ ' ~ r.
1 MAKING A SS-CERYrrtI srftt+ d t.r o ~ cl - - io~.« sr.¦f r+?
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tURr1l, CREMATION, REMOVAL CEMETERY OR CREMATORY-NAME ICKwTTON Ur• of pw« fiat 3
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BURIAL ,t• PINE GROVE CEMETERY- - "'--£08ZPIF.RCE -F'i~ARIDA
DAiE . rp«•«. O••, qu. , tUNERAI HOME --NAME AND ADUtESS Snlp d • / O wo - ur• w row!., start, Tr .
•,w D EMBFR~~ 1.97 SARAH MEMO
~ ~61? fUNE l D ECi RN - REGIST A y A1tIfE - - fWlsuwf
•r, ;~~e ,y ,M ecember 22 1978
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~e~e~y ceR)ty fhb fo bIa a true stud oo~reCt Dopy of the Local . -
--~a~Tar's record en file in the St. facie County Heafih DepaA- ~7 I+l} aTr - . .
^t-nr at Fort Pierce, Florida. „ 9 . i. + 3 ~ ;
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~Waming: hot valid unless raised seal of the St. loch F~tp ~,.vD Fz%t;tsi),cD -
County Heahh Department is affixed.) ST-LIiCIE C{~p~tY fU?. •
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N. D. MILLER, M. D. Ai:CDRD\'Ei'ctF~EO '
County ith Offiur fi Loral Regtseral - ~ - i
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' l)~te Deputy Loesfl Rwist+ar .
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