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HomeMy WebLinkAbout2160 44~U2~ ~ P- ~ ~ 3 _ _ _ _ ~ ~ T.1D oTAt[ aoAttO or 11trw6T11 CERTIFICATE OF DEATH c.¦.D • <+UR[AY Ot" VITAL ~TATIfTtq 1RAt[ YIL[ N0. lc=.1 rAe- FLORIDA •f! •Nn BI TN N RtdtlTRAR•Et HO ~ ~rgcrly GOD[ NO. 2. utYAl R/t11>r[MCtl~ArtMwdAr/ t!whAMrc Rrw.11.r..MiWM.> t. otAU o~ w?nE .:.e.t.a ~ oouRTr ~ sTAn e. cou¦Tr , •wa •ill S~• Lucie :'Ion=-~~ ?c ~1¦ec/ 1¦ ~.r- 0. pT1,TpaR.ORIACATIOK t. K hAtt Ot ,EATM e. CITr.TOM¦,OR IOGTKIM t. ~S a[S:GE!KE 1td10E C1Tr LIMITSi :wS•DE CRY l.raiT ¦e¦c¦t Yit3:Cti resi~ w? ~ t• i'i=Y•ClI TES., won rile. t •AwE or /y ¦a I¦ My+rr. /r..aa w//rw1 t sraET AooREss NOSIITAI W v~ ~ 114TITNTKM .'t,• t'~fs:CO 1.:;::0. :.G:;~)~ '.s i.:.:~. nYG•. NAMf 0? ITrM Afi[~e lwEt OATS XAwt? wl Yrr • lT1rOt«7?EeI) ISOSt35 21:'...:4V 11[ATM .^C:. -~T . S. SEK ~ OOIOR OA RACE ) YARR40 Q 11EYER YMRKO /.•DATI Of (11RTM 1 AGE IIw rt«t Y,r.uw t rW u.rJU IAIt ewedtnt A/w. D.w Mme. ~ r 1 t . 13 `.:~(iro tnooTrto avoRCCO ~':1•' =o, 1 ~i,0 >?1e1¦1>r i0A {7SUAl000ENATIOtE(Oi•r!/Adywrtbet 100.K/RDOr¦usulESSORi¦pISTRr 11. /IRTMrIACi(JTwftM/rTttptr¦wt?r) i2 clTltr•a A.M:Opuwtar~ t. ~e r- /writ .w1t a/ r~?14/ IW. Mre UI rytirtQ . ¦A¦e¦t .:O .v?1 t3't L ; iiu ~scOl• °l» ~ • • _ c 1?lett 1¦. Il. iATNERi KAYE It. WTMCR'S YAWE¦ ItAY( ti s0C1AL f[CYIUTr tK/. q. IM s t11pRATYR[ Ad/reu ~ . ~.:_-12-i r~71 r .l/}- /~rtx _i~'i..rv ~--7'1- , A t/ tAY![ M [tATE1 iiwtn Ml/•et cs¦at rwt /n 1 .>wotrf Iw:E~:u ttTA[[w IwerAl l owsET Arro CEA:~ KEr.stor ?ARTI OEATKwASCAY6EO/Y: G~V~/,~~ t/~~~%~+'_„r ~L~u-!L ¦eet the wwcoun uus lta yGQ`~ t1e eAr- / ~L~/n t a rt e. e• - ~ 1/..?N oue To p) +~G'i Ke~~l~ ~ZC'~ _ - y~/ -'n elt\ t.• r1~ YAha/ fet radrr• resletror /Liy nlux IsEE. 01~ TO /tl - e 1 t\t1 T>t ~ rMT K. OTRd MrwlrKAwT COw01YlOr~6 CtfcilWfRrK TO OtAtM i!!i bT REtAiED TO TIK TER¦DIAI O.SEASt OOIOITIOR G11RR M MRt i(w) was Al:ti,/SY feed Ar- ~ nREOwyEs trr Nwt\ ~ ~ yEg~ wt@ et Mhre ~ ~ t t 200. OESCRyE Mow uuWlr OCCURRED. (kwM wwtwe yiw/¦.r b PaE ! «Pw?t /I y4ee r/.) ¦DYl¦s Aes ~ ACCIOCrT fYK:1oe t10YK:fOE a1D~ee1- ~ O ~ u ate. er 28t TtY[ ttf Hwr Xwe, oDr. Ytw . ~7• ~ Iwutlr a i 2a/ t1Y11Rr OCCLRR[O 2Dr. rE,ACE Or utH7er It. ti « w?wt e•twt. 2i/ cm. TOMRt, OR tAUTKM CW:RTr STAT[ trMll[ AT O NDT MM1lE ~ /«¦I.1Kt«f. turd, ylcr 114. Ae.) MORK AT MOtIK i - 2t. I AlHndAd Et1D deADA ~ o ~ And /ut DAr Ar~irr AG?A oA ~ DAAtA otx ~ _ AA • wtwt.d AtMM'A: And tot At oI tn~ enorbd/.. Irorn tAA uutAt ttwtnd. ell !te¦D tZ BONA ~ (lh «Wk) 21L AtHMlESS :St. TE S:Gwe' Are se le - 1-~ ~ _ s..,l,t. i b Aie.Te/e. 21c. tURIAI. CD[¦ATIOK 21e GATE 21r. NAYS OF CE.t[TERY OR CRF rATOdr 23f- EOCATgR (GSf?.~osD. M cMwrr/ (Stir. - . RErotAl,jspraht i.. ~ - T.tt.~ll2 21 fu1~RAl / oRSSK:1tATYRE ADDRESS 25 OA YEDEC0.•/Y~LQOCA1t[A GKTMR'S51GuA-TuQ/~ AIr.IYiS ~ _ ~ - (OU /~LL'+rE C.~2~ C.7` . ,~irr+v?7T,~.'1'?~ a '-919 .llfi~ 15 3S ~ f~,{L tt+il f:iCOKIiEU 3 ~.Lt~ GBtLytY.flN• 7th P~lj ~0 Sj ECOfiU~~ R T~~~~~J~~/ n 1 hereby cert+ty this fo be ~ trw and oarnct aoPY of ttte lxa l Reyistrer's record on file in the St. lucle County Heahh Dtt+part- 4~SU22 _ meet at Fort Pierce, Florida. . (Warning: Not valid unless raised seal of the St. Ltxie County Health Department is affixed.) } - • N. D. MILIER, M. D. _ ~ County Health Officer 6 l~ Ragistra . D~ Deputy Loral Reaist.nr 3ucr 3l0 natl. 2158