HomeMy WebLinkAbout2577 ,
4555~i9 ~
~T! Itti6 ~t1 X1110 i 1
. 9~
T ~ .
;
.~ielns or Nw,TM CERTiFtCATE OF DEATH
~ o? trr+rw~ av~TTarlae sr~Tts ~s Ila
FL08IDJL ~ . 529
t i. N afAT11 Coos NO. `wi
1~wt11awetlw~..w...rN.~ taw ~ . ~tr.wfww.~r.:.~
~ , S 66-025 o S
r .10~.0111+Of11TtaM, s. y K4Ct 0/ orATN i1TY. TOwN.w t,OCAT1011 1. If
- - _ ~ ~ ~ ~ IIbiOE CITY 11Y1T=1 Nlrl~ CITY lWlTff
a _ ~ ~ res No Ft Pieroe Np
y
O< (~OII b MyiNl, ~ wtM dhtM) C fTf~LT AOONLit
~ ` r` eM P'L - Pieroe hemo. Hosdtal 2106 Ava. d
N ifttl M(syt Luf aTr l~aM a Yts?
( «,H.n ~ 8livatd ~ ens Betts i:TN Kav. 19, 1969
~
f~01i0N Oa r,AOt YANNKO Q NEYt~ Mt~RI(0 OAT[ Or NRTN AK f rtal I rw •
~ ~ MwM1 0... ttww Ali..
r f ;t • ~e • Negtw ~ rnoowco avacco ALtg• 30r 1944 l~
` I Ri~i~ OOfaMAT10M( y.«! Mgt IOD Kuw Os wsw[SSa1 wOYSTNY 11. r14TNKAC( (BTttt «M~tMN tr~ery) 01100 « MUttt Op/.MI
_ s{~ p1. wsrt(y . wro N /trlr/fl
Qrocery Store Ft. ~'~cerce, Florids O.S.A.
s 'O MAY[ ) MOTNtiR3 aA1plN NAM[
~ ,
rssa. lhrank Betts Pearlio Garrison
- = s[wlMrr NO. • r1alATwc wda.«
26?-68-9606 Pe~lrlie 3caatling 2106 Avenue G. Fort Pieroe, Florida
~ enws N astlTrr liwN...b sr s.r•t>er b.r nMq~~(a. N)...~ (s)-1 / uTCxvA~ aTwctN
rta? r.MT ~ tatA
wYCw~t~~ W ~ 1'~it1 ~ F Kllrf~ll •i/ oNSiT A~tr ouTM
~ia~ !u.
tt/r• r / A C~
h, •
t>rw ~ ear To <N
Nt+ . YIO1 Qt owl.- Obt TO (H ~~'«'K
p g 4MI psM htf.
~ ~ rwl M. Otlq fiilslnNr ~Pi01ilOMi OONiMUTOK >o putty R1r NOT auRr a TMt RArMM. OIYA!! OOIOTYN i1Tto M /YT KU . TtA O/SY
~#M - KIwONMt01
~p,~ ; - Ycs w
70r. ocsctllrc ~ wtuer occu.ao. lEota •wu. yto/.., to rlrt t « Itip Il yw. ~fi.1
tloelonlT >IIMCIOC NwKroc .p.,~ _
~ ~IwN. tN?. YMr
~ - $ O
~ °'T a OIiYOt OOCYM[a mr. KAC[ MuV11r 1t.1.. h r .Mot Lv. >D/ MY. TOMN. 011 LOCA1gN OOUNTY tTAT[
~ i
~ AT O NOT /v/n~_lotNlltM~~ •
aG~.sJ. p . jtLj /I
'l ttf ffw tow+ _R_~i~w]--~7``~~_, /V`, ~ ~f ~ f a.~ b's •IIi.. M ~1.c_-s,..tq/
' >IINtA • tliw
to on tM d•t• •t•tod •JIe.•; •wd t bo•t M q tsws~ tM gwu.t•t.d
4.1 ~tF,Na• i MbU ( . « ) m u~_ its. an o
~~yq><.~? •
~sN?tat+. ~ ~ , tM al?T[ tx Nnrc w cc~crcllr oN carATONr t]/ IOCATgN lcTr,, w.rs. «n..q) (atra
i1-23-69 Pine Grove Cemetery Ft. Pierce, Florida
•.~Jta s Aoolass
rio s zs. arc uca rr uxx ua. aatsrlu?as sKNA
~?'sMa :~t. Pieroe, FIa. h+nbe~r 1 1964 .f9,t', . •
~r 4 r ~
.,1~
1 ~
j. ;
-
~ ~ i!
this b be a true and f~Or(eC? Dopy t~ the Loin v t • ~ _
ne1'eo'y f]artlty ~
Apistrar's record on file in the St. facie County Neahh Oapart• , • t':.'•'' ti ~r•l
at Fort Pierce, Fbtida. ? ~
(Warnirpl Not valid unless raised teal of the St. lade ,~tf ~ .
~ ~ #s
Gotnlty Heaitfi Department is affixed.) ~ -
. 4' ~ -
N. D. MILLER, M. D. .
Gpunty Health Officer 6 Lodi Rpistra~ ~r t..,'i~~~~ .
=
/ ~ Lf / /ice ~ _ ~ ~ y ..~lr'' .?i: '
pele ~ DepitV LOaI Ref]iatrol? ~ ~ _ .
,
~4 ~~7"~