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ttat. of Itlvtlda CERTIFICATE OF DEATH
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tt, Durinl _ Hlllcreo_t licalorial_ _Gar+ie Ft. Pierce St. Lucid Cor~ F_1.1~~~ _ ~
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! ' t .yt Lk'•- Ir Ka 12 1977
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1 hereby certify fhlt to bs a true and correct ~ ~ 7 ~ ~
may of the loco 1919 Alfa 23 PN I=
Rspistret's record on flle in the St. lads County Heslth Dsparh , t ~ _ r : ; ~ '
irntlt et Fort Pierce, Florida. F EO A PEC 17 - • " Y
(Vlleming: Not valid unless reised seal of the St. lads S DER POI~R A ~ ' i t~ ' ~ ,
County Hssith Department is affixed.) CIERK CIRCUIT CQURT s, ~ - ~ ' '
~RECOROVERIFIEO ~ ~ • ~ ;t,,y~
N. D. MIUER, M. D. ' ` .''~i f '
County Ith Officer 6 local Registrar - }
DAN Deputy local Reoi~r•sr
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