HomeMy WebLinkAbout0726 _ .
4 y6314 ~I-
_
. ~ .....~...w. CERTIf KATE OF DEATH i
v.:; ftoR~o~ 169
. ~«u~
:r wr: r~r w[ w MnpN~?w~rr..r?.?.., -
100~R'f 1. SCHMIfl'T : Mate 4
QZ9
~ r rw vex r oA~ aw p wM rr.. w. i•., aoum a aAw[
a s w + + w NOV.19 1 a99 k S~'. Lune
~ arr. eer a [otmou a sar wNw a wMa ~snwrooa-+r.. rr.. • r w ~o[r sr~. eo•.
f~t. P.Lt~tet Lawrwbod Med~cat C~~t >a~.
irArlM~! lrwr dlrMpMMiC011M1~ ?~r[trA~lO. fYMw4sollllrM.M'.Iw~r~/.w1
I~~~'Zd'•"'' t1SA Pau~.ine Cte+~ona
r,ow e~aMr 1~ n~ 000IAt10N Kw W rr p [IMAM a roar
ri 4 ~ o l• )~f ~fA Mobi.C"~'~~
tai
~"d`ca2~t"'°"+' R~,t~ted
w~oss-wow mwr an. a~a~ wunow •~w'r` TP~P~t Rd. NOi : i°i
~ FLo~,da St. Lu~clt f~. P.iehce R~t. 4, Box 'a4
MfIr.A[[M 11!/< rwu Wr wIw 11St //tl~~0_01~[+ {AIf
1/- - C• Q. $C~~ to ~ WWw{.•
I[MO~M~Mr[ IffM • I1rtl IY16 AOOtlf[ [n!!r O[ ~ t.0. M0. OT? 01 rOirM [+An it
Pet<ttlxt Scla~dx r,. RZ. 4, Box Sao. F~. P.i.~ree Ft. 33450
may. a[I[Ar101~ M~OIMI.allr rar.r,, arnenl a awron-«~re wa?raw on oe rows w.~e
~ Rt~ot~a,L O~akda,Ge C~tQ.te~y r< ~oK N. C.
• rare
-:3: ? BAT1~ ~tWERAI HOME
rw.r.. ..~.~w.r .r fraaa.[...~..w...rti. ....w..+
.r w.. r wra .~..r. r..~r r...~.~r r~.a
- ~ w[ srr ww p ounr ~ an ron~ rr.. w+. nou[ p owr
,;,a, . ;
. - - s [rI[Ie a wrycwr w plp anr~w~s/n~•. ~ ~ woNOir~co aun rr.. r.. rr rww~[s woo rte.,
- 4MIf u~0[[~0ldllll~IMg10At1.[II0KAl!>tlNtlgl'~ItM./~., j
se f~•SL ~ ~ ~ZaM~l'fa ~h• ~'fi• ~[O~ i
as ~[cev[o w r+~. w: ).r - - - j -
,QL March 19, 1979
' [.....«...ra.w i
s[ .w.Mn d s car r.. .o. , r ,
~ ~ ~
~l A[ A pll~Q p. Yww. ~~M w1 rr
M J/' `
~ a Af A 01. f irra/ Y.~r. s~r1..~ •r :
+ , t
M
- ~ Opp [,OM/KAM ~ it r MR 1 M ~ AY10[[~ W OW
M (tray Jr• .
• ~ a
~Qwe`r~,r~ an rr.. w., n,, wu[ p ruir+r wort ~uln coal[[[s
_ w~rr At ~ r~ r. wAa p w+w+
R ~rw..wr. r~o~r?..w. r.w. wuraw mea of u~. w.. an a ww n"~ E
.~.th ~ .
M .
s
a.~q, os~? .tlM. b b.. oarn¢t oo~? olF 456314
ra.olarr: record or+ na lr+ St. ~w County + ~
.t Fort ierp. bride. ! ~ r
y ~ ~ ~ , X919 AUK
(Wamirq: Not valid unless raised seal of the S1: ~ '.tir,,~~,
County Health Department M •ffixed.~' - .t ,~R,~~C0R0~0
y~ . ?>''~~+y~~ # ~ ~pO
TRASH
r'_ ° ~ ~ r C T
N. 0. MILIER, M. D. ct ~
~Courtty Ftealth C+ffiosr i1 ~ ~ s . R~QItpVI'RtFIEb
i ,v ~ • •
Ors local Reoi~t.ai
. F
• ~ -
' t
ari~x3~.~ P~cE