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CERTIFICATE OF .DEATH -
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45632'
1919 Atli" 27 Ate i~ 29
tlarab'y cKtify this b t~ • frtt~ and aort+aA aoP'Y o~ tha Local ~~LE A NE~ FO
Ragittrars noord on Ella in tha Sf. ludo County Flaahh Dapatt• .
marlt at Fort Rierq, Florida. F~i~BER POITRA~ ire
(Wunirq: Not valid unlaat raisHd Baal of ti?a Sf. LucN CIERK CIRGMT T ' .
R>:CORDVERIFIEQ " fi'''.•
County Health Dapartmant is affixed.) " -yi ~ ' ~ J ,
MILLER, M. D. F~. - , f~;
N. D. ~ ~ ~ ~ -
Gou~ry Health OffiOar a tod IEpistnl y~ .
.4 3 jJ
Dew Deputy Loal ReatahM . ' •
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