HomeMy WebLinkAbout1796 • ~t
STATE QF FLORIOIt '
• _
' 4S6935 Ro6e?f Gra1~'wTll, P.avemm
• QERAR~`NI ~N,~f OP
, ;
- • a~~i~_ .ti ~_tehab~litativ~ Services
R Y N~. ; R PALM BEACH COUNTY DEPARTMENT
' ~
PUBIIC HEALTH ~
,~~iIS TO 8E A TRUE COPY
N GISTRAR'S RECORD 901 EVERNIA ST.
r~ ~ ' ~ 1A'EST PALM BEACH, FL 33401
• ~,Rlid unless the nlsed f ~
S of the Bureau~oi Vital A) Q
~ ~ DEPUTY REGISTRAR • ,
- YII~t 0~ l~NLL
CERTIFICATE OF DEATH sEln nu [a._, _ _ _ _ _ _ . `
r„a~ .,.,,•,K. f l O R I D A tOp.E [lu Ia
3 S 9
'i1' DtCEDf Ni-rFAME !list AtEOOIE tAS[ ii S[t wT! GI O[At IY.. O..• E..1
or mm
.EtEYNtNE 1• MARGUERITE J. JACKSON _ _ Female. _ ~J~.Ly 15,1974- '
- -
tUC[ 1K tACE--..! , Msr. t1a,l, A(rE-W tuiq, EROEi 1 YIAt IMrDEt 1 OAY 0111E OE 4liN /r.• Ar• Ir./ Ct7WTY OE pEa1N
I.rNrn. I r •Iat./i/ rod.-r-oriYS `-T+OIMi'1-MIIQ .
• White _ 7`I E E ,July 24,}9_01 Palm_ Beach _ _
E.IiY• 1OAIN p tOCAlgr: Oi DEAEN NOSIFIAL Dt OTN[t ItB:IIYiION--I.ww /7l w.•..J..• p. ~.....N rMr•/ a. t.y~ b . Fnpo•a++ I ~••r.•. r
6,0'30 7. West Palm Bea_c_h_ 2601 6oundbrook Blvd., Apt_.__105 _ _
' SlA1E Oi NiTN /IJ .w CITIZEN Oi 1111N[ COWRY MAiiIED. NEYEt MAtlIED. SUfYFK/lu SIOUiE p• ~s1.• ••vl •
43.1.• ••••.n/ ~iWCAlEO. OIYOK[D ISIroJ1/ _
17Ual tESlOf•+CE • Missouri U.S.A. iD Widowed 11. .
vl.a[i[DECiaSED _
II<ED If pEaTN SOCIAi SEQitIIY AtUMiE! t/yjaI OCCU?AE1011 /Ls•E.•/r.J .wE l.o. 6n•r •I*001 ,IISrNES$O•I•.t7ySTfY
c.StITUTIC°-. G+vE _ 263_05_9743 _ Housewi ~ _ _ _ _ _ •
irt~t?[rKE MEOit 17 _e . Own Home
•D<E.6bK iti•Ot+Q[~IAEE COIIiTY C:EY, TOWN Ot IOCAT1pN TtEfT A/j1 tV1iMiEt IrrSrCf C . • ....ENS i
_ IyFlorida F.Palm Beach [k West Palm Beach F.~5421 West 45th.Street I•• No
EATNEi--iIAME Elm YtODIE lAii. ntte-ilEwroEM wrE rltsi »IpJIE -
tS. Geor e B . S ren e 1 id Rose 1 ~ ~
I
IMigMar.i-N1EM[ r1.1. I.wrl • ~ IlllK ADOfESS SItEEt Ot t.i.D. NO. CITY Of TCN+. STATE Zl?
1~•L nne Jackson Fischer [:2601 Boundbrook Bivd.,A~t.105 W.Palm Beach Fla. 4
itAlAl. ClEWirpi:, ifMOYAI. OINEt /SI.v.I7I C[MEIltY Of (tfMAlgf--NAME 10CJ111QH CII? Ot tOwi• SATE
l.• Burial Woodlawn Cemetery r« West--Palm B.each.flotida
1 • s • -
z MO"E 1201 South O1 i ve Avenue
1:. ; 1+ ~a ~(..crl 1
uattlebaum-Holleman-Burs
- ~o t• •A. E.:• d -,r In•.:r<l•. MM •a-...•e a• •Et +.n•. i••• •M 7T O• Yu•E •f ....ro•w e.+•f ~ r ...e••vo•e.. ~ ••Ir w~ r.:..a•I. .
` rb• o..r or v vv :o.~a•NI~ID'~1 ~ eu.•.•a M r.• r+.e. •r•i r•n a••a• •nr b ceva•1.7 ,b`•1
f ~y I <•.•~s•• w1 ECI.-__-- ~!''l1 ~ 2 !a•n~?r a.1 E?MI ~ ~c _ _
i wTE S.G+.FD rr.. M.. 1•.s 01 pfaTN wiE S+GI.ED rY•., D... I..I~NDE1• Cf DEATH
~g~ July 16, 1979 1:00 A. ~
• :.o. M ~ r.• 710. _
~ 6.1=~ _
_ - ' --1- - - - - - -
I f~ haY1 Of A!+P~Ir4+N.S'UaN6O!rNt itMh CE 111i.FI rJ•I. Inv1 s° X_tD pEAO IY.-. l1... 1•./ 7fgWClr fO CiAD •N_••
- r >E
71• AT M
a A. J. Schwartz, M.D. a„ _
La Mf A•A aD01 FSS Ci CfaTNrF1 l1?r ra;(uy, EaEOIUI f/AMI••f I) r!•M r,a.•r
Carl A:drew•s,irID 705 North Olive Avenue, West Palm Beach, Florida 33401
. t[aSnai 1 n ~ T[ tl([I t
t ^ ` , i
y 17, 1979
. ~~ri.~.R 77. ::..v... r, :~cx ~,;1 • C .~2;- • ~ - J _ _e..~e....•..., ..~e a.~,•F,
- -r _ - _ - - -
.AH (M•~ a.t 7. IVYFDIATE (AtR[ [I\lIt Va/1 Ot/ I FPS[ IN t7 IR 1•~. Ia F, I.O IN.E - ~
E IMVID.a fl ?Atl F;I / C,....~.,-~ ' /!~.'OZ'
•c'•tl+s. i.rt ._.L-1~-~~~r~~- r~ll~.t..,'~,~ 1.•e..s~breen e.~sN ad •Y•r.~
•+^trn r+.- ~ DUE t0. Cit aS A CCr.:fr]uEr+CE Of. VY ` ~
uuu E+tsi
1 ~
• ~ at - _ L- -
` OIiE TO. Oi AS A COrBfOUENCf p/~ ' I^'•'•~ 0•'4~'a d•OV`
(l 1
. h1 _ - '-1- '
, IAiT OTNEI ?~'PUL7 CG++Drf1C7•.S- G>d.r .aq aw•k.• p M 6e+~ AP oa n+o•rd a aa•v ,•ven IAIT F iol aatOKl /p,war Was VtE if iFIEFO TO Yv:-'UL
11 [-.AMIfiE1 ra,.a J. 1•. w
• No 7• No '
' 'r•w elq ACS C['ct_ S'J ~'Df a wTE M IN ~Jiv iY.. d.. 1..1 r,Wt Oi 1rFX1i1r OF ;Galt! rCyN orJUiE CKCUtiEO
NCNEK.M V.DETEiIIE+HfD . y.I•r -
b f 7! - __177 _ ~j7~__.~_ _
MS r_.-.. a• IbrVi• AT Aqf[ ra:. r• 1-. ~ MACE Oi u.1U7Y-A. ~o••~e. •a•~. +••ee•, b••q, oN._e ?.,.y.q. EOCATfON STIf Fi CM ti O. I:o. CIrY Ca TbArl ~ STaTE
:<7i ib.
•'-<.r OICIIS 77e 77/ 770
Fo•.• VSfal71
8ggl
5
Return to:
Walter B. Hutcheson, Jr., Esq. ~
McGee Johnson Jordan Hutcheson & Young !y;9 fi°~~ ~O ~ Sc
2601 10th Ave. N., Suite 314
Lake Worth FL 33461
- - - - - - - - - _ tao i~Y A.
' af~Ci)~~--- - -
atx~
8001(i~ PJtGf1~