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Rpistrars record on file in ~ St. Lucia County Heahh I , • '
mint at Fort Pierce, Fbrida. ~ '
i FILED ANC FELUriuttl
(yyarniny: Not valid uRiess raised seal o. the St. lute ST.IUCIE000NTY.fIA ; r ,
Cpurtty Health pepnrtment is affixed) ROGER POITRA~R,~t ~ _ u-~r~y.~.
CLERK C1ttCU1"~ ~,~j~' = ~ f ~t ~ -
RECOAD Yf.R1f lEtt / ~ ~ i. ~ ~.~F` a~
N. D, MILLER, M. D. J
County Health Officer a loot Registrel .a ~ a ~
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