HomeMy WebLinkAbout1726 CERTIFICATE OF bEATH 4b2'~09
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INWRMANT-NAME MAR,RJG ADOIESS luau a s.r.e. ILO., crf a ?orrN, sr•le, Irl
17i Mrs. S lvia Leitzes IJ1.21 S.E. Avenue Halland 1
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CERTIFIER- E mre a rlw SIGNA R - n A SIGNED IroNrr, o•.,.wl
11s to ~u QST t11~ Feb.5,19?3
MARINGADORESS-CEtiMlER s/aer !a..r.e O N .n lu
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BURIAL, CREMATK)N, REMp1Ul EMETERr OR CREMATOtr-NAME IOCAl10N cm o. Nrrr sun _
,~~'l~emoval ~ Mt. Lebanon Cemetery 1k Iselin, P1ew Jersey
DATE /rON?r, o•r, .e.sl fUNERAI NOME-NAME ANp ADDRESS 1 uaeli or s.r e. ro., cm Oe w.f1., u•re, Tr 1
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I• ~ ~ F CERTi F1 ED COPY
T hereby, cert~fy ~_the-~aboy~':to be a true and correct copy of the Local 'RegisCrar's
~ record gi>t.'J~i1~• iri~. the Bcot~~lyd County Health Department at Fort Lauderdale, Faorida.
4 (WarningrNo~ valid lii~lLe~S~;raised seal of tl a Bro yard Co my F alth [le t..is affixed.)
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County Health 0 ficer and Local Registrar
10-12- 79 Q~.~~e2~~
BAR11~S Chief eputy Local Regi trar
' Co! Plato -Suite /O/
6~S~N. Federal Hury.
Fl. Lauderdale, fZ ~?A8
4~i2'709
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ST.ItlCiE LO.':i T "f.,'
RO(~R PGI ; t..,;
CLERK CiRCUIT T :`;,`cT
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