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~M"~ CERTIFICATE OF DEATH nA""""°-
o.~.1...1 d E4•M..~ rYirMMlw =./.1..
~w ...rl.ilc. FLORIDA EDEAE Eiu f1o.
Tm oecEDENr-uAre Eusr rEOat EAST su wEE DE DEAnf /w... M. I•J
of Hurt
T. CHARLES ARNOLD WHEELER Male =.Se t.30 1979
lEACR IFIR ll1CE-a.~., WMI•, loll. IIOE-lit E110i/ UNDlR 1 rE/1l INaDEI E wr DATE OE MITN /M•.. fJ•l. I•.I OOEMIr OE OEATN
Wh ti a 81, M~ ' Mua • Se t. 6 1898 Martin
aTr• Iowa w EDCATION a DEATN ?IDSnrAE d o1NEl u4nTUilON_N•.1. n/... E..•Ur. r...•.d....1..1 IF EEOEr. Ol I16T. (1d•r•
aiE... Ew. Mr•+•+ fsr•.lh
>wStuart Martin Memorial Hospital .
lTA1E Of MITN /I/ w V GTIZM Of MMAT OOII~/R11 11ARtlED, hYVEt MAltlEO. 51/tVrvING S?OIAE /I/ •i/•. rdw r.d
as_E.,.........,/ wloowfo.olvacEO /a..•:l.l
:~uAE.E3IDENCE Canada U.S.A. TD. Married 11. Louise Hum hre s
wNElf DKEASED SOCUI SEGRITr NIWIEI 1161M1 OCGI/ATgN fGr. 4.f ./.r1 Jr 4r~1 [110 Of lIRN1fS6 Ol 11~IAilr
uvFD. if pEATN
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~*Iss~- IELDfNCE-SiAtE COWi1f CITV. T01NN O! IOCAi10N teEfr AEO MWIEt
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1••. Florida E..St.Lucie Ik. Port St. Lucie 1•d 3057 Treasure Island 1... Yes
/AIMEt-1/AME FIISi M100EE EAST 11011(!-MAEDEN NAPE flKf MIDDIE EAST
1S. Charles Edward Wheeler Henrietta A. Mutch
UJl0114A/A-NAPE /IfN r ln.l? 1111G ADOIESS STIEEi Ol R. i.D. ND. Gtr Ol TpNq iiAiE =M
1/.l.ouise H. Wheeler 1»~3057 Treasure Island Rd. Port St. Lucie Fla. 33 5
11R1A1. Ct[MAiION, /EA1CYAl, O1NEl I ~N••/11 CEMEtflr Ol CfEW/Olr-N1WE IOCAT1pN Glr W IOlM1l STATE
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Tla Crem on 1»_. T_ ri -County Cremato~_ 1«. Stuart Florida i
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f11NfGl DN[ f.Ar.•• N:FUI NOME
1~ ? 1~,A cock Funeral Home 505 S 334 4
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;y !S.•.rr. v I:d.l ? ` _ - _ _ _ ' ~ I ~.•wr• ..d ir41?
DATE S1G1rt0 /Y.., An. i.. 11018 OE DfA1N € ~ DAIf SK.NEO /Y... Mr. I•-I NOYI Of OfATN i
3 NAME CN ATTEND+NG l7Rt51C1AN If ONlI iMAN CFlirllit /l•.. f...l s ° ?s~~Nl]1MECED pfAp /M.. 0... I•.l IlON01?1CE0 DEAD IFfw.l
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0 70d ~ l~~ s- ~CJ//~°!~ _ _ 11d oN _ _ a- Ai Y i
NAYS AND ADOIfSS Of G[TIFIEI 1A/IlK1AN, M[DKA1 f[IW11tF11 /l.l. .-...rl
l~Tl,1l _ wrE lfcElvEO lr [FGIIreAI /r._ D•f.
t.~ r-:. October 1, 1979 _
CONd T1pFIS =>t•- /A}•r•..I ? . T •e,! r _ I iLc_ ~ r - - - - _ --..1-
VvN101 GAVE ~IMMEDIAIE CAYSE (p/[A Rs f 011 a Ietl[ IlA ttf)o~ pl. If E.:frO l•l.l (~f- j
IISE TO ~ • fxr'/
!MM[DIATE MIT iW ~V/wf / ~
uusE al E ~~P~/'f - - - -
STAi1NG TN[ (t.r«w. b1+••w •ws •w+1' 3
~nr~Ni OVE TO. AS A C0IEEOUENCE Of.
~C~e~o~a1~n~!~,, of yhe. T~/'osfafP ~//4~a~ 45r%xc /0?-7~
OUE 10. Ol AS A C018EOYENCE q. - / _ _ . - - - / _ _ _ I Inl•n•1 ltl•••w •nl•1 N 4d1 .
~ /AlT OMl SIGNIfKANf CONOITIO?4-.C••d.••w wwi?r.l ti M•dl l.r wp wEf.•d tew awn M IAl? 1 ME AEItOK'I ISIM/t WAS CASE fEfEllE010 MEOIGI 1
11 - - - 7rrr/ FlAM111E1 /Sl•.1/f L•r N•/ .
r,.pey~ n.No Yes
1 EDE,~E~NDiTtI~MEI.~o M.ErNr/ ~`E d NaM/ Iw... r.. n.l . i'Nwl Of INMr M ~ns l1/E NDw ENANV OCGMIfD ,
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? 1NAllY AT wOIK /fNA/f In MACE OF lNMr-A1 A...~, bn....I.e«. /aMry. •11.1• b...ld•n0, ~ lOU1gN STI[FT W l 10. N•. Gir d TOWN HATE
/115 f•..n SI=. rA• Mc IJI.../rl 1
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='"3;~> -4 ~ T hereby. certify this . to be a true and correct
. - < copy of the Local Registrar's record on file in
. r.3. ~
the Martin County Health Department in Stuart,
Florida.
r,~ ~ (Warning: Not valid unless raised seal of the
_ ~ Martin County Health Department is affixed.)
' 1
Archie McCallister, M.D.
. f:~Ee a"~ "=~""::':Count Health Officer & Local Registrar
4 ~~A ST.LUCtE CCUYT ~.F; y
s ROGER f of ~ ~~r.s
_ u~~K ~.F~~:T c,.u ~~32i1 P,~15~,3