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CERTIFtCA~'E OF DEATH
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~ CHARLES WILLIAM CLAGETT :.Male Aril 11 1972
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George M. Clagett Unavailable
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CERTNIE!-NMIE /trtf M tMh M. M
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Melvin wolkowsk
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TWewl, 01EMAttON, lEAfOYAI Oa CRErNTOlY.+NAAfE t Te0o1 _ esrr a to+rw f•.ry .
Delra Crematorium De
Removal-Cremtn Ta. y ,k Tray Beach .Florida
ATE rro.r~•, o.?, nul RItsEl/LL NOME-NAME AND AOWtEit r ftwet w u.o. wo., trt w tOvw, aa, Iw r
~T« .13 1972 .Hai d Fun ra" 901 N. 7th St.,Ft.Pierce F1a.33450
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rz•"' 19TO ,A - T«. 11 14 1972
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~ +tsreoy certTty thu to be • trw snd correct Dopy of tt>• iota- . FIlEO AN'. , ~;UEO `?~?~4~
tegis•- , record on file in tt» St. facie County Healfh Dspart. ST. RUCI',' . ~ 4 - F~~_
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•nenl • p~o ~.e F(o?ida. _ ClE'• ? -
(Warlil... ~.ot va~~d unless wised seal of the St. lode
County lier~th L>epartmerlt is affixed.) r
DEC l 3 34 PM - _ _
N. MIIIER, M. 7. i
County Health Off~cer 6 loot Regittrat
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pMe Oeputy t~ocsl REtaistrM - ~ - ~ ~ ~ - .
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