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HomeMy WebLinkAbout1392 • stag of Florida CERTIFICATE OF DEATH Department of health and Rehabilitative Sen•ICCS *rATE FIE.[ EEO _ _ VITr~I. sTATIS'fl(;s FLORIDA pEG1iTRAp S NO T vPE OR PRINT OECEASEO-NAME 11'x'+ 1•)+ SEt DALE CIE pEAtM ror1.- ew.. •eu 1 PERMANENT MARY _ J _ D'AMICO ?Female ~ Se tember 8 1978 BLACK INK LACE ..•a rfwo. wru.ur 11.e1w.. AGE 1•s+ Vrof• I .af e•o~~ 1. e••-__ CAIE CN ElItM . rtY•Ir, ew.• ((tueft~ CM pEATN f1E sfu•... •~urow• ••f.ts1 rot ~ o.a rqun - rr •f•f White_ _ _ _ _ __53 se ___l_____ x .Nov. 2 1924 t, Broward C/ Cnt- tOwN CN lC1CAltp?f CM DEAtN 'rLef c1N s~1ts tIOSMAI W Ot?fER NS11TU11pN-NAM ~r 110+ f11wf. (•nf s+Nf1 w•lo NYrfff 1 • srfta. •n oe //o ( ~e Plantation_ _ _ tf _Yes _ _Pl_antation G_ener__al Hospital _ _ _ StwT! CtE tIREM a ro• 1r " s •I~of CITIZEN C1i wful COIlfftEV MARNED• NTvEE MARlIEO. - - SIIRVrvING SE'CWSE 1 r .rf. c1.i .•.of...~.w . v~ cplrn.l w100WEO, ptvptCEO lsncr.l ..1.f.~.a~f . s Pennsylvania _ 9 U.S.A. +o Married _ ltt_ Pasquale D'Amico _ ausfs SCK+AI SEC'IMtr NUMIEt USUwI (xCU?A/ION Ia•f ..10 o. .off eONf e11e11w ..os1 of [M•EO Of N/SENESS CIE INOUSTEr ~•lo . s1w1r oU Unte w rOet mlf. Ia1, Mr a gnffe 1 2~~=14-885.6 _ Homemaker +b Own Home ntrot rce NtON _ •0i1'+s'o'• EtESWENCE-SIR?E CQUNn Cnt• TOWN. CIE lOCwtION wslef c1f? Ir.m S1tEEl ANO M/AHEt Ifrftr• qt Oe Ib1 +•A rida 1AD Brow rd +k Fort Lauderdale tb No t.. 2537 Gulf stream Lane EAi11Ef-NAME flyl rpOa1 lwt+ ffO/IIER-NAIpEN NAME fMft rleelf ut/ 15 Vincent Hamiel +6 Helen Bemben IWORMANT-NAME MAINC, AOWESS Is1N0 W ! r • •10. Cltt Oe rorw, tt•+f. fr1 +J. Pas uale D'Amico +ro 2537 Gulfstream Lane Ft. Lauderdale FL 3331 EME 1 OEAIN WAS CAUSED 1T ~ENEEt aX r Of~[ CAUSE /Et Ilt; EOf (off ESL. AI'b 1[M Nf11/ffN fpNNt Iw11. M tt Irrwtf twu / ; pl l ( 1. ~L' ~•L ,S/'J~"~ • ~ i CONNf1pN,, 1. w11f, Gu,~(?. Y'~ ) iL C ~ ` / i VNICY Gwff tiff W (el lrrfelwtf C•YSf 101• ~ ,p. ~ w) . coMafOWIKf b ftwtlNG tllf YNtft• tnr0 CwYN lwtt kl ?AEtI R OTHER SIGNMICANT CpN01TIONS CoNMOV••.I.ONIMYhMG Nw1r Npt +f0 ro twH 4111fN w rut . Iel AUrCMST ~ TES .Ifef fINMNGf i/1f a//N. 1.fs of Not YNttO 1« MNtrINN/c c• \3 ~CGDEN~. SlltCtpE Ot A I rON?r, M.. fuu ffOW INAIRT OCCUttEO + sNlff Nwglef p /Nwn /N ruf 1 M ewn n, tn. It 1 W IIffDETEWINEO ~ . INJURT At WORft MACE CIE NJIIfr •t 1101[. •••r. s•ffff• rwC1Ot•• lOCwhCIN 1 suN/ W t • 0 110 . un W ro~N, stwrf 1 IfMCrt ffs W N01 OMKf MOf .fK .sNC1I.1 C~ iOt• pl 20Y . _ 1r Ow• •f we rOrwl Ow• •f we wr0 u]• Y.N /M~ f11.f ON 1 tMe Wp b1 fr 1M OEAIM OCCVttlO wt trf Vlw(f• Or CEHIIEKATIDN- x011 f~,~ .MTSK/AN. rOr1N RY t00• 1srwlw IrOVf1 O•M• wr0, ro fW ' N n -1 j` TC) n ,n ~ E• r n _ •+o r of w tNO.nfocf- • - 21a efcfwsfe r,Or - ~ tE1 ~ 110 `J - O - I U rC ~ ?t0 21e C1. LU LM t0 1M (wYtf1U t+? _ ` 1_- CEetrKAtION-MEDKAI E><AASrfEt CIE COEONEt or rw s•sn a 11y roof o. N.1r 1r eKf + -.s ffo.louNcw w.o : ffwrrlw/1pr OI M f00• wrpJt)• tM wvf StlGwtpl• 1•n r• Ofwgr_ ew• •f wt rOVf qw•w OCCIMNO Or +W Ow•f wD D"f ro M Cwl/)f'!1 S•wgO Z?a _ _ _ M - CERTIEIEt-NAME ,n.f Oa .f•rr. ~ oE4ffJ p GATE 51GNE0 1.10••^1• ow.,.E.. Lawrence Russmano, M.D._ ~ ~ ~V'~ ~.G`_ Gt~~tt%IGuG ~ ,x 9-10-1978 .FAKING AootESS-ee.?uK. 4100+ S «Ho ital Dr. `1~ f1. X45 ro.1.1 s+:. ay: F e le Flo ida 33317 va, +9n IQ? WRtwl• ClEMA?ION. R7FAlpvwl EMETEtf CM CEtEMATOty-NAME IOCAtION c1•. M .or.. st•n ['aces ovcv5 Isrfcln. a.: Burial _ _ ~•e Holl 2k __H_ol_lywood Florida _ _ ywood I~inor_ial Gdns._ - OATS I..o»*~. o.. •t •a1 I/UNf¦Al NOME-NAME AND ADOaESS ~ slfefl Of t f O r0 . C•+• Oa 10 Nw- f•w4. P?, ~I J t. 12 1978 ntFRED HUNTER FUNERAL HOMES INC., 6301 TAFT ST., HOLLYWOOD, FLA. fElNft C1t-SIGNAEU RECiIs~y~ E-SK,IJAJUEE Owtf tfCE+vEO tf IOCws fEGlltlA¦ nn ~ < t-~_ ~ !j-. s~ : ~ ~/u a~-~'t 4 • Gc • L ~l~". zco • / / / r { CERTI FI ::D COPY I hereby ~e~tify the above to be a true and correct copy of the Local Registrar's y . record.oq•~ile~;q the •Broward County Ilealth Department at Fort Lauderdale, Florida. (Warn2.xtg.~t :~?%t°~id ui~~•ess raised seal of t e Br~j•arfl r,c• my 1 al th ~p~t. is a[fixed.) '`l I eat th OI Fi cer and Local Registrar Co Inty 11 sl t •'T J • ~ f ~i/GQ~ ~-Q J • CiTief eputy Local Regi tray I 1930 JAri -9 52 fIlEO Ak0 F~C[;iI?,1 U ! ~01~ a ROGER POIT~ASR CLERK CIRCUIj C~URI 1 r if COnp VfR?ft' 3~ 3 139 0