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HomeMy WebLinkAbout1362 ..l.• - - 4'~3WiHS halm l~eacl Coun~Health De'(t +/artment - • _ s +Irf••• ~fwsw +.~Q~OO s • ro. • r ~ OO.Onr-- - r+ - _ T~- state of Florida CERTIFICATE OF DEATH Department of Heatih and Rehabilitative Services F L O A I D A - trwrt E*u~ Na. _ - _ V[TAL STATlSTIt'S acau.raAw s No ~ ~S ' rPE OR PRINT OECEwSEO-NAME 1a• .1lO.! uu SEa O.irE W OEATN • •aarw, •e. . t = PERMANENT ~RBERT L, RADIAFF - :male ~ ~ Sept • 7.1978 BLACK INK RAcE ~r•n. 11leq, •WlKw Iw.N... wGf-f•+f rr!! • •a! vo!! f f?a• CwTE Or R~tM 1.o-.fr, O•., COIJNTr d OEAM ~_T~ fK .1f4Cf•T1 - pltw0•+••full wCf M•{ f1f 11O! W •!•!1 - . ~ white ti 7i se s< .April 14.19D7 Fal>A Beach _ CTR, IOwN, OR IOCAIlON pi OEAtM rso! cw+ ,r.Ip NOS!t1Al Ol OTMEf Rrsn - 1w rpt w !:O•!!, arr! trr!• w .w1.!!! . ~ wc+• •!s a tfo ,Boynton Beach ,t n_o ,e 42$9 Royal Manor Drive • S1ATE OF WM I M MO. r v s • . 1...! CITIlEN Oi YV11A1 COIJNiIr MAffl[O. NEVER MAtR1ED. StAN11~N[+ S!'OUSE art. 6rq r~rlr rwn! ~ n?~..~! s Illinois "w"~1 9 U3A „w m1pO`"i~° Larena Seegert ~.Hf fM(UflO _ - .,c x.. 90Ceiu SEC•1Mllf NUMREe tISUi?1 OCCU?/1TIpN ~e1.e O¦fe W .aa w1+! Mrw ..os: o:- [wOOr MKR+ESS OR niDilbm '"(ulnp r i10ltra~ lM, N!M r qMN t - - 33o-a3-16y+ _ Tool do Dye Tech. Tool do Dye Factory .r,•of•re rror r? tJa- r~tr •O~~~s'~'1 eES~DENCE-SiArE COUNir CtTr, tOwN, OR lOCwItON - wftnO cw• t1.n ~ STREEt ANp-------- f slecr• .u 00 r0 Florida ,.Palm Beach Boynton Beach ,b no rM 4289 Royal Manor Drive IAt11ER--NA?~E - ny, wyN! fyt MOTNER-MAIOEN NAME /ru reN! - uN ,S Nilliam Radloff - - r6 Anna Reimer tlIORMANT-NMrE - ~ - MAaMG w00RESS fora p...•.• •IO • tw+ p g1r11• tt•N, »f Anna Radloff 4289 Royal Manor Dr. Boynton Bch. Fl. 33~}35 - IM rART t oEwtN wAS CwusEO Rr: IENaR ONEr oNE cwuSE /ER trtE rOR p~,1s1. ANp 11 .atrNw pw!!! w M•w. - - tR wlwr Pals! - - • uWNtl! t.aH /M, O,N ro, d.f • COrSlOIwK! Or: - fLnwG tN •wtN. - - ttfM6 t.Yt! UN - - . ~t~ _ • ?ART ¦ OTltER SK.N1fKwN1 CONWtgNS= cwwwews co.OOft,ra.w ro war !Of 1•ot runO ro c•OS! e1.e1. w •.et 1 IOf AuTOrir r rES f•er .IMO/Kt. eo•. - f os e. ••o. RNlf1N f11 w•lwwww prt• a oeaw .~.~1,,~ •CCfoEf~t-w~i 13~ A f.o..nf, w•. n..f +9a n0 19e O.fIpOE: O! sROEtER!lINE° !qw INJ11Rr OCCURRED f efwl. wtrr a wwrt• Ir rut . O. r•r r, w!. tO f ~d - 20a ~ ltb - 20c. M 29e . -IN)aJRT wT IYl7R[ RACE Of NJURr .i ro.r, •uw. snr., t.ctof7•, tOCAl1ON - 1 stNlt oo s.r.O fro., an o! to.a. u.a f - tsrlc/n vs a •.ot grKf lfOC..!!c 1f!ltrtt 20e 2'Or - - 20y. ~ - CERTtTIC/1T10N- 4ww M• •lu rp/N 0•~ •!w! •N uSt M1• f/f11. YQ! OM 1 ~/Owl I~IDt ~y~ M! o(wM OCCYMfO .t M .IKI. 011 flit! ?!•tSKuN: - TO o •10.1fr M• .R,pN f0•• w•nf N•1w 1reOOf Owq, W, q Nt1 f •m..etO tw! 7f0 4 7 7R 2tc- ~ 29 /c• or ewn.eu. ew 7+. Ncl.:le •00~ 1~ 8 'ri re 7fO : 2UPM to f•1! C•r!!f!t nano CEEiM~CwTgN-rAEWCwI EiAM?IEt OR CORONER O« •rt usls o/ r•r wOM a as tw! O!clr+.+ s.w>•olwKee oeu l uarl•fq/M M W !00• •1+0/O. f11! rf•af1W1O11. 111 Orrwbl- ~ ripYf•• NT n.. rOfr. 0!•w oCCUlNO a sw O.a wIN 01w q ww urssaf u•wo - 7Ia ~ M 720 - CERTtrfEt-NAME mn w r'w1n i-- SIl'iN r ~ r! a ..T.t ~OA1E S yNED .~a•w1. e••. nu f 7Ja _Herbert L. ~ Hachtel, M. D. Tae 1 ~ ~ I-! 7x 9/12/78 MAafr+G woaESS-cERrofE~ - . ~ Palr!urlTrail wo Delra Beacham 1 Florida ..a5 Fry111 Sf7. 2b va. T9~7. aqo CREMATION, REASOvwI EMELEtt OR.CREMATQRI/-NAME LOCATION - frf• p to,.. ~un cremation - 7.~alm Beach Memorial Park :a: ~ioynton Beach, Florida OATf . 1.1011T¦, w•, nu 1 fUNEtAt HOME --NAME awp ADOtESS ~ siMa M . r O 110 . c1•• M to.1., sfwn. t1s 1. - He Se t. 14, 19 8 25a 'zell-Faville-Zern 1 111XO-Road Lantana Florida 33462 - rWERw C7 sfGr+A? REGI+Tw Ar o•n Otc 1+lo s• rota aasru 7s0 ~ 2W - Ise ~ • I HEREBY CERTIFY THE ABOVE TO BE A TRUE AND CORRECT `r'- ~ COPY OF THE REGISTRAR'S RECORD ON FILE IN-THIS OFFICE - (Not valid unless the seal of the Palm Beach County . . - r Health Department is affixed) , - - : ~ C.L. Brumback M.D. ~ ~ f.,,:.SSe~tember 14, 1978 Local Registrar SEAL 4~~` Bureau of Yital Statistics f West Palm Beach, Florida ~ J~fN 24 ~ ~ 27 - FILf~J 1110=Gt7x~ - ST~0~6E u~7~5~ - GlEfIK CIRCWT tX~t ~~~4 ~~36i - -