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StatE• ut Florida CERTIFICATE OF DEATH
Ikparlmeat of Health and Rehabilitative Services ETTrJ?re ?lu No. _ _
VITAL STATISTI(;S FLORIDA pEGIEITfRAR f No .
t • i'E ltli PRINT DECEASED--NAME r'a't 1'sr 15FR OAIE o. oEA1N • tort+. o.•, •t•• r
1+~ Paul L. Epstein ? t'lelo ~ PJover`~ar 22,197C
''I /InTANENT ` - - - _ _ L----
E3l ACK INK RACE rw•ry. »t4w- .ru+t•r I»o•.». AGE - 1•sr u»on 1 to v»ou 1 0•. CATS Oi RIRTN ~ rO.aw, e.r. COUNTY d EIEAIN
rc 1 weal. 1 auwo.. •.t•es• - of r•.s ~ wo.,ii ww •t.t 1
. _ _ Uh ° to _ _ s. _ se _L k 6 9r~ward _
CITY. TOWN. OR IOCAf10N OP DEA1N •wtrot an \r.nf MpSh1Al OR OT?UR NS Ul -NAM( lu .Ip\ Ir UrM a, aM UNIr ..N rlrrtU l
~ ~ (T { wK N. •b W .b
C Fort Lauderdale_ _ ,t _Yes _ „ Holy Crnss Hos_~ttal _
~ ~ S1ATE Of RIlIM 11. wol Ir r s • . +tiCinlEN Ot WNA1 COUNtty MARRIED. NEVER MARbED. SURVIVr+G SPOUSE 1•• ,.lat, ant r.1tltN .1..•t 1
ttlV.rN. t w10OWED. DIVORCED 1 wcr• r
1 tt\~ewtt a Io ~I Mary Fine.
_+rtl ettt.xa ! Pennsrylvania_--- (L,S.A.. - --1--~ar~'ied - ~ - - r---. - -
.~.tt a.nr SOCIAL SEC'JRIT NUMBER USUAL OCCUPATION .a••1 solo o. rota nowt ev¦•N4 roll Or RIND Oi WSRVESS OR INDUSTRY
! vtt10 w r•Oa•~r4 \Nt, Nt» N 1t r.tfo I
~ti \•~•~r•ow, ar.t 17 ~I!C- ~,/~'C) ,y .a/tp~ - rJO MeI! ~S__ Qsth •
It\er»tf NaOat _ 4Lll~YY=~LLi ~A 114i. - '
RESIDENCE-SM1E COUNTY CITY, TOWN. OR LOCATION Instoi
cln Ir.us STREET AN NUuE•E!
t r tour. .ta o. w •
~rT 14 r ' a rye B w d t~~ F rt Laud date I•o Ye r 28 N.E. 17 h'a
EATNER-NAME rryt r10Mt \.Sr MOWER-MAIDEN NAME tusr x10011 uw
Is Louis E stein to Rosa CarZsetin
INTORMANT-NAME MAAMIO wODRfSS •wun oa . r s r0, un a rorw, w•ry, trI
r•a :I:ar 5^~ tein •I.r.;23 E. 1T tia Fort Lauderdale Floricza 13301
PART 1 pEA1N WAS CAUSED 1Y IENfE! ONLY ONE CAUSE ?ER t~JE TOR e • trao.lrw 1M
r 1. ro>. AND k!) attietr orate .rle w••
C I~ . Irrtouq twvx
~ Ir,Adenocarcinoma of pancreas. Septicemia due to 1 year
1 r .rt proteus and E coli .
laJ ~ COwolrrONa, 1• .r•, .
rwltr 6.•t ¦Iat t0 ICE _
\rrtN.t1 (.Va! 1or, 0Yf t0. Ot w! • COwxQNerKt W.
J lt.tlrG twt VMOta•
~ etira CAVat l.at
_ to
?IUl ¦ Oit1ER SIGNMICANT CONOtT10NS co..ano»f co.nuwuwa ro et•r.1 w/ rOI nwto ro cwat aMw r» rut . l01 AUIOISY K YES rut tlwnNaa co•
1 •ta M NO/ a1Hp0 Ir Mlterlrw0 Vu
a n.tr
NO Iy0
Mr~?1~ 1 /ICCWENt, fUKIp! OR A~T~~-WU~rO»rr. w•. +uR 1 ?101M NOW INJURY OCCURRED I tNrU ...roN or IM/V¦• Ir .•at \ o. r.u N, ter I.I
ItOMKtOE: OR UaOEtlRRYINEO
~M m, rx M 2oa
INJURY AT WORK PLACE d IPUURY n wOW, ••er. seen, r•.ow•, IOCADON 1 sour oa ¦ . o wo . eln oa ro.w, sute 1
I wut• of w wo 1 o••rct aloes .etc uncr.. 1
xk zot ?^~I -
CERTIEKwTION- r•0.1rr e.. •tu rprrw o.. ,t., .w0 usr s... ww: 1etJ•.u.t oN 1 ~roro ..o. •N.r rq atwrN octuuto •r rwt rote. o» rrr
PNYSKLN~ ~ rp»rw o.? nu . • •rrH Ol.rw IwOVU O•rt. .w0, ro 1\1t al
1 .rrlw0lO Mt 1O O. r• arO+UOGf. C
21a otct•ue .row 4'/2 5/~~ yto ~ ~ 22 7tc 11/22/78 Zee did no r• M ro n.t cwxln at.ry
CEfit IfICATION--MEDIC~I EIAMINER OR CORONER o» r.t a.s1s w rwt rove or tN.rw rwt oNta»+ .•a aao..ou»cto ot•o
t t.rw.rp» o. *«t aoe• •wp/Oa rwt ,w.tSrl4.rp», r. O.ww», rdlrr a• .t•a r01ra
ot.rr ocevnt0 ow Ire o.ry •ro ovt ro rq e.vxn/ a•.ryo
~ M ??D _ _ _
7?a _ 1 w
CERTIhER-NAME .nq o• roan - - - ~ - - SIGNAT l/ oe4w w ant DATE SK,NED Iro»rl~.
o....t•a:
Howard R . A oe 1, '~h-~. _ ~.15_~ ~ t~! . D . !~x 11/24/78
MwRNG ADDRESS-Cf.lY1ER sratn-w o _ un w •o~~~"- sort r•?
a5 ror.n Sr7. 731 Ta
ti•ar '971. IR? BURIAL. CREMATION, RE MOVAI CEMETERY OR CREMATORY-NAME LOCATION t•n of ro.w sort
ace. OPCYS tsnelm
as Burial ztD Beth-El Cemetery ik Fort Lauderdale, Florida
_ -
OwrP ..r.•-, c••. •t il•vERwl NOME vAnaE wrrC AD~tESS • .•.:r o ..o . nt- u c s..re.:••
~ z.e_~p naRivers~.de fit^n. Ch~~el t5~80 PI.E. l9VAve, PJo•Miarl~ geach.Fl_or~da
~UNEtIy{ OIR~ OR-iL UR ~ RE tS RAC- S1 AtuEE / t OaE t1 Cwto R. ?otwt t1eQI~ wt1
} J ~
T
V
CF.RTT Fi i:D COPY
I hereby cetti'E~i;the above to be a true and correct cop} of the Local Registrar's
record on fi~e• i~n the Hroward County Ilealth Department at Port l,alfderdale, Florida.
q
(Waraing-Ndt valid unless raised seal of rlle BrT~ •ard rte nt.• 1 _alth I'!St• is affixed.
-
11-28-75
_ - ~ t Ct.nnty }lealthO ficer and Local Registrar
Chief eputy Local Regi tray
-
4803'T~' -
1980 NAR 2I AID 52
FllEO ~NC~~pE~~Crsr~tk 0
- S RGGERCPOITRASA
JERK CIRCtAT COWeT
RECQRA VERIFICJ~_
au'ac ~7 P~cE 2'~ .