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CERTIFICATE OF DEATH
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~ess , E[iCII~1S H. Of~D ,Haile t November 20, 1975
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6602 ' ~2 /Feb. 2 1913 iSt. Lucie
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1 Aet~by oertlty this to tx a true and correct mP'P OF M! ~ . • ~ . • ;
Registrar's record on file in the St. facie County Heeyl Dlprt
merit at Fart Pierce, Florida.
~ (1Narning: Not valid unless raised seal of the Sf. lUid~ r~! ~ ~ j -
County yealth Department is affixed. ~
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N. D. MILLER, M. D_
County Health Off+cer d1~Loctf ~ _4 .
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o.M o.iwhr local ti~eo«+-«r .
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481039 -
~~~27 ~~'20
FILED ~ttC RE j~~
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ST.lUC1E COUN
ROAR t01TRAS
- CLERK CIRCUIT CQ1f~
BOOK ~~,o PaGE ~j1
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