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state or Ftorida CERTIFICATE OF DEATH
lleparlfnent or Health and RehabititatiTre se?rrices sTwTr rTLC Ero. _ _ _ _
VITAL 9TATISTICB FLORIDA N[OfEiTgAP'a NO 311
TvPE OR PRINT OKEASEO-MAW ~ne• .leett 1•?1 SER DA1E CM QEAfH • .oN.N. e•.. •t•a l
IN MARY FLIZASEI•K YOUNG E Fetttaee , Mce 21 19y1
PERMANENT
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lwtfKa-NAME tN1t •11eet1 t•ft MOWER-MAOEN NAME wf/ r1ee11 tNl
Cahho~ Neluton Fneeman ,1 Beee.ie - Jonas
INEORAIwNf-NAME MAIMK wOORE SS If/rn Oa 1.1e r0, [ItI M rorN, toll, [r1
John C. Yours 1ff 4047 Gheettuaod Dhi,ve F#. >'.Lehee F~. 33450
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RIMIAT. C T1p11, REMOVAL 6METERY OR CREANTORt_NA/M( IOCAt10N cln p NT..1 tl•w
;'"`fiat-Che~rtation Neehon Cnema#o~ti.urn Wee# PttCm 8eaeh _ Florida /
t)ATE ..pww, a.,q.!~` -.TVNEiµ NOi+[-i~~Mf-iNO~wDOR[SS ~ v.n~ of ~ • ~ o . tn. oa
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Mat ~4, 191y 8ai.itd FuntUca.C Nome 901 N. 7#h S#. , . >si~cee, Fl. 33450
VS. #812 EWER t Efto~r- SKiNA - E REC,1 - •rpq - owp Nul.[o eI tOC•1 aann•e
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t iTeroby certify thin to be s true and correct copy of the tACal EC ~ CQU~M A. ~ t
Regisfrer's record on file in the St. Lucie County Health Depart- ~~t' _
mart at Fort Pierce, Florida. ~IEA CtttCtllT GRIM t
(Warning: Nof valid unless raised seal of the St. ltxiE~~~M VEtilFtt:O - ~
County Health Departmont is affixed.)
~s~s9
N. D. MILLER, M. D. ~ - ~
Covnty ealth^Oificer b {ocai Registrsr
IOGI ReO~elrp~ - '
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