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~ CERTIFICATE OF DEATH "A""`'~~ ~ -
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FLORIDA wu Ip 311
T/re t~E MIOOIE 1~ SE= p•TE G/ DE•IN l Y•, Iy, r• J
aE.;1.~, Anita C. Gic]eon , F1Qlmale , _Nm?y 19, 1979
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1~ 1• Iiuci,e 1~. Part St. Lucie 1•• 2930 Santa Anita Yes _
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INIOLMAfR-JY1tfE /[rrr I1wD ADDt[rs =itEET 01 E f O. •10! CCTV Oe itrlw STw'! [b 1
\ 1~. 1.. 2930 Santa Anita Fort St. Ltycie Flt~rida 33452
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' oATe ~ IEf._ Ei.r. r.I IClle or OeA1M W1TE sfeNeo /r.. Ei.,. r._l - - _ a DEAN Bound Dead •
S~ wwE a •TTtfOnXi IMfSKWi IE otNtt TIYN cEtnnEE, r,r• r wj _ ~ rrof.oufrcto DEAD /r., a.. r.., rtoNaetto DEAD /x...,
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NAME A/O AOOIlf Or CRTIH9 t711•EIOAN, Y[q[Al E7UNW'Rq /TSM r ?+r1 `i
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ttnKttAt o•tt tECEMO p tecrsle•e /r.., 1.,, r.,
oo«D,~',~ EEa b.. -I~i~ 21, 1979_
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ARTRRTASTi FRATT(` 1HFeRT 1]TSFSSF~ ~
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w~,.~~.r~f~~ No ~ Yes
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» _ ___Z ~ Sit~g upri>i;ht in Chair .
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~ nereoy art++y tnls to be a true and cotr«:t aoal? ~ thtl ~0 ~y -9 t~1 47 ' - %..t
Registrar's reoDrd on fll~ in the St. LutN County fleaith _ .+~1 . f.
msM st Fort Pierce. Florida. ~ICO 1?HC FECW~-o .
CptytiKFlA. h;
(Wamir~y: Not valid unless raised seal of the St. lucb p0i RASj ~ ~
County Health Department is affixed.) JtK CtRCW ~ 4!'''
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N. D. MIIIER, M. D. ~ ' ~ ~ '
County Hea h Off icer 6 lr~ atra+ r: ~ • x' K'
488965
F pew Deputy local Repid.er
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F :.;,r X496 ; a -2759 ,
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