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.M++.r.al 1. THEODORE E'OWARO (i01LNICKt SR. Mate , Isla 19,1980
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Lucie f#. P.t~tce R#. 8, Box 1138 N 'Mf'r's
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Mahtha Go.Gtwick R#. 8, Box 1138 F#. P.i~ce FL. 334S
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y 20th, 1980 i~ 11:00 P.M_ .
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„Khalil A. I. Cassilnall M.D., 403 Na es Road Ft. Pierce
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t ~ereoy certlty thts to be a true and correct Dopy of the Locar
Q~ictrar'S record on file in the St. Lucie County Heahh Depart- _
ment at Fort Pierce, Honda. ; -r
_ ,
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E (blaming: Not valid unless raised seal of the St. Luca _
County Yealth papartment is affixed.)
_
f N. D. MIIIER, M. D. ~ ,
County Health Officer b loud Regisfrsr -
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~ a / ~ _
~ Date Deputy Local Reotetrr~r
493301
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~ t9~0 JU. 18~ IIIR II~ 27
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