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HomeMy WebLinkAbout0740 K • • 48349'7 , r E CERTIFICATE OF DEATH ~ t~~rArrrT d /t/.l1it .ri Re~rL111bM1+e Clnltt~ eTATt hfrt NO. lLOaIDlI ! ~ T.n, w wiTT IN Ilr;o~etTTAlI•• No. T~rrirAwNT ~Ni! tli AirrNN pA - 'w/ 4 pA 1 Mwti M . n.rf 1 AlSlrr(IIM{ l 1 T~IxLLIIV~t JIiFFCRS C'>VOD!•1xP1 T. tI T. ~ rAa I.Iw. Irr•e, •riilt•11 rlrl•r, AOr-up rrii• 1 1 OATj p MIN 1411q M , ppyTRr p pAAt i1C. 1 MTtr11 ililll.•~ 1 qlN? rra MA rrU1i rw• INi 1 6602 tfiita 7d iltar. 9 1!f01 K St Lucie • r•ni cr1 ?Ir11i M Ir rr1 M wi4 Nli iiiip w Mgiii i ritrr wi ar Iq . rt. rierc© ~ >ti YQS ~ rt. Pierce Dtemorial IIo ital • 3TA 1. r« r1 rui 1MNT MArrlTl, NTrN TA~AMEO, Ir rrr, r11r rAr~.1 r•ri 1 aM~Iw1 MIbOMl.. 1 mewl ~ Illinois LISA t4~rr~ie~c n. Luxa Rardin " :.~i .io~w.q 1..~, a.1. ; :°1• «.e...a..wr..e. « aNO p wgr~s a .IDUNRtr w~.'0'}..: n 325-2~-5109 Ti• Faxtner Farm' n rT~wrwee-fTAR tdAwr eTT,r, TawN, a wuuoN er. rM ~ 1 wi w Florida Trr.St. Lucid Ft. Piexcc3 w. Z ~ N..?.510 .Jo s vo ; TATI[r-NAfI[ i1~i1 rlirtl 1•M Mp1wA-AIAOTN MAAN iM _ _ rlrMi YM n. I;li Good~,rin ~ I' nn . ~ w?arq AOMESr IMri/ e• a~.r. r0.. trr M qK R•R. T.+ ,k ~ irs. Lures L. C:oodtvin 2510 ,Terse nve. rt. Pi rce Fla.3:3~50 wrT OU11T 1r11r tw1A[0 rr, trlrttr.Owr oit twos[ ru UNT I~Or ML AL AIO kJl N•if1 ' ir. ~ t.~ardiac Arrest with Complete Asystole ter.w~o«~ r uw .rlt....t nii.i a Probable Acute ocardial Infarction it f•~IIM~ i i r11.~ Ni q, o• a • ps.wowl.o Oh - w» ~ Arteriosclerotic Heart Disease t ?An Ofi1lr rgwr:ANT DONOITgw. towbar oarww.r q raw M r« nuln q ~•ru ewir w w•1 . Ir AlApsr r r[s .na IIrNr~i cer- • 1IN ? Iw wwwr.q t~rw cut Me nt ric Insufficienc Iq « I.erNR. w. It•t? iIOM Mwurr OCCwIr[O 1I/ri• w1.a a rurw w. rn 1 a i•~ R rir /i / j TA Tic K tr< 1. Miillrr AT ~MOrt u w.r, 1•uL NMI, IKb•1, WCATION 1 Mrl M a1J. MO., trr a IOw.. M.r / 1•ww wi e• Iq? w.e.,xt. IORr11 ~ NL s ClrTl/ICATIOii- rr1~1 r~ .u• Uerw N .W r~ 1•!1 Yr Illr/Ilw •IM rr 1 M/w rD1 ww rr NI11r OOOIIr~le •1 w .1.0. a • 1 fMriK4rf ~ Owl1 W AY .r.1 ur• NM. IIIrr•1 Tla Nn•w. war a w rgryr.l• ilr . 1 •Mwq wr 8 2 TK $ n1 Tw. T4.1 ! 48~ .ter. q r ~ t CTrTrIGTIdi- uA~irlir r* p.. M ••sr a rr • N >a NrrIM f1•tr. . row ar N•w wr N[ wr 1'.0„py.Ib1.W 1••rw•141 a rr qr. •Ir/O. rf rlgiut•rOr. w w r•rra., nO.11r M~ .IU rpa• a«.r1. a...... q r a...r/ a.,r. Z T 48 P q rTS 8 2? ~ 1 t 48 P IIINp wwr •~MMN a{,Iy 1 Mt,~WI ~ Ahmad Rashid M. Tom. /N'1 l•Y~~/J ~ 2 ~'~d~"~or~fi th Street Suit ' rwAT, CrEANT1pN, rEiiorA? TA1f a OT~ATWtr_i1,liK louT10N a1v o. Ii.1/ nw F I swcw 1 Ti•. Removal Tw?Jrunrtond n T4. ~ t Iwp~lrl, Mt, IiY l TwITrAt IIOMr-N~urE A/q A90rESf 1 HMi1 a •J.1. ro., twr p q~r, p•r, it l 1 r• s. X614 ~ i _ 30 .1'atos Fun~e~ra~. t Ione Gox 777 I~ t . Pierce t: l 33~'~50 - - Turf n uTtwi riorriu Arr. 1970 a ` rlcdi~. Tr t h.nt,y o.nify nta to be . tYUe .nd coact copy of »t. ~ ~ ga~49 Rpfsh.ls Troord on file in tl» St. lucid County t?leslth OepAT~• ! . ot.nf .f foA PiNa, Florida. ~ 1980 .Ax. 21 PM ~ 02 ~ ~ (WamiT?q: Not vTNid unless raised s.al of tl+e St. Luti~ _ . ,1 - County HsaNh DopertTrwm is sffilced.) 'rj•, s ~ • . FIL~~O A~F C 0 ST~OGER POI~RA A. j~~ -r. N. 0. MILLER, M. D. s z~~ ~ ; .f N~ Coumy 'H.aitlT. pffia? i Foal Regist7et CfRCtAT T - RECORO t'ERIffED _ _ ~ f/ J~ G~ ~..a-rC~~/N `f ~i , w. i . po1F, Deputy Loal Reofstrar ~ i ~ ~ . ± _ _ 7_ ~ . ~ _ - i . ~ I/ ~ ~ 1 600K ~5 PAGE ~e~