HomeMy WebLinkAbout0186 4968'72 ~
CERTIFICATE OF DEI~TH •
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IY~lW R1 t! IY.\1111 FLORIDA
tra[, Ot rtlNt IN ""'t t?wau Rf01lTRAR! NO. 196
?ftMANINT INK OECEASEO-NAME 'raa• r.ftre a.tt SEtt DATE d CE ATN 'rorar, a, r1a¦ r '
SEE tAtll00l EM
rs[wEtlEaws , p~ WITHER LAW , Male , March 31, 1976
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lK . tNN• r Ftawf.a . Iutr rpf j Mq wOlrp rfa al.t ~
6602 ~ » 6~ » [Jan. 27, 1913 Saint Lucie
~C~l Atl A •wa+N t'n .rnf MpSMIAI OR Oll[[t NSTI .w ..w 'r Iuw1.. OM atMt1 u~ wrWta.
Metro of W w0
n Fort Pierre Yes N Fort Pierre M~noria_ 1 Kospital ,
• S1ATE d WM rr woo w Irf • .rut GTIEEN d W?rAt COU+Itr ttAtMEO. N[aRR etARMED. SutvlrtNG SIOUSE rr .+re• OM weir ruN r
cpwran a trY,Oar~Q~ OIrOIICEQ r tNtn r
~au.a..,.lrtt / Florida . USA a MarrleQ ~_-_-Allie LaVOn McDaniel
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".w r N.r SpC1Al SECillbit' NUMiEi YSUAt OCCtNAftOtt ,one ae,e a• arw.-~o>,t ew'ro rosa
of Tewp d MKY+ESS Ot wOUSIRr
occottee N aaOYfuO aw, btr r amu r
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wit [E 261-16-5575 If Gaxdener 1,. Agriculture
•a.ralrow. ~ tEStDENCE-SEA/E COUNTY CITr, town, Ot LOCATION .n'N cn ?rm StREET AND NWteER
lorida Saint Lucie Ilr Fbrt 'Pierce IIaNtN.~w •'o Rt ~4, Box 189-0 '
EATMEt-NAME aratr rMN1 up MOtNEt-tfAOEN NAME arty rROll ufr
If Era Law 11 NLL
INtayAANT-NAME MAItNG ADDtEiS rtaafta p •.te. b • to W qrw, fa.at, two
IE. 'e wn Law Rt 14 Box 189-C Ft. Pier~oe, Fl 33450
TART OEA1M WAS CAUSED ar: (ENTEt ONtr ONE G?VSE Kt left EO! NE. AND tap M?wUw OrNa a i w.aw
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~Of - Ei 71r M. 70
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CEttYIUTION- .war tfa aeu .a.ar wa alu t•r raa y wlrN aar.t ow , e'f er •roa fwr awe OtwM OCCaINEe ae a.t race. a f.e
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~ i:E~titli'w!10i1_M[DICAI aAMI?tEt C t a ae ua•t a nw woof tr N•M 1 r+t NceNra w.t •aowwreeo Nu
ea.•.-•a'or W .r1 t0e. •M/Of M 'w.paryarq•., rr N Otrr'O•', wOMw Ma •laf wOYt
N•ar ottptN b• oat pre ar» M a0 ar Ut4Har PaNO 1 "
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CERiNIEt-NAME r.:.t~w .win - ~ SIt3NA UtE - ~ wet a ~w.t t , w ~SICsj1ED rro,'w.. u~•..w.
_~Yid M_._Blee~h,M.D_ < < L?\(l:r_ ~~L L{r1LU~
MAtMG S CEt[EItR arYlr a ro c, W rp..r T' u•h . e'.
rH ~ Vlr inia Ave. Ft. Pierce F1, 33450
tUtlAl, E,tEAtA/rON, REMOYAI CEerETfta Ot CR[etAtptr-NAM[ ~tOCAT10N c'.. a ao... sun
. ancn r
,y Burial Ft. Pierce Ce~tetery ~ Ft. Pierce, Florida
DATE ap•,M Na..a •a. • IUNERAt NOME-NAM[ tflp UOt SS • orator _L_
w April 2, 197.6 t,,, Yates Funeral F~ocre, Box 777, "Ft «Pireroe;r~~'1 33450
v• S. t611 iVNERAI -S~aAIU REGiSTRA Syr
~AIWf OAat NCU•to to ItKtl ftGUrtAt .
pR~. zv~o Jr~. Y~ajtc. 7a. ~.r'ccc•..l N+ A ri 1 5 1976
" 4868'72 .
t iTREnwy~ oettify nib to 0o a trw and correct cagy of ttw 1,ocAe
Rvpistrers record on file in the St, facie Caunry Health DcI{len• iAen 20 ~ ~ ~Z
rrlent Fort Pierce, Plolids. iiGE+ _
(1Narniny: Not va+id canters raistni tHTal of rho St. Ltxip r RNC FEC~FOCO "
County Heatth pepartment is efFiKExi.) FIL-~ f Y.FI A. -
S R~ER
POITRnS
" CLtRK.CIRCrn1 COURT ~I - • .
N. D. MIiIER, M. D. ~ _ e.
Gaunty IM Officar b I,ac+ll Rtiisitar RLC~^O `:rklF~'t'r - v~- ,
Delta DopEEty. Local Reoistrsr •~t'
• t.
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6f~lKchi~ PdGE ~W
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