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CERTIRICATE OF DEATH
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L ADOLF ~ Mi TWARDOWSKI Male October 18 1975
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' I hereby certify this to be a true and correct
copy of the Local P.egistrar's record on file in
~ ~ Flori~ain County Health Department in Stuart,
• ~ ~ ,(Karning: Not valid unless raised seal of the
' =f ;~1r ~ ~ Hardn Gnu~t_y Baallh AzP~!r~e~~ is aff1~~>~~
t_ ~ ~ . ; ~ - Archie MkCall aster, M.D.
~ ~ - County Health Ofticer 3 Local Registrar
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q~0 SEP -9 1U1;~ 31 .
~ Free one Ffeonnt o
- S•. UC(E COUJV f Y. i t A.
CLERKG Cl~n"CU T
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PLEASE ~2ETURN TO:
C. R. SHAMEL, JR.
Attorney at Law
212 North Federal Highway -
( Deerfield Beach. Florida 33441 -
a~338 P~ 45i
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