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HomeMy WebLinkAbout1477 i t r ' t'""'""'~' ~ CERTIFICATE OF DEATH - - t?n.•1•••f d N..M.........Ilp.«.. s...rl.. urea .r..,a1c. FLORIDA toc.t nu Mo. ~ r 1•., r ~r rr:pt DECtptMf--?IAYt htSt r1100tt 1•St Sl[ pAtf Ot W •:w; v., r... 1 • • .r.tr'ultwt_ _ I lda _ _ _ _ no_tenb~r , Fer.>•~l.c , /1ri~?.~?,1n7~ - _ - • G------ - - tl•C[ 1M[ f•(!-~~. MNY. .4d1 •G[ /t ,b•..d., tYfDt. 1 tllAt WOIf 1 Wv OAtt Ot V.Iw IY+, p.f. 1.1 rOOrltr Cf Ot•tw Awa Wo+..•a lI• rOy-~- A~~ `MOMS t MuR tthite 1. ?7 t. r sf. ~ .April 15,1~p Bro:~rard _ _ _I~ - L---~- I- fni.10"1•~d t•..-~~ny or OtA/M wOYlf•ld Ot1lf It4U _r - - - - - - . • ~ ~ tyt104 M. /r/ ••r n ...a.• r r•r -1 ^1 [f y [ [ . _ t , „ Ia~tdordale bakes F11. Medical Center fin::' F,i ^r.t itAli Or M1If1Ir/w w p11fW d tNM1f [011Mt.t •rApIEO, NtvN YANrtO. tllfvtvrgG sr011t1 IM N•. l+. .•tIr ~ - Af~. YN w1oow~ rK?r~_~~ _ - F at :,s•ol..ct . England", , USA ,D_ Nl~do~`ec~s t1 - cur 7ta•sto - f•1 ~r~p D[•1M iOdAt tECl1?rit MIM.t? IrilYl OCQwAtIOy fcw. h.? M.-t l... r...., an,p d WStr•!ss 0! 1rrDVSrtr py1•, .rl.v 4r. w.. .[fi..Il 1'~:urION, GV! j . E.K, K,oa 1?. 037-18-3685 D IIOUS@Hl ~e O~m Bone _ ~~u~iS10M. /ttrOtNC?..irA1t - - Down an. faw« d loufa« t?l[t A.,~ rA,Yttt cr e.r. ete• is Florida Bro•/tard I~?ttderdale Itzl-et; 3~so1 IJ! 47 Ave. :'`~1 ,,.«lties-•.. ~ rAlwtl-flue star lfrf)Ott us1 alonnf-.ar.laM wee nn• Yroou I~u ?:orris Sch:~nrt~ Itinnie '.:cr;-s i~ •~~1--r1ANt /?y. I+•11 VulNtr3 ApOfl$ - Slrllt Oe t f D qp Can Of tQwN St.•l ]~f Nifa1 _ 1•a Phy11i:= Y.ersler t„ 155.0 I.'tk~ Tree Drive Ft. Lnu•Ierdale, 1a. ??3?~ N"~,!- v[ut.CttY•TNVf •twrt•l•OtMlt l!!•rM// r!lalltttd CftM.1Mr_tf•yt lOU••O•f Clio Oi lOraY S•••f ~r• ~ Rrtri^1 _ e'•erv ,t[Op~ hocks, Florid[-;i t~.rE.. - 1 _ r gr~rf., Kyrl r r._-~ . -k.~ ~ ~1f: t = ;eno••.~h Ct:arel^ (P,nn Q^1;i ~-i.? I'!-. ~il~r.•~unrisc 1M~r.• 1..•. _ ? .,.w. . ~ ~ " /1 Tt..0.+..~[. s•.w.~.ws^.•.f~r ...e[•ya..e,. ..-~e.-.~:•.aa f y ,IV/~ ~ r Y...: •M M +v ••-•f. M•r .M I'Xr OM 4.f b 'N [•s.[H.1 [^.Y~ l.awr.»... r.r.r J S t /a....• . r.ar ~ i wet steaeo rr., or ~ o•tt s1c.,ta r11... fA..i.., .rvp a tx.*M - - r _ 7w AUf;il.3t 23, ~9~1 771 ~ i 5 y V ~ 71? 71[ Y NAME Or AlfttprrG rMttKrAM lr 0111[! IINN ttttlfltt /I/M -,[rr? j S MOhOVaCEO W •O [Y•, M. 1• / »pn,y.;.,tClO W b /M.[..,~ ° ~ ?S 7/! O•: 7tr •1 V wntt •w.oatssos eEaufref lfMrsrclA.,. wr>ru? ec.rwea nf/.-.•.~Y/ t 77 Donald Plc )4D 410'1 S. Iiosnital Drive Plantatior. I.1~rid:' ~`z ffGl3tf•l ~ ~ (•a f[ eKE1vFD 1• alGtVr•. rye, .7... 1• t - ) r~ ~ ` / 1 ~ c•vt 7! WMFMAf[ CI4At Ir..71J o•tr e.~t cfnsr rrlt cu[ roe r. r. /s/. ~.o n11 1'•+.•.['?.•,........•.,.. ~ : , ~r ?uf M i ; rM 1 Sensis/ Renal Failuref Cardiac Arrest i~-__ - 1.Iyc out w. d ~s w corfuoulr/ct or. .••.•..1 M-...., 1 r 1AS1 f ILE•0 ~H[ kc- 1 CCFOEO 11, Perforated diverticulitis w/ S~~UC~I,E C0;1yTY.f! A ~ - a!t ro, c. us • co.atn,tMct of. - k f~tT1LR5 _ _ 'Bladder Fistula r 1 ~?Yf Oi111? slGrwfl(/1M1 CONOI110M~-(ry~•n sf+iu•~ D..[ w.[ •iYN ti [s.r rww w ?.tl 1 bl •U: tt /Cr.nTi~ . f ~ : e a: r _ - r: ~i..a . M n I.1~ [ ar/ ~•Yt•[;a l ~I[r: r l •.7 t( 111 ~ ~t+a. V•MaMtl ACC10E•f7 L1KtGE - OA[t Of walUl• /Y•., l..• I..) rrp{I! O/ rraltl?r Cl Xfrb/ 110W trtw•!r OCCNrEO ~ ~r ~ KIOt: Y IIOEI~f\-W-[I^t0-/SI[e.I,l 771`---` ~7h ~77! _ _ / I4Mt' At 1K1I[ /!I•••/I 1•. !.I.Ct C•f IvAM`/-.[ 1r••.. 1r~. ?'M•. t.tti•P..M<? br•!M•y. lO~~tlOra S[f1Et M f i O_N. ~•f. M •n.v~ a r - t i • i Its. - M•/ /S,•[~!I! • C'MS Jf. 7/l ~'t'~.~71 ~ _ ,~J _ _ _ ~ ~.y ~ r ,.r. ,ire+; ° •`-^a J/ r`^ i~ I: ~ n.~! ..,`^1.,,'w i ' ; .rte- `r•,", ~.t.`!. • .~a`~ ~ - . - ~ - CERTIFIED COPY o,~ I hereby.,certif~?~ r~ :`be a true and correct copy of the Local Registrar's record on file; ~-.Br ~ County Neal tlr Department at Fort Lauderdale, Florida. (Warning-Not~'v ~ j • ~ul•ese?,'~f~tsed seal of the Broward County Health Dept. is affixed.) a~~1~- - ' ~ r Coun health Of'' ices and Local Registrar 12-26-79 ItK E _ Q~NG~~?~'L~ ~ . Btl01f JJ~7 PAG t'.. = f Ir putt' Local Regis ar ~ -