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CERTIFICATE OF DEATH
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Thomas Irving Small ,Male , Oct.1 1980
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6602 _ l t F .Oct. 26, 1927 St. Lucie
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Fort Pierce Lawnwood Medical Center ~ rs00A
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1Au.t.FL01•<[F • Florida USA tt Married Nina Sa
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t.. Florida . St. Lucie Fort Pierce 4525 S.Ind.Riv.Dr. o
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Harry I. Small Evelyn Grogan
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tr. Nina S. Small - 4525 So. Indian River Dr. ,Fort Pierce,Fl 33450
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Burial t. White City Cemetery to Fort Pierce, Florida
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„ Leonard Walker, M.D., 1700 So. 23rd Street, Fort.Pierce,Fl 33450
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a~~~ October 16, 1980
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~ , Hereby certify this to he a tt'W and QOfT'Kf ~pY ~ the Lout SLlUC1E (CLY.'t.fl~.
~ P.~GER P~tTRAS
Registrar's record on file in the St, facie County Health DepaA• CLEitK CI~U~:.:;G 'nyJ
~ spent ea cc•t Pierce. Florida. : c : _ : ~ - - - '
(Yttarrting: Slot vapid unless raised seal of the St. Lucie
County wealth Department is affixed) 5Uq/~~ -y~.Y
N. D. MtIIER• M. 'D. ~ , .
Couroy Health Officer 6 tool Rta9btrN
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Deputy lout Reoistrar `'-..1~~
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