HomeMy WebLinkAbout0200 SOSS65
CERTIFICATE OF DEATH -
..•I•.+•r tet~..r.t..•.rsrss t.t.t..
FtN N•tyM. FLORIDA tow.tle Ate 666
actat.t-were twt twwe lest u. wnaot.nt/r. w. i
a Iuwr
•l•dl tt•[ ~!c • i' ~i •41-j
j t ~e t ~t•~ w.w[ t wv o•tt w MuN rr.. e... ?..l cover. a a•Ttt
Yoi ran wtits~ "
6602 _ r u r ,a t l•.
ut.. roww t twN Npyl ? a oetee wsntutgN u? •...r .~.e.l a toer' of usr Iw... ~
n~ h lr
s••- erNru.«•. urKewa wlMr cotlwtn t o. Neves wwuo. ui.d., w.wr
vs., rr.....,, vgoteo r 1
seu.l Nreuee r t• ~ It• r
tvttel OeCe•ft0 9
OCnQiNlO tpivtw '•t e1CUt~i _ t ~ ~ / ~ ~ t r~W •/.•d bM ft10 t1< /IM•~3• uaDlate?
nit~M~Ow 4v1 ~
~~IK~ItNrOet l t>L
ets IN -it•Q 1p11Nr1 GtV, ieto Alta Itlttl•et Ila,Oe d: t~
t ~ultie lk ~ l..
1•Ttye-1Mlt! htll rgp:t IAtr IIKf--.NgeN IMY( qtr I IAH
1 f 14
~eW1 ! t4M r L.r Rttp r{ ftq[ 01 / O Sure ty
t, l>. 2 _ ~ l ~tJ
•t etror• .ottteerfl.ar„ etre txer•ton ~ i e r tr•t
Ib,-~~~!`'~ tee ~ Nc t ~
- w•.u•t o:eec~ •vr.•~ u
• Tw b r t•w. M.f W «a...M r. •N >t.. r..... •t wi.+rr• IrsN. r.7 •.++•.Y•r
•1u• •y M • i rw. ~ .[..wN M M w. M W /t••• ••O r M ••m•M NnM.
a swn
s wfuwreD rr.. . r.., tout or a•tN - ~ Dote ~4wo rr.. w,. r.., tou• a oe•IN
IE re. 3 O r
1= ti•r1 p •nlw.wo t..ts~u•w N OtMtf tNMI Qftlhle / Iy r 1'w1 j MOMDIIJCID pnD tr•. Iw, f•1 MDNDII4t0 01.0 /Iw1
L '
Los tta oN aw •t r_
..•.i
.w •oo.lssor an~sle[ uN.s1u,N. rtelut a.s.lwta rr... «s•.•.,
a.~ RI rnwsv, r/SO'~ tc. (,1-S-RI ~onr 1X'rE La= 9StfsZ
ncs~s•s e•te eteuveo a et4tsiw rr.. tr,. r..,
~o~t~ ,w~.,. ~ ~ Novetaber 20, 1979 _ _ _
d.w. - - - - ~ .
.lt•o.W.l t. .rrlWtll was (nr/II o.tr O.• .10f[ I/1 U.1 h/, O4 •.0111 - - - ~t•rvMM.rw•w•«+~..~
~rreWt:e rut w (etE*+ettAtti ~ 1
• ri •2! /A/t:MA CF `~Rrto'ect wlT-r~
ft•t•vG M .
~hv~; OW q W •3 • CONfteut•tC! Oe. 1 irrvN Mw••. Mw. w WO
t
~ ~
Out i0 q ns • tAseeetteNCe 01. ' i wlrva •wi•l w si.b
W ~ ~ ,
irr ot.a s :~anuwt oorolhotb~wsr wlwrr MI LaD r.t r ..tIN~ r •ur M+• t.?•n l M •rl'OIF /slw.1• w•3 fwse HreMtD r0 rtOtOlt
IL~1 f•• r r/ hi•rltlt!lflriA lr r bI
v.Wbt •CC•OlM, I4rU0e v D•r! p fYQeY rr•..I~.I•./ toU• p rrttcr OtfOlee tow INyU OOOMeEO -
wOrK~b rHwOlltWtNle IIIw.??1 _ _ _
V.q.1• •1 wCi.[ IfLNt ra I:Ke O/ wNAv~u h•o. ti+...~..~. ~t...1..NO IwY.D, lOgltN;l1 tlleer Ot ! / O. W UTI d rOMM SVi!
I ors f~2 •t (f1«.I,1
`~°vs~aA n• a/ D.
teareby cartMY this to be a trw and correct copy of ilea Loco.
Repistrsrs record on file in the St. facie County Health OePart"
mart at Fprt Pierce. Florida. .
t 1,....~ t tlnle~s raised seal of the St. lucle
County Health pe~artment is affixed.) r s j R.
- t- . ,
- - • ..w ~ M ~ ~ 3 .
N. D. MILLER, M_ D. ~ -
County Ftealth Officer 6 Loud Reg~strat .
r
Oeti Deputy Local Reoictr,e? ~
.%v i~l-J /
i' C t~l C. \11 .1: i~ \
~LE.tS Lii::.'vi[ L'G:. i
~ ; c; _r _ - - -
I ,
i
i
i
a~x 3~z PEE zoo
_
r~
f;