The URL can be used to link to this page

Home My WebLink About0226S Woulard/02-23~79120 ~' 51()'7Ei0 sa~~ ~r F~orid. CERTIFICATE OF DEATH Ikputment ot Ilealth and Rehat,ilit ~-~~~s F L O A I D A ~*~TE i1LE No ___ V~TA~. STATISI'!CS RCGI~7RAq S NO 1 v~E Ofi PRINT ~OlLE~SEC--+,wl •~•. •+~•~ ~•~~ S!^ o.~~ a oe.rN •••• »~• e.. .e.~. ~E ~MANENT ' _ RUTN _ G. I3ACIi~1AN ~Fema 1 e ~ Au~us[ 18,1977 BLACK INK ~wC[ ~M~~I. M~G~J. ~r~~K-M ~wN~a, AGE -~.f~ u.w. .~.~ 'o..c~~ ~~~r -~ CAIE Of {I~lN ~o..... s.. COUNIt W OEA~M 1~C . N~tW ~ ~~~we~. . ~e~~~~ ~O1 W~~ rOUH .r ~~~~ ~ ~ ~ White ,~ 74 ,~ I ,, ~ ~ June 19, 1903,~ Broward (/'~! n Cm, 1QWN, Ot IOCAIION Q~ ~(AIN ~titW C~ a~~~f NOSh/Al O~ OTNE~ NSIITUTIQN-N4M~ ~u yp~ ~r I~M~, 4~~ 1~q11 ~M wyr~1~ ~ 1 C~1 • ~M(M1 ~~f M MO ~ Ft. Lauderdale ,, Yes ,~ Holy Cross fiospital ~ S1~1E W~NM ~ n ro~ ~« ~r f~. r~~~ c~ntEN Or ww-t COUr+ler MA~RIEO. -$vt! M~~~~ED. S1/~vrvs~K, S~'OVSE ~•~ +~~n. o•~~ .uw~r ~uw ~ ~ cawn• ~ wi00wE0. OrvOt~lO ~ sncr. ~ ~'.~~~,..~. , Pennsylvania ~ ~. S. A. N ~ „ ;. , -~„~ ~~«.w. --_2.~~~ied-- - 4lotaard J Bachman--- - .~o ~ a•w. SOCi~I SttVi~fr ~+Ur~~t~ USU~I OCCY-it~O-~ ~u.~ a.~ o~ ~.wa w~.~ ~wwa ..os~ w [w0 01 WSwt15 W~-+OUSt~~ oc:,,u~o ~.. ~p~wG uq. f•Iw r ~P~tle~ ~5.,~~.,~... ~n. ~~ 178-18-5569 ,y Operator „~ Telephone ~lt~DIwC1 ~~qN .o~~s~,o. ttS~OE-+CE-S-~rt COUNir C11Y. tOWN, W IOC~t1pN •»i~m i~~ ~~.~n STtE[t IWO NUM{(f ' ~ ~f~K•~• •~~ M u0~ ~a Florida ~q Broward ,,, Pompano Beach ,~.~ 1'es ,w 130 Cypress Club Dr. 30 i~IM[!-N~M[ na~ rbou ~~ft ~+O1M[~-wurp(H N~r~E nq~ r.~1 ul~ „ Nerman Gustas~n ,. Luc ie l.'ells INlpWANt-Nrw[ ru~wG wOprESi ~+~no o~ ~. o~.o. u•• w w~+. s,.n. iw ,,, Ilerman W. Bachman ,n 130 Cypress Club Dr. ~305 Pompano Beacli F1 33~~ ~-~~ 1 DEwM W~S C~UStO ~Y ~[NIIf OfN~ ONII CAUS[ Mf tMl~ !W fo~ 1-1. ~-~0 1[-~ ~•rr~o~~.u~~ .».~~~• Nr~11r OwNt ~N N• u 1rW0~ w (~Yf~ • . , ,•~ ~ - r ~~.~ C~-~ ~~ c{1c~~ ; - Ut-~~ .~,~z~~ .a, . . : . or .. 1 ,) • ~ COM~IIIOM~. ~~ .~._ , ..- ~~.~ r .~,~. ~.., .,,, ro~.~ .~ rz l~ r- ~l-(,~~, t ~-~c.- /~ ~~2 ; uW~u~~ (~Yf~ q/, M p. O~ ~! ~ COMf~OVf~K~ d. p~t/N6 t~~ YrN! ~ ~•~..~ c,va ~.u ~q ,f.. t ' ~ ~ t L ~ ~ L L`~ L 1 Y ~ (. ~•i. ~ ~ ~i ~ _ _ ~Ali • OiMEt SKLr+YKw-~T CONWt~Or+S ca+~wwn cawwM..a w«.~. ~u~ .a~ wu,~~ .o c.vu c~a. .. ..n ~~~~ ~UfO~Sr q•Eg.~~~~ ~~..~~»cs c~ ~.~s o~ •o~ ~ 40~tl0 i» M~Qr~r~rG (~~ w e~.~r , ~~ No ~w p•~e-~~ 1 ~CCqtiaT. SUK~DE Of IDAIE rM RiIURY ~.O~M, M~. q~u -10UR MOW IN1U~t OCCUR~fO ~ Iw4~ r•rvH O~ ~rwn w r•n ~ O~ r•~~ M, w~r ~~~ IIpM~Gp1; Ol ylDI1lUMIN[p rn ~~M ~lw 7a M ~Y N IlUURY AT M~'J~IC -IACI O~ IN1U~r ~~ wOM. ~~~~. f~N~t. ~KWn. 1 ~ ~nc~n ~s o~ ..o~ OhK~ M~G . ~K ~ inca. ~ tOC~OON . ~~n~~ o~ ~ . • »o . un o~ ~o.... s..n ~ a ~!M 7M ~1 .--~ O~ CEtlqKnt~ON- ~o..~w eu •i.. I .orw. ~.. .e.^ .•w ~.s• s.~. .~;.~~ .u.~ a+ ~ so!ow ~o~ .~~~ ..~ oe~rM oteuuto .. ...~ •un_ w •.. IN~fKUw: ~T~ ..o..•. o.. .~.~ ~oe. ...~~ w.•. ~ou~• o.q. ~~o. ro +r u ~) l ~j' J A O~ r~ ~rp.UpW [ ~ .~~..o~s ~..~ ' ' L ~ ~ --1 \--, 8 I8 77 ~ li ' ~ f• ' ~ t '~ ~`L[/.t ,1~~` 1 9 : ~~P 11~ eu~.ve no+ )1~ t. I 4 r~ ~o ~.t ewse~s~ f~••~ CE~tY~Cwtp-i-M[OKwt EawirwE~ Of CO~Ot+E^ a+ ..~ ~.sn a~ .n.. - w a.w~ ~•~ oec~o~..~ ..~ .w.p,..uo o~.e ~_ ~ eu.n..+.o.. a nr wo. .»oio~ rr~ ....~s~~e.~b... ~.. .. w...o». I ~o.+~. e.. .~.~ .w• e~.~. uewhe w w.e o.n uw oue ro.~w e.~u~s~ s.~no // ~H ~µ ~ ~ CEebhtf--~~u+E ~nn o~ .i,..,~ S ~~ ~7 qr ~ o~ ~~TE S~G~+[O ~~o~+TM. o.., .ui L ~H J. G. KI;rIP~ ri.D ~~' ~. J`, .CC~I, -=~' `.'~ti-~• ~:~J•ZZ '~ ru~lwG wOO~ESS-CE~b~rt~ ~•n~• w ~ •p ~o r - <.n o~ •n~ l. s.•~~ ` i • ,,, 1930 P:. E. 7th St., Fort 1.:2uc3erdale Florida 33308 ~ ~~UR~AI. C~fMAtq-~. REMO~~I CEw~EiE~r OR C~E~IOtr--~E tOC~nOa r~ o~ ro~.. r.n ~ s.~ca. ~ i/ ~~~r~ ~a Removal_ ~.. Arlington _ ,~, _ Lansdo~me Pennsylvania j OwiE ~r0~•~, O~t, q.~• fUNE~A~ MOME-NAM( ~rrp aDWtSS s~n~~ c~ ~. e»c <~• o~ •o~~ n.n, n. ~ Au ust 22 19.7Z__ ~_ T r ` i V S- ~512 f~1+[~M iRFC70~- S,'+~~U ttG~ t - S~Gr r '~u~- o.:~ •~u~~~o ~. ~oc.~ ~tanu~e R~~. ~ne ~~ ~ Qi!/~ ~a ,~l~U ~~~c~(..ct-~ R~.,j ~t r~.P-~ August 22, 1977 i , ~,, . , ~; ;~`~ ;t. .. ..~: :.~, ° ;. ~~ ~ =;.: ~ = :-~W,arc~i~-N$t val:id unless' raised seal ,. .. ~ • =: ;~;t:~ ~ ': ~o~c ~s ~ ~34 9.R_77 ~ •~.'~ ~07iC~D !-? iHE OFi{:;;.qY ~rt,~• ~ ~ ~"1 r=» J L ,,'f; Y. "•_ ~'i;,~ _ ~- x ~~s•ra~ CERTIFIED COPY GDu~trr ~:,wh„-,~~~ '- •y, 7.Y ~,, , ~ , . ~. .. ~~ ~ I:~t~reby,:Cer~i~fy; the above to be a true and correct copy of the Local Registrar's :.s '~~'r.,is ' . .recor ~ o i~~e.~i,d, the Broward County Health Department at Fort Lauderdale, Florida. ~- . F~~EO k-~c Fcco~rc S ROGER POITRAS~ CIERK CIRCU~i C`U~ /~ REtr;ah v~F:".' - - ~~ r 510'760 of the Broward County Health Dept. is affixed.) ~-- ~- '_' ~ County Health Offic~r and Local Registrar ~ ~.~GGt~J /~ Deputy Lo al Registrar - B~i~ P1t~ ~ r~ rn-.- ~-.• , ~~ U~ CL7 ; ~ ~ rn ~ ~ .5_~ ~ . ~ '.