Loading...
HomeMy WebLinkAbout0447f .wls Ot- :o~~• • teRal ~~c- ~rd •aen ~ro~~r~r r:eeuted ~na .1~1 ~e ~I~e~d .~f Pff- ~an~~t ~~~.. r ~ s . :l~i~l~ ~ft~ P~r- ~~w~~t il~et lwt •t . ~y•.N e.r UD~s~I trtctee ~.~ rii. c. e..- itie~t• ice e~• • ! • ] +Sl~t~~~ ttni• 73 cur• •f- ~r d~at\ r e~for• a-1~t •~~ •pe~t- on •t os~. 11 lt~~• ~e te -• o.p1.a. a ccnr~t~. ~.s.~eu r•..ioas ~TATt sonw~ or H~wtTM CERTIFICATE OF OEATH ~.~ •UR[AU OR VITAL /TATitTt~1~92 g L O S I D A RATt RII.t NO __ e1RTM NO. R[OI/TRAR•~ NO. I~ 1 KACt O~ O[ATN GOD[ NO. 2. YWAL A[NKNt~II-~IrrdM~/ piw.ld.~~ tuiMrN/~~f '' 1 .. ao~,~n St. Lucfe 66-12 •. STATE r1Q~ °-1OU1i1 S t_ ~,~i~. A. CIT~. ?01NN. 01l LDt~TqN t. ~S K~CE Oi O[ATN t. CITI/. TONN. M ~O[ATIOM t. K RESIOENCE tNS10E CITr LIYtT5/ FL. Yierce rESQd -~op ~'t. Pierce R~~ INSiOE p?11 LIYITS~ vcs^ w~ I. 1U~ME Oi I l/ ~Nf iw -wpltl, ~i~e ~E-al ~I4ta~1 ~~ lEN6TM Oi 1. STREET AOOItESS pl A~~M1 1qS-~TA~ OR S~11 M IA IhSTITUTqN }t. Pierce em. Hos~t. i~aX__ ~ -- -- ' ~ ~cs0 Mo 7C~ ) Mnirt o~ fllnt NN/fs Iwit ~. d-i[ KNN DA Ysa Kcuuo a ~~Mw~~~ Emma ~.stella KirR °EATN q ~ ZySb ~ S SE7[ 6 COl01l OR RAtf ~ MNIUIEO ~ NEYEII MARR~EO { QRTC OF ~1II7N ! AGE f/~ ~ar1 li I~OE1 1 tWt I~lOE~l1 MS t.t ea~sa) r..w 1~'emale White ,~oo,rEOp w~~EO Lec. 2Q, 1882 7~ ~ oa. ~ r«.. ~ x«. IM. uSU~I OtCU/ATp~ (Qirr ti~f ~/Nr! bae IOS KIMOOF WSINESSOR N~OtISTf1Y 11 ~IRTNM,ACE (St~ft w~Nel/~ twW/) 12. ttt~l ~ wNT COIMM- Iar6y ~wt y~ejr iw/ h~t. tet~ i/-tt6N1 ~ :ouse~i e liomestic Indiana U.~_ I3. FA7NE11'S NANE 11 MOTMEA'S YAIOEN NAME i~omas South Sarah Ritter IS wAS O[CEASEO E ~ r... ... ~ ..R,...~ YEII IN Y. S. Al1YED FORCESI 16 9pC1Al SECYIIITt NO. 17 IM/M~ANY'S MYIYTYK J~T Yates, ~u «.. «....... ~...../....o.~ : . ~~io I wu-~.. Ft Pierce. ~la_ ? u esuse o: oswTN (rs.ra..t~..e caw. yn tt.r p. c•~. cs-...~ t~-.~ ~KrEnv~ ~cN /A11T 1. DEATN 1MA5 CAUSEO ~T~ IMMEdATE CAYSE (~) Nrterio schlerotic _heart dise~~ __ OKSET AMO DEATN ~ Y~_ __ C~~lif4iu. ~Jpt. OIIE TO l~) e4a~ prt ~ [~ - -- --- - -- - - ------ - ---- - ~ - ~DMt t~K ~~. lf~fli/ Ht Y~~t1- OIIE TO (t)___" lt~N daa laM. -- ------ ~ ~AIIT It Oi~Ell Slf.tifKNff CONOIT1016 COMtM{RMC 10 OG7N RR MOR IKMQp i0 TME 1[~YIIMI OISEASE OOIpi10N 61Y01 M rMi 1(~) 1i. MAS AUTOISY ~ . ~ERiOQMEOT rES ^ MO ~ F~~noe.sv~ ~lG OESCR~~[ IIOM YUYRII OCCUM[6 ~E'~uo wuw~ y~~~.~ h Hrt I r Pot !I yQe~ q.) ACC~D[NT wK~oc NouK~oE ~ v ~ ~ ^ s 20t TwE os I/orr XMt~, D~/. )eo -------- - - -- - - - - - - -- - --- tNJUR~ •. w. c D ~- W ~ IO/ Ip)u~~ O(C4RNlD 20r ItICE lK ~MIVIIY ~~ ~, 4 r~rf M~, mJ ~~T11. TOMN. OII lOCA110M C01lMi• 11ATI MMNI At ~~ MUI MMlll U N~A. NNM/. KItN. ~p~. aN . f/! ) • MJ11K ~7 wURK 21 ! ~r~~ndM fA~ d~c~~~~¢. Sp -~.1=~~----- . to -- -~s.~,~ja~, •nd /wt N~ Aj~ ~li~~ oa ~.JJ~L_1V _ U ~ • ~i j D~~tA oceur~~d ~f ._ .__ ____.. __ _ rn on te~ d~a ~t~t~d ~swr, ~nd to tM 6Nt d m~ 4no~Nd/~. Iro n~ tM uu~a ~t~t«i 1L t10MATYR[ (!M~-t[ ~r !Yk) t~ AODIICSS ~71t. OA?E 51611[O Alva L. Orr. t~l.ll. 616 N, Ith. St.Ft, Pierce ~'~ n 9..~~_Sf, 2L FAe1ll UErAT10r. 2~ OAT[ L3t NAME Oi UMETE~Y OR CR[MATO~Y 23f. lOCA7qM ICYI. fMef. ~r tNUI!/) ISL'~ft 11[ 1 tytC1~/1 ~u~~a~ 9-1?-1956 Hil~lcrest Mem ~ardens ~ . U ~v s . v r ~l~ri~3 j~ iUM[11~t D~11[ OII 5 SIGNATURE AOORESS ~ 1E RECO. ~Y LACi1L IlE i ~T ~• ~EGISC~AS~s 6_ . Joserh 4~ . Yates ~ F t. i i e r `~ _ i n~r~py e~rtfly thfs to bs s iru~ and correct copy ot tne ~u~~~ R~pMtn~s rooord on fil~ in the St. luc~e County Healrh tk~ah m~r~l rl Fort PiKU. Florlds. (W~ml~p~ Not.vslld unlesa r~isscf seal o~ rt,e ;t. luci~ Cpunfy VMlth O~pirtme~-t ~s arf„~e.iJ N. ~. M~~~a, M. o. ~ Cpw~tr Mesltfi Office- 3 l«~I R,sAistrs~ , : ,- , / .~ 6~~~"r ~r 1~~ < c ~' .* 11,~ -•t~' ~- ~ . ~OM~ D~piAy Loal R~o~•t.+~. sso8sz 19E0 OFC I 7 PM ~ 32 F~LEC thC F~ COEDf D St.lUC1E CCUV 1 Y. FL R. ROGER POITRAS CLERK CIQCUIt CIIUR /~ F:Cr,RD ~~ ~~r:: ~,. ~l_ __ - .~ ~ i;'• • , .%~ ~ , ~? ' . ~~"~ ~ -{ f~,e,..r ~~ - • ~i_ p / . . ;_c ~•r : ~~.t%~ ~~ " - T~~;' , . ' , ~ . ... ~ ~ - r „~~?~~;=~~ , B~~K345 P~E ~4s