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Home My WebLink About1809i ~ ~ Ii~l / Ol:IC1A!-~-A~W I~tl~ Y':O [ 1• f OIN~\t ~ a Y:• .:• W GI~~r~i/~.A../• 1 ...r:..~ ~• 511:~tLeth :__ _ 9 _ Co::~~:r,s .. _ ? Female _ _ Sep~.~.197~- ~•~~~ ~K~~~.M~~ ~F~ `•:1 w•~•~.~r~ a~i1~1 •1~~ .I<'1~ 1 G~• ~-'fC~~• ~r~.A~.f.• /,.hitQ•j•~'M a•+ ~~ ~a ~ NI~w~ ' r., , - r..a l D-•1 ~iW ~ •~t • wt-it~--- ---" - ~4 - - -" ~ - - ~ -` - ~ -- - ' AF ~' • 13,1905 __ • . _ '~lk.- - ---- - )~ ~ ~ 4t~. 10irq Or ~OUI~ CV :.t~'w ~.~.I+r•~ tl~:,'M~ .VhR~r.+-~.w ~~ .r r...~... ~ «r . . ~/...w.l r ~ wrt Y .•.St ~~..~.••• J'~ ` ,o~ ...~ i.. , r.•.. . ~~.. "_~~~=_~~v~L~ _ _ 1~'~r.ter Hay4n Nc ;;,~t..>I =' E.:.cx. R~. ~ si.tea~.n.~.r.~.. u•.:n.~~...,~r,~..,.. ~~....~~.~.~.v..l~ ~.. • .~.~.a.,~..,.,.~-....., C/I.w••+wi `w.af.7C...a1C ~~~•. ' , • ~.:~~. ;y~ ' I12iL`ois '_ L.~ ~A. ~' M~:i~z'1:•; ~ :.~~ J GG::~en: - -- ~.~ ~~Lt.rr YqV.lllA~!~v.r~ll ., i.N~' i..~..W...~... ..~ ~ .~O`~: ~ i~~~~' - • .q.l~... ~ _ ~.... ., . . . . .... . ...~~ n~i• •~r~+, r ry~ L )' p ' :c...i~•aii~ e~u~ ~?_ 4~L2. ~2 _ 2?YJ- - . ~ vECZL'}..~~~}' ~A Jal~Ct~. IjI:~C1 ~ -- - ~ ~tLL~f.el~te.tf ~ •:V.'. • v~ a .~r_.re.~. t•a t~ .... ..W~~ . tr ~ •. ,~r :1 ~ .~...•. t« ~tFlorida ~,o St. I::ciE ~ _ f~ort °icrue ; ., l,-13 ~Y:ippc-;: ~i ll Cir. ~... !es ,.,w._...,.~ „n~ ~ x.,- ..s ~~ _.. ... . ..., ..~~ „ - . ,.~~ „ Art,i:lr hsQ-.~ll ~, Mar}• Po~d N(Ir.~.i -A.-~~ I).~. v • • r~. .•!. ••.il11 .., ~• ~ ~ • ti~ . ~ ~ . . . 1'~•! l•- ,ti Leo J. Co~~ens ., A-i3 ur1~:l~ooz-xf:l Circle~Fo~ F•.•.rcc.FloricL~ 33~-[e •.f.i ert..4el..u.v.~: e-~ai..,...•.. :e.~ ~~.;,~~~~... w. ....~ ,~~~•:.. t•.L. ,.wr. s•.•. ~.. Removal ,e All Souls Ce:*~et cry ~. Ct~:rdo:~, Ohl~ ~ --- - --- - - - - - •Jff~~O'~~_•~--. ti~I~~ K~r~ ~7 b-Ol State Rck~ci ._ ~•• ~ -~~ ~'rell ~.~c••.:l ~:-~, e Poz't R1~!ieylFlo?-1c3s 3~5~;} a~r T r , ~~ . .... i ..~.. •~. ~..,- ,....~ .. ~. ~ .. . ..~...r.w...•«..w. -....~.•H -~.s~.-+~- •r.~ ~.r w ~ w. . .w r ^ ~.~ ~«s r ~. .~• . • MO - •~ _ Jw ~ N ~wM'. •-'~+f i~ /f..y....II-- ~ _ • ~~ c-c~C~ ~I~ ss •-r.._It..Y ~ ., .... :.~h ~-..ae .r. e... ~ ~~a~4 .i ie. . ~ .•e : ~.r ,~. ..• i • ~ ._, . I i ~tf ~. Q- ~ 79 T/~ •~~ ~-~~~ _., ~. ~ ~ ~ - - . .., - ... ' _ .. _. . ,. .. .. . .. .. _ ~ w..~ • r.t v,. . -~~ •rti t~• , n r.~. ~ j• . e. •e r. ~a n• ~ .7 . , l.., . ~ ....~. ~~.••.:•_•~~.•.,...._. • .~ . ,....•.•.. ~.,. ,_ ~ > >J .~Q~~_~ ~. ~A/LiCf/~L _~`-7~'--- ~-/~:~•t!-c'/_' ~f/iv:',,.~ ,'jt•;~r;•;J~c_. f,~ 33f~~ n~ ... i r- ,-•~. ..~.. ... ~. s. . ~Y~.. . ~^ „ . .,... ..~~ ~ 1 ~..r:~, ~ ~-`~;~ i ., ~•~ ~~ . 'v', ~, ~`~'~~f ~ .. ~ . .r~l~ ~r~ ~~.lS! ~~ ~ .1 .. . •f~ :. . r ~i ~. • . . w -.r- w~ :~s .. , y. . .... .~~ ~u~ r.~ , • . , . ~ Cf~l~D~:; f ~•1..•~or~~~' •l ~ /~~f ~~ ; ~ •~ I\.~.M v_t " CV ~~.lti1y .•If .' j ~ .. . _.... _r ~o+~ :.! V1! , . U ~O~.SiB•.~ ,%'c~iic~rp f~1SJ~,+r.~a~ ~~rf'~-` ~~v~~~•~~s~>- : -- - . -. ..- ....~ ,... .~. ~ , ty,~ ~o o~ ~s • ire: w.~~• i , • . ~ . • r~rt . ~~, . .. .~• .. _ . . . . . . . -. . ~ .. -. . .~ . , .., , t- • ' ' . ..4 ' .r:.. .. ~ • • .~. . ~. ~ •' - - • .. _•. . ~ , ...~ . . .~. ~ .. . i~~:~ 1:• ~/~~ _ c~. •:. ^~•.• a. ti ~. •. . ~• ~. w ..i: ` .c. . ~ .~ .~f.t•~~r .:~.. ~ i - - ~' ~ ~ ' ~ ' . . - , '....._... .. .. ~ , . . . .. ._ . ~ . . . . . _ .. .~,~ -... , . . - ,-.,, . _,.. .. .. , . . , : r: ~ ~ ; : ~. ,._ .:.., -,~~~ ---------=- ----- S1524~ ~.~... ~.... 0 ~ d w.r~ ../ ~~.f ' , w~~l ~~~~SI~K• POLK COUNTY HEAITH ~EPARTMENT / William F. Hill, Jr.~ M.O.(Directorj t.~ r • ~; ry CERTif ICATE OF DEATH ""' "" "° ~ ~. ~ r, iIORtDA :a,,.:~~,,,, Il.... 1 hereby certify the abave to be a true and cor~ect copy of the Locai Re ~J~ tr r's reco~d on f i le in the off ice of the OIVISION OF VITAL STATISTICS. at the POIK CO~NlT~#IE~TF~ ~ UEPARTMENT~ wINTER NAVEN, fLORIDA. ~~bt~F ~~,,,~9p~ ~ 3~ . , St. (Ur.~£ ~~~~ ~~+~aF~ • ~ Rp UY t . ~. ~- ~ ~~ ~ Counity Healtfi~~~~~`1t~t aplf_l.otai Registrar ~ .-;;r~F~H~R~~'c ~s~ ./.. ,-r=l: ~,j~ :t~iw~ ''7:'-..` {~ , l ~ _.~ :: ?:.~ ~~ 1 17i, i {i :~ ,.. _ : ; '`;~ f; E~.' '.,"~_• 4,~ ~r i ~i' 1' / ~, 5 ''r#O -- - UA~TS~UED - i~ ~+'.'~ ~ ~• ~~'. ~:,; CN I EF OEPUT EG I S~TRAR . Q, , ,. .lj~~r+f~t -~ ,~~t~w WARNING: NOT VALIO'UNLESS RAISED~~. 'fT"x~"~*~.~Q.tVIS10N 4f VITAL STATISTICS POLK ~. `~c.-~ ~•: . COUNTY HEALTN DEPARTMENT 1'9'dCf~~~~b: - . ~~~347 p~~1803 ~.~.=.~. L ~ X -~ __ ~ o ~. ~~~~~- ~~- __ ~~~. ~~~.~__ . .t,_~~~-~.