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HomeMy WebLinkAbout1106 '~...~"•. - --• • -- - --- ___. . .,~, . 5z1681 ~ s"''•'"""' CERTIFICATE OF DEATH "•,' -"' "° -- - -- - - - ------ - a~.~~....r .1 N.dM awd ~de-~BwM.~ S~nk•. ..,..~ ....,,..~. F i o a i o A IQ:~I ~II! NO . M(~.1~+!'-rUM! /i~St M'YI! • i r l~.. St. . 'f~..~.~. . . ~. ~ ~~, ~ 1~G>;IC D'lIC:: : u ~79 ]tU : F•~,.~ ~ I,.7 ly 13, 1 -- - -- -- -- ..._ •.. ..~ ;;_ -- - - _ . . [~ p_ww,. S~-. [ ~v f..r,yor VCft ~•N~ ~r+tll~ i 0~~ an ..r p~~w..r.. n.., t• ~ ..~;..t• ~~ ~o.•.~ +-:.~,.~.-.,.r..,~.i ~r..~ yOS I~ r..S f :.-_,~t 1 6~.n ~r . . 'a?~ite se ?O ~ ~. --~ ---L`----~-- ~ Anr 15~1c~~ •~ [~roward ~ 1 C'tr. ~^wr~ Ct tf<~•~~r.; Ot O[a.w ~,~~. . 7: l;n.[a r S'r~l+~n.:- • ,-~ ~h ... ~.. . . r.. • ..~ •.I..-~..~ . ._ _ _ . _ . . . , ,~~Y M ~r.S' ~ - f ~ . M• ` • . .. . .. ~.... ~~. ~-r .-. ~ar. ,,, ~.r , ~_Lauderdale Lakes -- 5103 N. W. 35th Street ~, '.! F ~ ~~n _i: - i . .S . :1 ~ . . . . I.OTN!t/S/.sJ/i -:4[~tir ^ •i[V~•.^D• au. • •. j •a . . _ . . , .,r, , ;~ .-a., ~., Removal „~Roxbury Lod~*e Cemet~ry ~~ W. Roxburv 1+.assacHuset+ - - - ------- . ~ -- -- _ _ --- - - - _ -- - - --- --- - ---- R.•:[~~t p~ 1C*M-~Syvs.~l ^.raai ~r~rt _ . - _ '~' ~.'ft~-k',~ ~/- •~ ~,i ,:,,t:enorah Char.els r?;17 '1. Q,~:.:lnnc~ Fk Lt1v:? ~•~nri se ~ ?'~~ o'e r... ,~ ~,rf '•~w. d.~.~ xc,,.•«f e• .v ..... s.-. •f ~ .-.1.~ h w,e - f ' ~b~Yl ..M ~ ~ - ~ ~+ 1•,• ~• r-.. • }/~-. ~.• ~.v! w . ~-~.v1~~ s 'e1'.~ ` sr.,r..- ~ ~ . .~, ` ', r' . ._,~... ~_ ,<.. .....,, n~/ La~C _ ' `-J'n. ~_ .f`:,/~ Iat i~ ~ na•F •.~~~.fD /v.. M..-~., ~ ---- ~~ oi c[,:y ~--- -- . . . . - ~ ~ ~L.•. •. -: ~- , w. n.., • C ~~a r .. ~ . . ` r -~~- ~~O E ~ _ 1... ~ • ~~ 4 i_ - - - -- - -- - - - -- - r- _ _ " ~ s = S July 1G,1979 7,. * _6 : OQ p " - ~ I[ f~f ITTE•~irr ~V15:[~~N 11 0~4F~ tM~N C!~'11:[~ Ii.)... ~. ~.. • 7 .. ' "~ ~.. 1 -.. __ ... lSllOUI~ 4. . _. •1~~.. . .. ''LZ..~"'. . , V _ . . ` ~ . ~ , ., . . ' - - - - - 7~+ ., July I5,1979 •~ 11:23 a ° .~v~ n .. . ~:EiS^~ CEai~~ ~s icrng...~.f. wFD:., a; r.iH.~ ~.. ~t.~. _ . _ _ . _ _ . _ _ .. _ . ~.., : , K ne J. Garvin, M.D., .E., 5301 S~v 31 Arenue, Fort :,a~sderdale, FL 33312 ~~:~•~.. . STa.lC~/'~t.~Ir/w~i~ ~ . ~......_.,.., C~f12(NOrMMaiCd1R~• V~~1iFD.'-FV!~NarttfD. x ~M~~. ~~,:.-~~ ,<....,., L'~v1:IrrY'}SF/I~~.I..r•~•+~1..N~.l _ _ _~ . Rucciz U S A wfdo~ red ~ ~ -' -'- -- . . . . „ ~ ,~ . ~ ~ KK . 1 ' ! I •~;Y~If ' _ -- ... . - -,.~ ~,..r:.-.~.,~. -..,..~.• ~ ~.- . ` ____.__ __" _ . •.nnos "' _ _ . . ..__._ _ _. __ ' -ass~. •.~~r.. ~~ U~obta i nab 1 e ----- ---- --- - . ~ - ~..,.r...:...,......, . .,. ,. ~lou:;e~~i fe ,_~i ~~ Ot~~n f!or.^.r_ _ ~ ~.,.E .~a.c~ rvra. -,•,. rc..~. ~-: ,.,:,~.,. . . . '~'+ ~ ~~~.e .~r. :, oe~~ -.... '. . ~ . . _ . . . ~ .,~, p: - -. . - - ~ e ~~, F7orida ,., P.ro:-iard ..- Ianclerdal~ L11-es ... 51d3 1:.:'. 35 ~trect ;,- _.. s.. ~ . .... ':~,~ .f~i4!f_ r:aVt t~iSf Y~~IE ~. ~..[t Y~ ,,~r/ •.~V~ ~ i" ~ V.~....~ . ~ ,5 Garl Tate? ~-~ar_ „ Chan'~ Unobt~i r:~F~le r.:~so.•.• ..~rs rl....- r..,.l a.~c•r. c~v~~.t S-r•~c -;c . . p .~. , r> •~r.•. rE I r ,,, }Iarvcy Ru~nick ,,, 211 I~z}_c.;ood Drive Sto~ ~t;~ton 1:as~~cht~~ett~ 11~~1'al C~fV~•~n~. IFM~JY~ . , ,•, :..,-... ~ ~ ~ ---"? . -`t~'"iy~-~ ``''ub Rep; .. ~au~•,,.: sr V rrs n.~~ r:ar ~ •r.:nr OI~ r~. ... r I ""'" Acute Car3iac Failure ~ --- - -- ---- --- -- -- - _ _ . 1 Cvf ~O 't s~ a[r:•:SF7JivCE Ct . ~b~ Chronic Conqestive fieart Failure I :+.;E •_ ^~s .a a r ,.s~,r.~..re O~ ----- - - --~- - - --- ~~-- - . ._ _.._ - Generalized l~rterioscierosis -~~t O'~+ft •. vurU.rt C~YAir~~•q_Gw}•e-. _r•. b.•,y' "' b;•+, . a-.t •c ~- .. ~ . . ..vr ~ II z C Dfr~i SU::~n~ y._ _ '-t'r r41'l~r rv. . 1. ~ . iw.~~ O~ 1•. r.s• V~V~J~1 V'.~.(~t~V'~:ID /t~.. ~~; . . . . )'' r ]•! IJ , . ~7~ ~~ ANX[ /S~..Jr t.~ 1 e:~rF Ot IIt!t:~~. J. ... e. ~ ~ .. ~~1 ~ ti-v `v•e'Y . ti, r.: ,y ~ ~.. It~..., ~1~ 711 . . ' ' . ~ -V ••1 ~ _t 7 ' ~ - .'~'1.~~ " ~ ~'••t ~~. . ^ ., c.-. , s.: .._ n., ,. ~:•~ Jul~ ~~ ~Oi`~ _ .- ~ ~ i - - -- - -- --- ~ . . _ . - -1 '~. ; !?inutes --~ -- .• ~~ . -' ~~ ~ ~ 4-.~ . . _ - __.___ - ....- . ' ~ ~ - ~ ' lears _ _. _ " ~ ' _ _ ,.i b.•. . rr _ . .--+ ; Years ~ ~• .' . .... I: .• r~li ~~<<:ItC'T^ V,'~'I: ___ ~: ...-~ ..y,.f~. . ../... -. ~ % IIQ ~ ~ "~': i ~r w .:.JIr . . ~ r~f:Fl _.___ _ _ ______"_'_'___ _.- •~ ' 1'1 • _ ~ - - _ . __ . _ •~'i[~~ .,l ~ ~ _ _ _ _ _ ~j ~y _ _ _ . _ . _ . _ _ i • r~ ...A.~ __-_ . '5~..~ - . ' ~ . ~. ~ •' CERTIFIED COFY I hereby certify the above to be a true an~l correct copy of the Local Re~;istrar's ° record on file in the Browacd County Ilealth Department at Fort l.auderdale, Florida. (Warning - Not valfd unless raised seal of tl Rro~~~ rd C~ y/!~~ n~is af fixed, j 5~16bi1 ~~~ ~33, i~~ 1 26 ~~r ~' 2s Co~mtv Nealth Qf icer and Local Re~;istrar c't.! L ~hf «CGPi!i it ,{~ / r~ ~ ~ .~ ,~ 9-17-79 ~' tl'~Ii cC.~v;'r.i: a E~t:~ERF'Cl.~r:.~. ~ Chief D puty Local Regis rar ~ r~ ::~R C:~'~.,, c' ._, ~ ~ ~~ - 5o~x~51 ~acE11 ~ _ --- ~ ~ _:_ ; - - ^ ~__