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HomeMy WebLinkAbout0938 . _ . ~ ~ 1 . . . . , • ' - • ~ . ~ ~ 1 ' , ~~J^~ ~ g~~#~31~3 ~ . ~ . _ ~i6/c~, C~R'r1f1CATf Of flFA7H' - w,.. f l O R! D A ,ou~ wa~ „e. ~m OKMlMI-NMH /NST ~ YtOC~4 41f Sf¦ tyltOr7lAMfM~. t•.1 ~ Otlr~! ANNIE AIIGUSTA F.CKGttFICLD ~ ,ren~le ,Apr.17,1982 tu~c a~c uc~ ww w+. ~.'.t-~w ~++ap ~wfa ~ rtar wora ~ Nr Wl! M~sfM I y~.. I~.. ?..I cown o~ a~n. ~ - , . ~w w-~. •a.l lar++1/ l~~al +:.~i.-"(-b~'~f ii.Wat T`~i:+4 •.Wha.*_e ~•-82 ~ ' k ; ~•Dec.10;1899 ~•1~lartin C1T/, •J.W O~ lOfJ1i10N O/ DlAM MDl/~Gt O~ OMl~ WI~NT~OIh-1i~~ IU r w wM. p~ r..w ~I ~~M•/ N HOY Of IKI. IVa~y OO~, • IMr. MIM~M I f ~.wh: ,Stuart h Stuart Conv.llcscent Center r.. Ingatient - - - - - - 3~a~t M.vrn~~t ~r ~ Gt~1lv ~ w~Nr ~e~~ r~t~,1o. ktv4i ru,»rt0. 7WVtrNA YdAt Iry.~.. e••:•~•• r••l '-i.~. r+. .r.r~1 MnDOnA. 6vpaffO t ~n?rl ..r;~~l_and U. S . A. WidoKa.~l ~ ....ae e: _..:to l:~e:~ ~:rw'~ Y~C~:.~SeQK~~~N11Wl~ IIfH~~OCQPAfWh(4rL.I./.r11ww+1 Ut4dWYYFfiOtwRVi~tY c`cL' • r ~~.y rr M w W ~N. J nrJ! :v`::K f~ ~:264-42-~474 ~x{Vaitress xRestaurant iss•aNct-srw~t wwn ut+r. rowww wu?~w ~~IEI AAO wu~t~ V'--' nd:OtdtYUWtt n,-.~. r.... ' ~slorida ~.~?tartin ~kJensen Be:tch ~..2457 N.E. }Iickory t;ve. Ko :•nce-xwt h+w a~oou uw • n~t~--au~orn wwe ~~etr r=oou , v~s~ ' ' Albert i~fobbs ~k Annie Smart waa~.~.t--~.+wt ~t.r..• t~?~e ~oo~us ' auet: Ot t~ O. M. 6Tt OR qwv sr.rt i~ ~,..Albext Termini ~,.245? N.E, fiickory Avenue, Jensen Seacr, Florida 3345? ~u~~~.ulwf+ON.rt.o+~tio~wis.~..hl e[retenaaew~wr_w?rt aou~~a. a~ro+oow*a s*~~! Cremat' n ~.Tri-County Crematory ~k Stuart, Florida • w...? ~c..~ A1'COCK FtJi~ERr1L ttO~tE ~ ~ ~ ~w. q o 1 7V~.~ • ~ ~w,.~ Ar~ W ~ ?IS O. lw~s ~.a~+oM. va.'r «.v~.~r_ w.« ~.s+ ~ A~e ~ w io. ~j~ 1• ~ «wN r A. dr~ vd M~~ s~d M e'~e uw:.t ~~+YI. . j~, t ~ «..a t..6J, I~ ' y ° ~ . rsw+.....a l..r.. ~ ~ i f Wt! " /Mti Ow ~ .l Moua a a•TM ' ~ /O `7 ~ ~ OAI[ LG+fO/Y.. 0.., / ~ ~QI! Ci C~FAfM J r y ~ v~s ~ v 7~ ~ r A` 1~~. r ~z - ~ s - - S ?,~w! d ~s:[r+OMiG rHrSKtaN Orwlf tww eeen~Ua rrri• ~~•w~ S° ?~O~AV.CEO Ot~D ~r~. o... r. ! NWt' ..c~o e:~o.d.~.i !y t~• 4N fb nf r~ ' w w wro wOO+~sf Of Ci~r~f~l~ ~nnSK~~w, Mldt~t tw+udq /iir.~~+r~ Jose Chang, M.D., Skyline Drive, .lensen Beach, Florida 33~15? th,~at~+f owt~ ~t •tn n rtuu•,alr.. n... l.~ . cc,..+ (s.rw.~~~ - - - - , - - - - ~ - - ~ - - w.. -..r S~ ~~u.!:. UMS(. IC~T[t ~[I O~t NLS[ 1lR [tsl iOll f••. 1. ' ' . ~ t+w..::~+.«. ~,.r~• v-~ 4...+ IV'_ ~t.~•~ 1 i~ ~Ia~ ~ V' _ ~G~~ 1y~ o t.i-?~+ I,jy/ ' j f f'3+ ' i.i ~ ~ s.. - - - - - --1---- - .+~r•:. ~ out ~c a~e ~~.s [ ..ce a. , ~ t~ ~ M-..~e n~...+.-..• ~.a,+..+ ~ L~%C.GI ~'1 a4~~ d7~?~~~(/~~ ~ ~ ~!L- ~ 1 R' ~-------1 ~-i' iC O! AS :3MEWF`1C! Ci. -t}'---~.-_-- _ _ . 'MV~w1 ~•.ww c'M e.d d.~w t ~ ~ try~~/~. 1 ~ ' ~ - \:/v _ • -i+r~ - -L ~ I Iasf Orwl~Srin i~~fr h0 S-f.~,d.•w~w..~~A_~ww.~w ca.ra ?a-t~1k . ~u'CK~is....!. +vaSUR~~•N~l:7~weWC•t ~t ~//A / ~ _ r ~..r•.~ [ur.~.t~t~.-eJrt..«~•l ~ yl~•(./s l/rV~ ~-~j- ! ~ [n I~iO » YCS ' p•aa.b'.f KCiiTtr~, gNC~?T « WUl Oi :N.!He IY..0.•./•./ ~ ~~:EIO~ r.a~y .tXhN Kn. ~~.r~sr (~C~p•~FD - ~ Kltiti~Of. l~{'!'Nrl~lD Nl•e.hl _ - _ . ' . _ . _ ' . _ ' ' ' _ :'s- ' ' " T» " ' ~ ]h _ Y ~d I Y-'-. IY,lrtf I' M6at 171-r.~. 1.. naCi :lr ».Wr-~. y.~+. ~..w. •M.:• ?.yry. ~Cl~:.^?. . S'~tH W~~ D r~. C~A W to.w Stw!t ` la.s ]~i. r~.i Mt /a~«.H/ : P•. » :a_.s r.~ ' :+a e ,,•..-.s.+a ~ i I hereby certify this to be a true and ` correct copy of the l.oc11 Registrar's ~ record on file in the Martin Cour.ty i Health Uepartment in Stuart, 1=lorida. ~ ~ f ~ (Warning: Not valid unless raised i ~ seu; of the Ptartii~ County H~alth ! . ~eplrtment is affixed.) tJ4S?aU~ ~4J~ ? B~, ~.~t ; Archie rtcCall i~ter, D1.t). ~ ' County Health Officer ~ l,ocal 1:eKistrar I ~a .i, 1 ~ ~ ~i~~, ~.1 ~S~''~3 i \ -r --r~~--- ' ~ U~~itc ~ Ucj~ur}' l.oc~l .c~;iSL1C { . I " i ~ BOOK~ PA6E e~)O 'i