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HomeMy WebLinkAbout0939 _ 3U'~6~2 - - - ; i~c f ~ _ . ; - 1 + GER i IFtCA i'c: OF DEA ~ H i. ' , [k~..+..re~ .1 I l.,hf. •nd R~6~61h~au.e Set.ke. - trtw*e r~L+: Na . - ~ . ~HVicax~ c~c ur n~ u~ F' L O R I D A - ' , T~11, O~ /IIHi IN ~~w~'~R~~ 356 i ?l~MAMINt IHK RE6IGTRAR•6 NO. . i SfI M~0100[ f01 ~~EASED--NAM( r~~ft wvx~ SE1c DATE 01 OfAM ~~ow~., ~ j i inrwnw.s , AD ' ' iL•' ' r Femal ~ Au~ust 13. 1970 , : ~ ~ - RACE ~~I. wlOq. ~.~~K~~ IM~~~M~ AG[-i~~t u+~t~ ~ av~t~ ~ ear DAi Oi ~HM ~~O~a~r. ~•r. COl1NiY 01 DE4iN ~ Itt- INftrll ~~~nh•r ~rl~~fl W~. wt1 ~OV~~ ~M. n•~~ ~ ; ' ~ ~ ~ wi~ite 58'. - ~ t • 6602 s. s.. - - - ~ Nov 9l1_ „ S~t . Lucio • CfTr, 10WN. IOCAt p A1N ~ri~pt t~ ~++n~ Hpf?~tAl OR OTnE~ NS11TU1 .-NAKE ror t~r.~1. one fni~~ •w ~+w~t~ ~ ~ z ~ lrec.n .ei o~ »o . . . ~ ~ _ n I'ort Piorco ~ os u n. O. A. Ft . Pierce Atemorial Hosni~al } S1AiI p 4~M ~H rp~ a ra~1 CIf11EN Of WHAi COIR:i;y W.iR~EO, NE~'E! MARtEO, SVfVNFiG Si~OVSE ~M om .uo~r wa..t ~ a • cow+..~ - w~oowc~. avoccco ~ vx+. ~ ~ ~ - ~~~•~~~~b~»~~ ~ Alabau~a . U. S. A. ~u ~farried. u. I;Ibert A~iendrix ` 4 rM~~/ O/Ct~flo ~n~~ b a~~ SOC~~t StC{M~TY Nt/Wf? LSU~t OCCU?~trOt~ ~~~•e a..o o~ .ou oa.~ ow~.q wf~ o~ eWp O~ ~US~+ESS O~ Ir+OVSit`! OC(VIIlD N . ~'ORK~ \~ry. Iriw U IIh1l01 . ..~,",,,,,,.o"' laz~-zG- 43z „ ldouse3aii'e - - u~ Own Iiome _ , ~»a Nron = ~!SlDEHCE-StAtE ~ CWM'f CItY, (OMN, O~ IOC~TiON M~y~ tu~ trn~ S~~EEi AHD NVM?EI ~ . ~ . If~~tnr .11 M MOI . , ~a Florida ~n St. Lucie Fort Pierco \o ~~~210 ~h .re . . ~ _ fAIi1ER-H4~E - reN~ ryou ~ i?f~ NO~HER-MA4l[NH4AIf _ I~ne .~ao~e u?~ ~ ~ i ~z H3.rd Huckaboe u Alico Truitt IM?OMM~NT-N~u~[ ~MiI~NG ADO~ESS o~ ~a. cm w ro.., ~r~ ~ 4 ~ - _ ,,,;fr. ~Elbert A. Iiondrix 2105 S. St. rt. PiQrce ~la '~'iti;cl r ~ r.~o~~...~ .~:~a..~ ~ ; ?A~I 1. p(AiH W~S CAVS(O ~Y. ~ ~(N1Ef ONIY QNE C4USE 1(! IMrE iGf (S~, ANp /t ' • ~r• , ' Y UVS~ ~ . - •IIS'/11+ 0+311 ~ri Ola~• , ~ _ ~ . ~ a o ,c/fr 2~ `r7-_.~„ u- ~ ~ ~ ~K,.. ~ _ . . ~ . , . ~ . _ . ; i ~ows~~ro.~. ..r., ~ ~ . . . . ~ . + c~ o..~ io 1?1 ~ ~ ~ _ c.w~ ~e~, ~ .o..~- a co-.iiov~.c~ o•~ - tt~f~w0 t+~ yr!{s• lfty~ (~1~~ \l1t ~ ,t~ _ ' ~ ~ ' . . • ~ f4tt • O C[ S~ HVKRHT CUr+01t1p^e5~ to~anp.~ ea+~t~~: •~.e ro o~t++ ~ri,.or iei.' o t~vs~ e .~t . AUip?SY - Ii YF S++~.~ .~~a~~.:s eoM- ' ~ 1 ~ ~ ~ ~c-~~j~ rt~ O~ O~ {~OI~~i rH Otrf~~~+~~+0 C~v11 ' 1 ~.1L~1 a~ ~U.'.1~A (~l ~ / ' ! V l ~.k/1 `.l'Jl3C.i y ,1V~.~VV~~lilt,s~ ~7v „ e~.~. _ , 3 i~~~.s i~~reroun. sv~ roc~i~ b~iE ~iua ~.o.,~.. w,,.~..~ ~nOUt MOW INlUR1 OC V~tEQ ~~~•ne ...w.~ a~.rv., ~ o....~ n. o~. • ` . ~ . ~ M~M ~ t~ OR V/0lflWIMD . _ . ~ {SS+~ I xv . m • ~y M 7~+ , . ~ :NNRr ~i ~XO~[ ?IACE O~ H1V~t.+•u.r. ~a~.. t.er~r, ~.c+..., ~ (OCwiiOra - ~ enttt oe a . ~ wo.> e~n or ~o•r.. ~..n. - - - ~ ~f~t(~~ nt O~ ~01 prt~ NOO..tX ~1Rt*n~ - ~ 1 ' " 7f~ TQI - I?~ ' ' . ~ ~ ~ lEltitKA/1Q?~- ..~+~w N~ wtirr e~~ ~.w uf~ s~~ r~...iMi ~tM W ~ O~O/4~0 ~t rI~ w.~ p~~iN OC(U~~[O ~ r.e ruc~.6+ nf . . •M~iK1~N: - r0'+~ Qa• ~t~t {OOr ~~r1~ 4!~!~ / ~ : . ~ ~ . ~ .n~..ere.'r~ ~~Os V ~ - ~ - - ~s,J* j ~f-~ " o .'..~.°cr,~ ov~ ~ rt. eicut~o ••o.-- - - --7.f - Ir~- 7 )i~ {~o n.: uvu n s..•~a. ' ~ . CEttN~C~lqr~-YEOK~I Ex~.Wr+ER Ot tOROwE~. o.<;.~aVn a o-~ row o. o~.:+ o~ Iat w..s rp.o,,..ps e• . ~ r~..~..ro+ a ew ~oe. uroio~ n..~?~~e.no~+. ~ _ ee,r~ otcverro w+~ ~.n u.s rx ro n.~ c.vst~y~.s~.*eo. . e•• _ ' Jh M It~ ~ . , c~ ~r~t OATE Sj'( t0 ~.•o»er, r~u~ ~ ) _ ~ _ _ - - T~F~ -~{i~t~ ry~{t : = n ~ t • - _ - = \ \ ~C ~ t~ 7'~ i~~~ : 7~'''~""~- f - ~ ?+t~KiNG DQiESS C!lertlA / ~ ~ s~.~~• o~ o.~Lr~ ~ t~n oo ra~,. 1~ ff - . t ' ~ : 71f = / ~ t t ~ ~ ~ ~ t ~ ~ I /v~~r~ v~ ' _ . ~UPIAI. CREMAi1pN. /EMOVAI ~CEMtTE~t OA C:E~5A/02?-Na~~f . IOC~TIpN Un o~ w+~.. yrar~ . ~ ti.~c~~. - - . I3urial ,n Hillcresti tiem Garden~,.. Fort Pierce F'lorida ' ; ~ On~F . IyP+i+, 0~1, ~/a~l ~ fUHE~AI HOME-MA.l~f ~r+J ~DOG:SS ~ ~~~ii~ o~ ~ r.o, ~o., c~n o~ ~o~~, t++n. ru. . . ~~~~st 17, 1970 ts. Fo~~ i'ierce 106 So. ~E~" St. Ft: Pierce, Fla 33k5o ~ - ~ Y. 5. ibY2 IIMEi 0'tEC7C1~--S~GN! '~E c[G~S~• ~-S~Gw~ii::E ~J o+~e ~ectn~o iOC•t ~[G~sr~~~ r.. ; e.~. ivio ^ ~ ~ - ::i ~~L/>~G 5 , ~ ~ r .t1..-f , Au ~t u - ~f~r- J" 3 ,.1970 s. ~ ~ - - _ ~ - ; - , - . • A!i^ ttEC~R0E0 ~ . ~ • , f{L"c0 ~TY FLA. ' a St.1.UCic ~UU ~ ~ • ' - • - RO~ER -v~~AAS_ `1 - ~ , _ :i,~.U~j `~QURT ~ ~ Mfe to t» a trw and cotroct copy af tho tani ~~E~ ~c- c~t~~ . ~ ~ h~y o~tt.fy` . . . r. _ s , . r. , z Rpislrers recard on filg In H» St. Lucie G~unN H~elth Gw{»rt- - ~75 *,d~ ~ - t»int it Fort P~~+te. Florlda. ~ QS a oy~' - . ~+IAY _ 8 r. . ~ t. i . ~ , • (yysrniny: Not va1id unless ?aised t~al vf tt~s 51. luu! . ' ~ ; County Health-Departme~t if affixed.) ~ ~ _ - ' _ ~ : _ - ~ Y j ~ - i ~ , , N. D. MILIER, M. D. - _ ~l r ~ ~ ~ ; ~ Coti,nt~.H~Ith Offic~r b l4csl ii~yistr~r ~J J~~''_:.u~,`.~",:__ . ~ - 1 ~ ~ r~ y t ? " ~ ~ h. ~ . a y,•. i ( A ~L+~~ `i"\ _ ~ ' i ' - ~ 's ; ' ' ~ J ' 1 A ~ ~ _ ~ J. , ~ ~ ~ 1 a . .s r~a ~~.e~~~ ~ ~ - ~ T4 , p~ D~p~tty loul RM~strer . - ; _ - ~ ~ . ` _ ~ ~ . ~ t ~ - - ~ . _ ..t ~ U R ' ~ - r - : ~ - ~ ~Q~~ 9 P~~~ 9 : . . } ~ . ; ~ ~ . . ~8 - ~ = ~ t ~ - ~ : ~