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HomeMy WebLinkAbout0794 rni. De- lTAT[ BOARp or Hu~,TM CERT(FICA7"E OF DEAT!-~ E~~~ eo~es a BUR[AU Of YITAL fTATiGT1Ct TS Pi1.[ NO. leaal r~c- ~+L~RI~A ord ¦hsn BIRT NO. RtO STRAR~s N. ~ propsrl~ 2. YWAL RIHOiNG~ •iteut~d rLACt OR ClATM COD[ NO. ~A'?+'+~~~dltrL 1/ivt.Mi~w: A~Siw~wiatr~~iiriA) •n8 rill ~UNTIf StATi A. CpUNTY Es pl~e~d t. I,LiC~C fn p~f- D. CITY,TOWN,ORLOCAT~OM t. IS ?IACE OF DEATN t. tITY,TOWN,OA LOCATpN t, t5 RESIOfttCE ¦~If~l1~ ixs~e~ aTr uw~rn . ixsioE aTr u~irst fll~. YES kp? ~S f. ttA4E OF tlj az[ fa R.apifd. ~t Hrrt! a~1~nJS) STREET ADDItESl XOS~ITAL OII 11/STiT~TIOq d 3. NAMt OF FbN A/IIW Lw! 1. DAT( MonU Df/ Yta? oeeutco "i'~' ~'r''~ CHARLE.S ROBERT WINN ~T~ November 25, 19b5 S. SE% 6. COLOII OR IIAGE MARRIED ~ IifYER MAARIEDQ ~T~ ~~ATM 4. A6E (1~ /ta?! ti` ~ Y~ Vk9E~ Z~ Hiti. Jut OBtA~q) ar..w n... Hwr. Xu. r ~ i c. rr,,~e White xnoowcop avoncEO Au St ?1i 189 70 - p 1~ 1 e 1~ ~pv. USUf~I OtCUfAT~OM (Qtas tl~ ef ra! Isw~ IW. XIND QF OUSINESSOR IMDUSTIIY Il. ~IRTM?IACE (57dt p fZrti/~ cetcnls/) i. CfTTII71 pF twit OOtlr(T1tYi •Sth p~r- ly~lr/s~pKoJ~oati~IhJt,~a~Jrftir~n ¦an~nt g~e,~gn St.Srid&I'd Oj.l Illfri018 USA Dl~alc !ak ~3. FATNER'S ~.A4lE 1{. NOTi1ER'3 MAIp[M KAlA[ or ~~P•'~s~•~ ~ Samuel ~urns Winn AnnaBelld~ Sheridan IS. WAS DfCE~SED EM[R IN U. S~ ARMED /OIltE51 16. SOCIAL SECVA~TY NO, 17. IMiOR1YU! f NOItATY#t ~~t C Wi1~I1 tYr. ~s. r yw1v~ UJ M+. Nw wi e M4~ d wri~) Yea World War I 8-0 -I?90 .~~u«, Indrio Roa . erce, a. tuntr~2 11. CAUSi e! CCATM [6'alt?OSII o~t atu pt?Jtqt/er (0). swf (e)•J IMERYALlEI'WEEN d1~~etoi ~A11TL~S[ATHWAStAVSED~Ys ET OOEAYH o~.t r1,. ~MNCOUr~ uusf c•~ Complete heart block ~uc~`c~en :n. Arteriosclerotic heart disease; hypertro~hy frit i c~rs~.~. c„~ur~,,,r~„r, o~ To ~e~ h ertension ocardial failure 15 ears rf tD tb• ~o~ld ~art r1~ fe 1 0 0 • 1 ~Eae «rx (~1. . - r• fscrar +~~I tb rRlrr- _ .iin~o ~ r,t~ t..++ (laf. OIiF TO (s) _ tiou~ f- FA11T I~. OT~EA SK~lR~NT Cq+qTqr4 Ca(T1tsRlTYq Tp pGiw ~1lf /qT REURn t0 ME IUYUYIL qSUSE CONpITION Glyi71 IM ?MT I(~1 . WAS AUTOPSII S • rERFOAMEDT s.r a..ce vcs p ~a~1 or D•[or• ~j. pEKAIiE F10W INJURYOCCURRED. (6ti11tr w~htrt sJf~/tt?~ ff par~ /o~ PR?l1I ~J(!rn •arsea •n7 ~ accioaMr wK~ac ?awKio[ di~pos!- m ? a ? ' tiow . -"-„c pF Hwr M~t?. Dq. Yen . Dod~. • wluRY w. y. w. il ~ 201. Ix1URY OCCURR[D PtAGE OF IfUU7l1' jt. h a~tasl ~10stt, mJ. CITY. TDNM. OR LOGTqiI OOUMT1f STATE WNiLE AT ~ NpT YfHRE ~ /u*./~rlO~I. x~td, o,~[tt bfN., elC.) W'4qK ATM~611K 2L l~H~ndsdth~d~u~e~d/rom 1~ fo •ndlut~aw hjm ~lis~on D~ath octurr~d ~t ~:3~ P-k- m on th~ d~N at~f~d ~bor~; ~nd to th~ DNt o! trU knor~~d~~, ftom fh~ uu~a ~Nbd. ~11 it~~• jj~. f10NJ1TYRL tif t0 D~ ~ (Dei?u a tYG) 228. ADDRF55 ZZt, DATE SK.NEO ~o¦ni.c. + H.B. Goodwin,Jr.,M.D., Ft.Pierce,Fla. 11/27/65 •ceu~~t~. ~ ~u.~~~ ~TE tlc. ?uMEOfttMETERYORiNEMAT01lY 23f. LOCATqN(Gll~.fawft.orcotial~) (StW1 ~ ova~n' 11/27/65 Scioto Memorial Park Scioto Co.,Wheelersburg, Ohio 0. s• ~d17 j~, fUMFRAI W.E 'S SKl41TUN $ DA ~ ZS. pATE RECO. iYtOGL-REG. - ~ ~ti6157RA11'S 51CNATYRE ~ ~ a...,oee Joseph W. Yatea Pierce, Florida 11-29-65 Anna Lee Denison, d.r. I hera~y certify thi: to be a true and corrsct Yopy of the loca: F.~ ~~(~j D R E C O I~ D ED Regishars jecord on fik in tfia St. lucie Counry Henfth dapart-„ ~ ~ mortf"at Port~Pierte. Florlda. ' O~lElB --R -_~OOK ~ ar~i : Not valtd untess raisad sc~l the St. Lucia ~ . _ ~ ~ ^9 - . . ~ - CoVr:ty HPalth Departmcnt is atfix8d.) J,,~~~ ~ ~ ~ ~ ~ O s _ : ; N. D. Mll1.R, M. D. t ,~`.~~~J~ ~ _ ~ ~r• • ~ - • ~ County Health Officer & local Raqistra~ .,-1; ; .;j~:}. ~G'~~,r~.p(~~''••.~;~ . ~ ~7. LUCI~ CGi.;t~TY=.', . . . ~ll: ...~4.~.~~.. . ~ . a~ t t ~ ~ L i ~en~ F `0 R I t3_f~" ~ - . ' _ - Dafr' ~ ' Daptrty Local Reqistrar d ~ - s - . 'r. - _ ; _ , ` ; . - 800K ~~V .t ~~e~ ~ ' - ,