HomeMy WebLinkAbout0963 IN THE CIRCUIT COURT FOR
ST . LUCIE COUNTY , FLORIDA . ~11~;~1
PROBATE DIVISION
File No. 83-110-CP
Division: Philip G. Nourse
IN RE : ESTATE OF ) ~S ~I ?S A9 :~S
JOHN F . McDONNELL , ) ~tl
FlLi:
ROGEF ~
Deceased. ) ST. LUCI~ ~
CERTIFIED COPY OF ~1~.9i~~
DE C E F
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i wARhI1rG: It Is iltaQai to aiter thi~ copy or to uupliwte Dy uhotostst cc photo~nph. .
r+~os >>g sooM Rev z-~e COMMONWEALTH OF PENNSYLVANIA
(100 Csrt. per book)
~ (FEE FOR THIS DEPARTMENT OF NEALTH-YITAL STATISTICS ~
~ CERTIFICATE i2.00) ~Q 2 3 518 8~
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~I LOCAL REGISTRAR'S CERTIFICATION OF DEATN Re~catered No.
i Futl Namc JO~T1 F.
~ oi MoDonn~ll
j First Mfddb Laat
Resideace 2 Reynolde St. x~ectoyville WTominR
~I Numb~r Stre~t Citr o? Town Count7r St~~s
~ Plue of W omin
'i Dcst6 9 E~ Tunkha OejC PeensYl~aoEa
:i , County Citr , Borouph o? To~rnship
Sr~ Ma1e Date ot Dcath M8S 17 s~.9~1 Rare ~ite
~lidow~r
ji Ih~te oF Birth ~r•15~ 1922 Binhplace scranton. p8 . Mariul Satus
Socia) SecurNy IVo. 169~18-89~1 (kcupation '~alAg0Aj1 Vetenn'sSerialtio. 13-116-5~5
~tEDICAL CERTIFIC.4TE inten~al Bet~eeo
i( Part I. Dcat6 was caused by: Onset and Ueath
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ImmediateCausela? Cardio PulmonRr~ Arreat
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DucTolbl acute M ocardiAl Infarction ~
; ~,~T~~~~ Arteriosclerotic Heart Failure
~ Part I1. OTHER SIGti1FICA1\T CONDITIO~iS: contribuling to death but aot related tu t6e immediate cause gireo in
Part I lal
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r' !~i \ccident. Suicidc or Ifomicide HoM did injur~~ c~ccur
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~ \ame and Tide of Person
j tiho Certified Cause of Death ISt.O., DA., Coruoer, 11.E.? J•-r' •McIntPre.~!.D.
~ ~ddress Tunkhannock. °8.
~ Street City
~ This is to certif~ that the intormation hece Riren is correcdy copied irom an oreginal certiTicate of deat6 duly filed Mith
~ me as I.ocat Reqistrar. T6e ariqinal certificate will tx forwarded 10 ~6e State ~'ital Statistks Offke tor permaeent filing.
~ '~MENT pF q (9 , ~ • ~ Q/~J 66-6~~
~ W! ~cal Repislnr ot Vital Statiatics District No.
o = R.D.# 2,Box 173,Nicholson, pa. 18~+~+6
: o = Strset Addr~ss Cit~r, Borouyh. ToKnship
~ ` ~ Mey 18,1981 '
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~ +l,~~~ ~~'1~'S U~t~ RecsirW bY local Rs~istrar
~ , M~y 18,19
~ D~Ie o1 Issua of Thb Certifit~tion
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~ RETURN T0: WiZliam B. LeCates, Esquire ~
~ 415 Southeast 12th Street
~ ~ Fort Lauderdale, Florida 33316
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