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~ ALACHUA ~ ~
County Public Health Unit 805'740 ~ i~~'
730 N.E. Waldo Road
P.O. Box 1327 Geinesville, Floride 32602
Telephone: (904) 37&5321 Su~com: 666-1610
~ CERTIFICATE OF DEATH
'~'""~T FLORIDA ~
~K ~ IOCAI F~IE NO.
~ OECEOENI-NAMf fIR51 1~1i001E IAST SEx DATE OF OEwTN~1IO D~v Y• i
NMIO~OOK
~s , . R e ~ Fe le ~ October 29 1985 ,
, `n RACE-!q MO++te &act AGE -liSl Bin1+Wy~ UNDER 1 VEAR UNUER 1 DAV DATE OF yIRTH140. Diy. Yi / COUNTY O~ DEAiH ~
7e ~Y~ .m 1-'~1 ~e 5~~~~~ ~ ~~s ~ ~ OS ~ OAVS ~ UBS ~ M~NS 6 May 25~ 1 7V 7 a
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C~T V TONM OR LOCA710N OF DEATH HOSPITAL OR OTHER ~ySTITUTION- Win! rlf nd m~~N~~. q ~ ft~eN and rn,mpp, IF HOSV OR iN57 IlnO.cate DOA '
~ OP Emlr Rm ~npit~lM/SpK~h~
. ,e ~o In atient
STATE OF B~p1Hr~InOt m C11~2EN OF MmAi COUNTRY MARRIED HEVER 4URR~EO SURVIVING SPOUSE 11/rd~ p,r~midln nunl~
TA ~.~necounr.y, wiDO WvOQCE ISWcdr~
~ e Ohio , U.S.A. ,o ~arr~e~ „ Lawrence F. Reect
~ SOCULSECURIT~HUMBER USVAIOCCUPAT1pNIGM~~~Oo/wo~?OOryQ~,n9 KINpOFBU51NE5SORINOU57Rv
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RES~DENCE-S~ATE COUNTY C1TY TpWNONIOCATION STREETANONUMBER ~NS~OEC1T~liM1T5 ~
" Florida Lake Tavares 21 Kelly Circle 'Sprc•~rr~saHO~
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~ fATHER-NAME ~~pST MiDDIE UST MOTNER-MAiDENNA~AE HRST MIDDLE UST ~ t
4 ~ ~b Martha Sn der `
F • INiQAMANT -NAIAE ~ 7~Pe a ~.~nt• MAILING ADDRE55 S?PEE i pR R i D NO G1TY OR tOWN STATE Z~P
~ ,~,Mr. Lawrence F. Reed ,~021 Kell Circle Im rial Terrace Tavares Fla. 32778
• RIAt GREMATION REMOVAL OtHER~Spen'~r •CEMETERYOACpEMATOR~--NAME IOCATIOrI CITVOpTQWN STA~E
~ ` Ocoee Florida
~'M ~ Cr mation ualit Cremator ~
; • i I~D~RECT ~g .r, FUNERntHORA ESS ~
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i ~ +90 ~
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~ to Me uuu~sl slateC nI~ i~f tune Oate anO DW~r and te tne uuxtsr sta!eC ~
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~ EF NAME O~ ATTEND~NG PMr51C1AN IF OTHER THAN CEpT~ilEp ~7Yp! o• a~~~~ EO ~ONOUNCEO OEAD ~MO Da~ v.: VRONOUNGEDOEAC Hu~~• ~
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NAMEANDADDRESSO~CERTIf1ER1~HY$IC~AN MEDICA~EXAMINERI~Iypewpmb ?
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REG~STRAN OATE RECE~VEOB~ pEG15TRAR~MO Da~ r• ~
z3a ,5,9~.,,~.,~ ' October 29, 1985
~MMiDUTECAtISE ~fN1 Nl~ONfCAUSFCf~+UHf~Op~ar~DiAND~c~~ ~iniena'OCtrrenp~xtanooea~r. ~
i'';"' Cardiopulmonary Arrest f~Q5'Z ~ Minutes (
OVE 70 OR AS A CONSEOUENCE Oc (Condi6orXs) ntrch qsve n6e b cause (sl - Lrtt ~r~Glrlyrip caaa WQ 1~ntcr.a~ betwecn onu~ ~na oeatn , '
e Adenocarcinoma of Lun ~8~ - ~ Days '
pUE TO OR A$ A CONSEOUENCE OF ~ In!evra~ Otlwten onsN irb Ol1tt+
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• ~ART OT,+EH 5{'aN6iGWt CONO~T~ONS- Ca+O~o~x cavOu~nq W dal~ W rot rMNO 4 tasfe p.e~+ n CMT ~!a) ~AIIT ~ F fEYAtE WIlS THEi¢ A ~l'T~S~ ~~S[ REiFNwF(i TC YEUC~'
p . PREGIWaCY N TNf ~AST 3 ~16N7M5' f~~q' .vi E~~VwEF~p~e~ ~.n ~ ro~
Z~~ _ 5. L~A ~t. . ?S LV~ 76 IVO
~VrpWo~ ~ ~CC~DENT SU~CiOE a DA1E Of IWURY (/b. DYy Yr ) MOUR OF IHJVR~ OESCRIBE HOW ~NJUR1r p~CI;RREO
~ MOMtC~DE a uNDETERMiNEOiSpufyl
?7s 27D 21c M T7d
lIRS Fortn 512, µ~r ~T woaK~so~c~rr VIAGE OF WJUR11-At MOme lum slreN IKlory d1~ce IOCATION STAEET Op R f Q NO C~iv QQ TOriN ST~TE
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I HEREBY CERTIFY THE ABOVE TO EE A TRUE AND EXACT COPY OF THE DEATK CERTIFICATE
~
FILED IN THIS OFFICE. . -
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N DATE P~0 9 3 5 MYRTLE TR~ C11IEF~,DEPUTY REGISTRAR
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