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HomeMy WebLinkAbout0990 i ~ ~3`~2S~i`3 CERTIFICATE OF DEATH s'." ~ / p~rN d Na~N6 ~ NIw~YiNN» SNVIp~ ,,,T,~ F L O R 1 D A 756 ...t Gi I~ r~~ OtCtGI`.T -N~Y! I:LSI MtCOIE l~lt S!4 C~'i Of Cf ~fti. Y.. M.. ! NIIMN~Mt BLANCNE - - STEGMAI~R , Fema.Q.e ~ Uec. .29,1979 p~~f~~..~ ~1lf ~.YY~• Voa?.. ~G!-loN~...~.bl UNOl~ 1 Yl~f UWlf 1 OA? ~~~lOf~:fM1V.,L4..Y.J (IW~JI~AiCi~IN'--" ' . . • } . ~ritb 1 ~ 11..1 MOS 1 D~~S MDUK ~ MINS Q (11)n~ ~ (Vtu~e se. 79.- ~ ~ 17~ ~QQ~ r° J~. Lll~'i~.G - (~t1 i~'. ~ I~XAII~ry ~I D(AIM 10.r511~1110~ OI11(! 1l.31IIUIION -~b~~ (1/ +M w ru\r., n~~ ~1rrr1 y~/ ~+?~~l 1/ NJY /w 1~~~ 1'~-1 ~o'~ JOA. „ ~.t. P~.ence Lcuoncuood Med~.cn,~ C ».eTM ..w..~.:.,..~„~ entQh. - - In~ctt.ic~~tt_ _ - - - ~ ) ~ St~f~Of{~~iMl/~..,~H CIIIItNO1YVN~tCOVHT~~ MAt~~lO.N[YftW~NID. SU~YIVIrA.YbllS!///.~J~.p•.+~-4•'u..~ u..~ W~ lO.DI~KID l.b.r.l.l „~.,,,,.,r,.,, , Nec~ ~yoich usA ,o°R~a~,ced „ c~uviceea s.t ma,ieh. - - - - ~ - ~ , - - • . - - - »o.:sec~rn.~+,,une USUAIOCQHAI~OMIGa~~~~JN~r!/r~4..., ~m.oorws~~tuoa~~:ann~ c, u,.;,., ....y...,,..w.....,~r......u r3. 100 03-5669 H _ ome Mafien N~~ - - - - q5~0~•Kt sr~te touN~r Utr, ~pwa ot ioc~taa ~ n[[r ,aNO ?ur~U ~a~.~nt :nr uu ~s ~ _.-.1 ~si«.!. t.~.• ,b F.~on,ida S.t. Lur,i.e ,<< F~. P.iehce .148 V~i.ncfu~2e Ave. l~~o i.•~t. ...ye r~aT kiooiE ~~s~ MOMEf-M~~DlM r,~t nar ~~oo~t i~s~ „ Lowi.e G1o.~Certhaup~ Ccvco.P.i.ne Bi~cha ._:u>•. -ni~vF /7»~ w I.wl Mw~u~+G ADOIESS Si[!F~ OR t/ 0 NO. C~iv O! iCM~+ 1'~~E Si1 „o Chcvice.~ Sxegma,i.vc 14~ V.i.nda.~e Ave., ~.t. P~.ehee FQ. 33450 R.i:~! C~14A'~O'~.QF~O'/AI,OTN(~/llrnl)I CfM!!lWOtC~EMA1p~Y-N~MF I~JCA/~~ly C~~rOt•JnN :'~'s ,e ,~mbmen.t _ H~ehe~s~ 6~emon.~.n.~ Gdna. _~t. P.i.ence F,f.. _ . _ - _ _ _ _ . +o•.n~~ G~~~ftr lsyw.. ~ ~ ~+ltµ MOMt ,b r BAIRD FuNERAL NOME 901 N. ?~th St. fz. i~~. 0 r., n• ie.• o~ ~ro~f AnM. w.~ ~N ad ]la On d~ Am~: ~1 ~.am.....>n a:w .~w.• qo•~r. op •.o. es.•~ _ • . • ~:"1 ,t,~~ ~ a ~~~1 l O[[~~rN O~ ~ ~ . ~4~V On1 Dlof~ onl M tl ~o.N~~! ~btiJ < . a~ n.~w.•...l/.et.~ / 7~ I~.~w....wdR.l.l Or•E :~':.!D /Y.. 0.. Y. Ut 01 D[AtX / ~ O~~F S~V:tOlY•. A<r. Y. 1- NOIJ~ G~ O[ArH ~ j~a xe / ~ ~3 ~ ? ~--L- µ e` ~~e - ' n: - -M > . - - - - - - . VM4'C~~N lf OTH[f TNAH Cl~tIR[f I. - S J It,7l~~CEO Dt4D Y..l~... Y. ~ pON'A•.CID Ot~D r~'~.•, ~ = 9 V lGi ]Id OY JI• AT . ' " •.~uE •Jb~F:SO! C!lT~t1[a infrpCuR. MFMCAI EI~MIAt~l11~1 ~.wl ~ - _ ~ ~ - ~ " „~tclvin {9olkowsky, M.D. , 802 North 7th St. Ft. Pierce F~1. 33d5 .•e o.~e n~u.cn e. rtas~n•r ~4.. D.,. 1. r ~ r ' January 2, 1980 • , »e <<....•...~ ~ - - - _ _ ~ . , z~ {.~-l.,-~- t 4~ . - ~ ~,..~.a c.~...~ a e.~ e..w : . R •.a.• V 'MN1D!~lf ~J~ l~ 4~L~~ O r,1V !1~! /Ol /.~,l~). HD .IX ~ - I / % `J`q . ~ ~ r ~~j~ / ~ ~l~ ~ ~~C.~~`1~v~i~--f~(,_._' - - 5..~ 1 _ , ~ Out ~O. O? ~ CC.~bt !+Ct Oi. /1 ~ - • / ' ~.~q~bs ~1n eru. o .f drod~ . . . J1•, ~ V 4~ ! ~4 ~ ~ ~ ill~/. ~ _ ~ -f~l_~_ - - ~ - ~ - i .~;e ~ ~ , e~~ ns t or ~ i~.~ ati.~ w.~ ~..i e.ew i J/ ~ ~ ~ „ /7V/fv~ ~ 2 ~ ~__i--~'-~ - ~ rllet c,~MS~!/.'.I~(~cr,•.o~~~.~.~b fw~d...or...a.nb.•.~q•on.,n.b.:•n;•,.6a~~ n~eC~er~W1 •uroai~rs..=.t. w~s~~sE~~rttttp+~ MeJKrt~- 11 f I 1 IIIM:'.(f (SJK~I} 1 1~1 . ]5 _ .1.W:e~.1 /:C~Gt•~t. SU~C:DE w'- " M~E Of INltl~'I /Me. Da.. Y. " MQit Of INNtY - " D[SC~:lf 110'M IHh/t'! O!.UflfO lf~Y~(:;.F c.U'.Off~iN~~.l~ /i~~~.lrl 1 . • _~17~~___- _ _M ~,d.. i..:J~r v~p[ r•..,~r. 1.. ?UCE Ot ~•~N~r _a~ Ay-~. ro,-,, • IrxMry. OBCt L b!,r~ry lOf~hO~~ SI~fEI pf f t D tie C~iY Ot fOVY'~ S'~t! NT~ !i~ ..~.i ~K /S~n,/s. _ 1~ [ n ~.v'iS 7t~ 7t1 t7p .:C~. u , '88 FEB -5 P 3 :39 ~ 8'~25~ 3 ~ ~ . FIIED . ot the ~a:o OOUGLA: ~:±x!;4 ':!.~RK cen~ty t~??s to t~e a true a~ ~r~ 0°pHealth Depan~ $T. LUC I E C i~ l: hI 1 Y. F L.. I nsreuy Rcgistrar s recor d o n file i~ the St. Lucie County ment at Fort P~erce, Florida. - !s (V1larning: Not vNacd t~n~~pa~ ~ t e s~ affixed l~ie ~ County . • ~ • _ N. D. MILLER, M. _ ' ~ . Counry Health Off~cer 8~ loa~ Recliatrar- ' ~ ~ ~,~7 . . . 4~~ ~ C ~ , ~ , ~ ~ ~ t , , r-, ~ Q~oufv loGal Re~ierrrr s~~'' . OaN ' ~ ~ 8~~.:574. ~;,~F 991 1..~~Y ~.."^~~K~- . ~ - + . ' r . . ~ X- _