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TM°~ CERTIFICATE OF DEATH ~'~5SJ~ ~
°£R1°""~"T FLORIDA
~K wX LpCAL FIIE NO. L `y
~E ! AST SEx DA7E Of OEATN(~I/O Di/. Y' 1 f
~pgppK OECEDENT-NAME fiRST MiDDIE ~
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i~ o?+s , Helen F. , MacKenzie a Female a Nov. 22 198E
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MCE-ep . Wrute. 04t? AGE-USt 8~rtnOay' UNOEr' ~ YEAR UNDER ~ OAV UATE OF B~RTH ~UO. Day Yi i COUNTY OF DEATN
3 Q Am ~nO,an Nc t5px~~~1 ~ris ~
y~ . White 63 saos , o~Ys ~ uas, M~~+s 60Ct. 4, 1923 Martin
C~TY. TOWN OR IOCAT~ON OF DEATH ~ HO5P~UL OR OTHER INSTRUTiON-Naml~~~n~e ~n ~~M~i. 9rv~ sbe~l and numW~~ If NOSP OR INST (~nC~[al> DOA
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• Stuart Martin Memorial Ho ital ~o In atient
STATEOF81NTHl~~~o1~n C1T12ENOiNl~/ATCC:UNTRV MARRIEO.NEVEpM.ARRIED. SURVIVIMGS~OUSE/Ilr~l~,q,r~madfnnam~~
7~ USA, n~meca.nrry~ w~DOWED. OIVORLE01SWa!ri
• e Canada 9 U.S.A. ,o Married „ Linus t~tacKenzie
~ SOCUISECURITYNUMBER USUALOCCUPAitONIG~v~~~ntlolwor?OOMOu~~~9 K~NOOiBUS~NE55Op~NOUSTqr
6_ mose d wo~~~~q r.!e e.an d ren.W~
+z 370-28-1947 House-Wife ~w Own Home
RESiOENCE-STATE COUNTV C~TY TQWNONIOCATIpN STREETANONUMBER ~NSIDECiT•LiM~TS
14 ~Spec~ry r~s ~~a
Florida ,.o St. Lucie Port St. Lucie ~b 630 N.W. Selvitz Road ,w l~.
, fATiiEH-NAME ~IRST MIDDLE IAST MOTMER-R1AiDEHNAME FIRST M~DDLE LASi
'~s Herman J. Connors +e Helen Ca be11
WfOR1iIANT-NAME(TypeD~PuNI . MAIIiNGADOAESS SiREE7ORRFD NO CITYORTOYiN STAiE LP
~~a Linus MacKenzie ~JO 6 N.W. Fl. 4 2
~ BURIAL CFIEMATION. REMOVAL OTNEAtSp~o~i ~ CCti~E~E~r OR CNEMATOA~- NAME LOCATIQi C~TYOA TQVtiN SUTE
~ee +e~ Wh ' e _ F r d _
Burial
• iUNc'RA~ D~p~g~ OR-rS~g~a!o~ ' i~;~1ERA~ HOME A
~ Roger L. Byrd Port ~t. °~~c~sie Funeral Home
es: ? / ' ~ ,9o i
~ Z Uest o~' y hnow!e6~ ea:n otcu.rea . n~ t~.me de?e a•,•: C~a~~ an~ ;L,e 2U On t~e Oas~s ol e.amwi~on aM;or mresiqat~On. ~n my opmwn Oeat~ occur a~ tre
~u Me causr!sl sta~eC ~ ~ , o ti ume. date an0 D+ace anO Ooe to tne uusels) sUted
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~ n~ > OATE Si N lNO. Qa~ r. ~ ~+UUR C~ R a~~+ oK DA7E S~GkEO ~MO DaY Y• ; HOUR OF OEAtM
o=° zoo '7 ax 5:43 P. ~a~ N/A N/A
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~ aF NAME O~ ATTENOIN~ PNVSIC~AN ~F OTNEA T~-A~~ CEQT~~~F~.r,,~ P.~-~ ~p OqONOiNCEO DE0.D!Mp Day r~~ PAOhOU~+CEODE~DrHOO•i
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i ~ NARfEANDADDAES50FCEAT1ilER~CMY5IC~AN'eED!CA'Ex4ti~ih~R,riyi,¢p.~r:,~/~
~ ZZ -David E. Bright, t~f.D., 725 E. Osceo~a St., Stuart, F1. 33494
REG~STRAq ~ ~ O~TE AECErvED 9r REGi57w~p~iuo. Day. r. i ~
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2~ ~MMEDtATE CAUSE {fMfR OML vO.vE C: U E PfR t f E~OH ~ai ~D~ •ND ~u ~ ~ Inttnat Oehcen onset a -_a;n ~
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OUE 70. OR AS CONSEOUEniCE O~ tCon6tons) +~c~ gave ~~se to cause (a) - l~ underytrr~ cause ~ ~~1IG~Y~~ OlIM!!~l M15H iM ua~~ ~
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DUE TO. OR AS A CONSEdtfENCE OF ~ Intlr•s~ Delween onsct an~ aeatr
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~ ?MT OTNER SK;N~f1('j1.4T CG~D~ilp1(¢--~pvyany e~r.'rtv'.~q.. xa• t.; •e+a•z~'^. csr~ - GAP7 1;~; PApT p16 fEMF:E WA$ TMEPE • ?UTOPS~ C~SE REfERHED'O NEl} ,
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~PrppxE~y1 ACC~OENT. SUIC~OE w O TE OF i^1JURY (MO Day 1'~ ) NOVFI Oi iNJURV OESCRiBE HOW INJVRY pCCUiiRED
27¢ ~ HOMiGDE.a1R~DEiEHMiNEDISpeay~
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RS FOf111 S~P, ~H~UqV AT WORK !SppcdY PLACE O~ ~NJUA~-At r~.yne b~m stre!t raCto~y o!~~Ce IOLA)IpN S7qEET OR R i D NO C~TV Qq TOiNN ~'ATE
1 84 (ObSOiAloi vas u lva e~~~ e~c ; Scecr~~ r
9v±ous editions I~~ r~ r
s of 12-31-84 - -
~8$ FEB 24 P2~3~ I hereby certify this to be a true and
~'75~jJ~ correct copy of the Local Registrar's
~ F~~, . record on file in the Martin County
' ~0~;;,., Health Department in Stuart, Florida.
ST.: Ll!~~~• .
- (W~rning: Not valid unless raised seal of the
Martin County Health Department is affixed.)
Kathleen Muller, M.D.
County Health Officer & Local Registrar
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' ' - ~ `~~l~emli~ o?~/, ~5~~ i ~~..Q
~ Date Dep y Local Registrar ~
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