Loading...
HomeMy WebLinkAbout0300 ~ ~ - - - - - . , ~ . ; ~ : . : • f' _ _ . . . . ~ • • - - - ~ - - - - - - - ~ . ~i~02~~1.d OFFICE of VITAL STAT1STtC§ / ~ CERTIFIED COPY ~~D°~ DIXON ` • Add Fea = r _ _ - ~c4'aY; - - ~ = - ~ L'is~1c o? ~rcnic Co~et ~ ~ ~ , CEATIFICATE OF DEATH ~ ~ _ ~ . ~ ' d.OGJ?l FIIE NA ~ry FWRIQA tj ~~O DU~~ Q~ t ~ECEOEti1/'E NAt~E (f+st +~~a l~W Q SE71 ~ ~ Herni.oe L. 1 r~sa.e ~ ~ ~ ~ DAIE df OFJOH Monh. O~? ~nt ~~CU?~ &ECUPoTY NVMBEl1 S~ ~GE1aM ~nl+dq se W~Ep ~ rE~W se Wr06R ~ - J 1990 226-22-5437 ~7 : e. auf t~i wo~oti a~ »vf . ~ eir+rtnvwcE cc~a•~e sr.r o?,a~.q4 Gor~» s~w.s ofcfs~rer e~ri w u~.~ ~ ~3 }.9~6i ~Q~.1 S~Oll~l C'.c'iL1C11jI'1d ~FO~(ti~ar!r4: , aa P'ti1CE OF OE~JN aqron.: ar. rrsMUC?~ons m onw sd.) 9a tN9~0E C~iv tMI~TCt pya ~ N~$P~ul: t~ y~oMl~+~t F; EMOu1o+pN~ tx00~ ~R" Nwsc~Q Moin~ ~ i R~sid~nu ~30M~t ~SpKljj Y~ . ~ ~ ac RaCi{Jtt t+A1~i IM nd IK~tlon, ~f ra ?rn~orl id pTV, IOwN. OR lOGtitON OP OEA7M !a O01MiY af DEAM ~ ~'3ari8a italOrlatxb Orlando 0~ r' t04 IIECEOEHTS U91J14.OOCUPw10H ~04 KWD OF 81JSiNESSRNDUSTRY tt. µOAiMi~~~ ~.SURVfVM~G 3~l~E M~: GM R~+idln new) ~ ~ O~oR~Q ~ - .(~aaZ~d ' \ Securi Married EvCn Jo~e~s u. ~sro~ svue r,~n cour+rr ?x arv. ~aw?+. o~ e.oa?r~+ ur. ar~ET ~riu ~a ~ - ? ~ Flarida Orlar~do 212 W. St. ~ tae. rKS~or aTY r~t z~ cooE rws oEt~Nr oF ?~sw?wc oa k~vruw oaow+ +s nACE -~ennc+n r+d~~n. ~6 r~?. c:EOF?~rt •s Eouc.~n01~ ' ~ lIW1Si IMfI ~M? ~30etJ1' Ho p 1!7 p f~. sP CuOY~. dK?4 rMMR ~b. (~l'~'dp aV?' ~IpOrl/ QqA p~'~~1 ~ ~ 1Yfei.'r1. /~/M!D RK~f~. Mt / ' ~p ~ S.1 Yq ~r, . ~ . . \ ; , Yes 3~8tM so.~rr A~L~te A.~"~^~'Y wn•~as. t,,; ~ . ' )7.FAi?fER9NAAAEI~.MWrIIWI 1~~AdTHfR'SHAMEIF+jlA~ldlhAi~i~nS~rrnM~) ~ ~aniel C~r~e11 r~Ke3iar . . , ~ ~ ~9t.MIFdiMIUIT'S Il~1El1~'Pdl°''w) ~9b1~1u~IN(iADORESS(9r~et~ndM~~OMwRn1AcW~MwuD+tG?YaRwRS~Mtj9Goa~y ~ E~on ~ibe].1. 211 W. ~nice St. , Or1arY3o, Flo~rida 32804 . ~ ~',1~` ~ ~ ?Of. ~fETFlOO 0P~15P'061T~OiH TOb. PtACF Of WSP06~T10N (N~rw?Oteln~e~t p0e~ Or 20G LOCJa1pN -(lA Cr Tprye}. 81~M 1' , i' oVK+P~~) ~,KBurnt fl G~anti0n CZ Raisov~! t~wn Slah ~ ! oa,~+.,, u a+.~ rso~nt Woodla~wn Mert. Paxic Qrlatr.~o F].ox~da . ~ . z~s s+e~eaua~ bF ~u?~wu„sE~ ~~?u~E oA 2to UCEhSE NV~IBER tk ?ur~ ~~~o~oo~ss oc ~+~uTr ~ . PE AG~IM;ASSUCN p?~~ru~J , Garden C~~apel ~ ~ Bil.l L. Kirg 1635 600 Wilkinson Orlarxio, Fl.c~rida i ; ~ ?23: ?e ~df~lu+oiwled~~. ~A occurnA a~ tM tn+~. 6st~ aM Dace aM dw b ~M ¢ 2~ ~ ~~anrr~qn ~ .on- M nYo~ d~! y ~nd T~it ~nd 1W ~~~+fliiFr~~s~atlMa. i t w , ~ a,, 2~. OMTE 81fiNE0 Wi. 0~15 ~'1 22e ?~OUA OF OEATH OATE 810NE0 (lla. Dalc N). 23~ 110tJ1~ Oi OEIiiN ; ~ ~ Jan 8 1990 12: 47 P w'' ~ ~C 7~0. NA?IQ OF ATTENDITiG CHYSIQAN IF p1 FiEft i HAN CERtIF1ER (typs w Fi~'~q ~ I3d. Pii0~J0~MCf0 OEAb (HQ. D~ 1k1 23~. /NONOUNC~~1 DEAO rllCt~f : i: i'i ~ ~ J 7 1990 12: 47 ' p " ° - ~ ~ t+. NAME IWD ~1DORESS OF GEFittF1E'a (PHYS~CIAN. IMEOK'J1C E1cA1,uNEfi1 r Mp a A'ir+! _ ' t~~~~ E.H. M.D. AS.90CIATE DIST. 9 M.E. 1401 I~cerrtie Texraoe Or2an~i~o x*I, 328p 2Sa. S118R~fi~STMR- SKINNURE Af~O QA7E ?SS IOCN. RE0~51iiAR -~URE 1Sc WTE ~Q ~ ~ `71 'i Ca~'! ~ l~UtY REGISTRAR JAN : 19~ i; ~ ~ ~ c~,~? ~ ~ ~ ; a~A,.. o• a~e M. aea~ oo +w «+e.? a. ~+aw a e~r:~y.,~ea n ca~se a rao+r,eee~, s~M«. snar. «n..n. ~,p~os;.nrr . aM oM cws~ on w+s. ~ e~n 4rw1 ~ i p~ ~ IiMlf~A7E(y1lJSE~kep' ' ~ ~ ~V ros~k'~ng~ind a~~ -A~ ~ ""i , , Arteriosclerotic cardiavascalar disease ~Years ~ . ~ ~ ~ dUE 1U IOR AS A 00~75fOUENCE OFj , ~ `+~o~~x7suy+i~tu+e0~+s. 7 ~ .-r,: ~ ~ ~ ~ 3M'. b ~v~dal~ 6 ~ d cause E~fer -HLYtHG QUE TO (OA AS A ppNSEOtiENCE pF) I x G+tVSE~O~seaseor~n~ry - I ftwt k*~ited e?ec+1s t ~ _ nst+~t~nO w dssQ~ tI?ST e. g~~, ; WE t0 tOR /~S A CONSEOIIENCE OF): ' ~ rAA! U_ 01ffQ~ s1~RGitw [OC:~SneptS eO~M~~WAing b a!i'h bul not retuil,ng u+ t~! 2T~ YIILS At1 AUTDPSy 274 MI[RE AV 10PSY fJ~{pNYC$ 1~ CJISE AEPOi~~~O ~ 0 ~ ~ ~wpsrytrrp nus~ gn~v+ in Part ~ pE AsORb~E ~ J?v~+lw8l E ~s1~OR TD OOa1vlE TrOt~ 10 NEO+CJIL E ttrs a lvo) OF CAUSE OF O£Jafi9(~s a Nol EXMMMER4" , f ~ ~ (kttKM~ ~ ~ Yes ~ ~9 IF fERV~[E, VMAS (NERE A 30s K SU~IGERY ~5 titEKTipYfD NI P~RT t r N EM[Ep CO?~0~1~ON fQR Y+?+iCH li YqIS PERFORMEO: QA(E OF Sl1fiGERY/4b. Q/l: l?~ ;.i;s~~~:, pAf('iNAN~Y Q1 Il~ PA$T . Ci3'~''s - 3 MOMINS? VE9 Ci Np • Fs °c` 1 ~ qR~ABIE 1AAilN£R Of 12a UA1E Of cuURY ~ t?btf OF 3tc ~N,fuAv AT YPORIC~ 32~. pFg~F~M~~t UAREp ~ DE 4M . tAtarn. Oay, 1t~•1 ~N..q1RV tYies a Not ~ V~ A~~ . > ;~+~'rrl~ccide*a su~c+anor ~ ~il~ , i~ ~ ' . r.T~c~a.:apeaet~rnrneo ~ ~}~s.'7 LG p 1 32~. C~,tGE OF 1ttJURY - At ?+onx. ~i+m. 321 tOGT10N (SI1~ and Mrnb/t a Au+d Aotlf Nm+bM, C+q' n. Sla4! ' ` ' sbN!. tac,tory, iiC. {Spsc~y} . *~~y ~~7 ~ ' ' ~T.~~~ l~?444~ O.L . - ~ ) L ~ } ' , ~ ; 1 ~ ~ . i - ~ ,t F~ y,?; 1 . . . • } ~ i ~Y~ ti,P_/._Lx_ _ ~ . , _t~: ~ - I. . ^ ~ ~ : - • - - - - . . ; : ~ ~ ,THIS IS A CERTIFtED TRUE AND CORRECT COPY OF TFiE`pFPICIAl. RECORD O[~ FILE IN TH15 OFFtC~ ' ~ ~~Yg`" ~ ~j~~~~#~~ ' C~~nr~C, R ~ ~ - " ' ' f , ! g ~ ~ . ~ ~oo~fi74 P~ ' ~ ~ x * sc• ~ 8Y: ~i ~ j ~{V6R !i~ EK30RDE „ F~' Dk~(TI'Y R~X'IS`TRJ~ Stale aegtsicar ~ ;7 - ~ ANV RECRppUCTfON Of TM15 OOCIlLIFN'T IS ~R01~617ED 8~ IAW. DO MOT AG(,`LPT . . - . ' • ' t• - w~ps~~~. W:1E55 QN SEGVRIT7 PAPEA Nf1TH COIORED ~AG1((,iR01J?ip R~70 G l0 EIBOSSEL~G~EAT MRg fLiR~I ~J84A ~8-C~Bi SEAI Of iFiE STATE OF FLORiOA AtTERATt(?N OP. EAAS.fiti V~ i~ i '"g `~'C7 ~s~ -E~-: ''~„s~..~ - - - - - - _ _ ~ s r~ ~ ~ • • e ~ ~ "y ~ s~ ~ ~ ~ . K_, ~ _ _ ~ -