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HomeMy WebLinkAbout2754 i ' ~~~~~~~~~.t~ • • ! ~ ~ ~ I ~ ~ _ - - - • - . - - - ~ - - ~ _ ~,7/ nat~o nixox ~ OFFICE Of VlTAL STATIST~ _ ~_~~8~ ~e •~urcy 8U'~233 CERTI~tED COPY _ ~t c~_i• ~ ; ~ ---~--r.-. ~ ~ • CEA'T1FtCATF UF DEATH ~ 7'~~ c.oc,?~ ~ e~o, - FL.DRtDA 'i~tgl . • 4~ u~Y Gldtk ~ UECfQENi'8 ~IM~E FFUsL N4CAa~ lau~ Y. SEX ~ trsale ;3' : a t~rE oc o~~rK ~`++tla. f~~. Wk frNi SO~tAI SECIlWTV Ml/M6ER St ~1'ist @ydat Sd UNDER 1 YEAR Sc. UkOEA 1 Oay : ~ @ 6 8 _ ~ 7 ?~cws wMUtss ? ~ ,'~y ; d OATF Of B6~T11 tNOrwA WI! lrwj 7 Qti~?tPLACE (C~ ~nd Sfw a fa~4'~ Cario~Y! Q Wi~f DECEDENT E~rER IN V S ARI.~O i'ORCES? (Ns n No) ~ 28 Yes ~ 9d OLACf OF OEA7H (('.hOCk odYane: aer sisVuctinns on oMw sW1 9D INS~OE GTV lMM7S~ (1AS a No) fx. ' - ~ ~ ItDSPf1~?t.. NDa1~C~d E3ilOutA+ii~'tfi OQ1 Oi?~EA t~ ltwcny ttoiaa Rue~lw~ta r rO~her ISI'at~'7 es ~4 Li oCFACl1(fYNNV1EN~~6ku+sxl9+?'e~f~NAnOwwnbPtl 9d CF~Y.TDVM.ORtOCAi~QNOFOEAli1 9C COiN~TYOFDEATH ~ , , ~ i'`, i.,> . ' - . . , oi q~ Df"..f0E/(TS l1StlA1 ~CCU~IOr{ tOG KAiD OF El/$DiESSAt~IDU9TH7 11. HerOr Mvw0. W+AorOd. ~ ~ 3UAYtYW(1 SPOUSE lN Mk yM ~+i~0a+ nama! ~ .~xa ~'~.~Vj.Sl~TI dvac~°'0lSPKrsI '~o` r ator Sales & Servi~ Married A&rienrt~ Wheeler " ~Js RE~IOENCE - S'fRTF 1Jb COUNTY 13c CQ~. DDV~[. OR tQGT10lt t3d- S7RE£T A1W NUNBER y~ ~~+r' , F orida Maxtin Stuart 268 ViI].as St. ~ y ~ Ue MIS~fDE tX7Y ~3(. 21D CADE 1t. MUIS DECEOENT OF NlSPANIC OR HAtT1Mt OHK;¢~t? f5. MC~E - M~aiCai+lwpa~t l6 OECf OENT'S EDUG710N 1ty l?AATS~ Mt o~ M~! ~$pecty Ne a lii - M Yei svxrY lfai~l ~rOa^. ~ Ne. fSP~I' u+~l' ~u 4~~ ~a+K~kdl ~ ) l~arkN. RAn~1 Wt+n. Mc) xt tin t! Yy~} ~S ~ ~ ~ ~ . ~~E CbM9~h-~a5.? y;~_; Ye3 4994 ~r i~h3.te iD'~ . tL F/t71(FJ35 NAflE (~ir~r k~4e04 CeS?1 S8 Y07HER'S MAA16 [~ai 4ftrd~n.Sixnsa~y y . ~ Char tes E. Bartlett Lt31, ' ari ~ Maude t~~'~~3 . . ~ ~9a ~?~FOh?bwrS Nµ+E (hha~vrii~U r.~e wututG ~noRESS (sar.rarw M,n+prat r~ t+ata ~en+~est ~Ma ibw~t Sr.roo tio Coa1 . _ i ~Haztlett 268 ~ii33as St. Fl ~da 34994 2oeNrttrr0oof0?s~b~,z10?r too.~~O~sros~no~rlc~r~+ddc.a~s~t~!a•a%a ~ec:~OC~?1~0++-- orw~«~ssa~. ~ J~~~ ~L~ ev1~+? ~ G~~+ 7 Mrt~wN kom state . ' ~ ~ c omo~ r~~ T r i- t 5 a u 1 C r s~ t A 8 t u a r t F l o r i d a ~ ni's RE FU ~~9FHwCE l E OR 2ta a 2+c HAB~f ANO AODRESS O~~p*11'E - ~ ~ ~ ~ ? ~ 505 S. F@deral . Stuart, FT.. 34994 ~ l~-Z- 2135 ~ ~ ~z 22 to ~r+e p.a nh a~wao . ?se e~ u~. ¢ Ysa, on v+s o.as d.~a+~+enawo anaur i~+~ertysb~+. n ary op~ion aeam oawno y ~ n'~ ~ ~ 1h~ WM dla aM p!~ aiW dw lo tt~ qtrw(i1 s~ mannsr as statW f % .F~, ; ~ (S un i ~ rn u+a 71 ? . ~.,4~~ ~ 22C Tf 0 FIOUR OF pEATH 2Jh OhTF $1GPIE0 (Ab. Qb{ 1f1 23c HOUR OF DEATH :jsi~~~ ~w ~?~~t!~ ~Y 9: AO A M ~ M~. F` ~ Md. NAME E PHYS~CJJw IF C1fHEA TH/W CERiFtER (lyp~ or Aivj 230. PRONOUNCED DEAD (1b. Dt~t 1s~ j ?3a PRONOtJNCEO OF~~ (NOUr) mr ~ 9~..~ M I ~ Z~. NANE At~ AOORESSOF CERTIFIER (PHY".,~GM1.1AEpGL EXMAkEf~ tlyy~a orPrir~t) ~ A1an Collin M.D. , 1801 Hi7.]moor Drive, $8141, . , P~rt St T~ci,e, Florida 34952 ~ 25a ~.ISAEGiSTRAR - S1GN ANO WJE 2Sb. L AEG~6tR~tR - St • 25c. DATE REGt5TERED i ? ~~L~ ~ ~.~~~.w,~~~ - ? f~ June 9 1989 I ' 2fl PART l 6nter ~M dmuec, inMns. a con+p6catwra maf ce~rsed tM OaaO+. Oo nd erwe~ ~be ma~fe d dyag, suth as arQwe a rvspva~ory w~v„. shak. o~ heen ~ -`'I, ' hiJua. lial onil one tatcse on ~a(.'h Me. ~ B!w~ Orttat ~ Deuh ~ ~~~~,~~n~, A • . 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BO F:07 ACGEa7 ~ ~ . z_._ ; - , a~rA~ iNG: tM~+LES6 CN SEGi~7TY /RPfA W1YH COIOAEG 6+kGK(3Rnliltii) A a7 (3~'lb EIJ9'"..Sbi'D Cv'icAT ~ . ^ SE~L Df XF¢ STbTE (K RQR~A. ALTERATiON 6R EAA9:Fi v - *5•r~, ooHti+en'ta~~tn:, ti~ri ~ t~3 FCA*f ~;+',w4 •C-±4:. - - _ - ~+ann rn ~ ~ - . ~ _.T. _ _.y . . ~ y. ~ _.~'-i s L ' ~ , F g ~ • T Y a A ~,~'~y ~ ~'~w~$ ~ ,AC-e~,.>3- : ~ ~ _ _~;~`'.~.r~,~',~~. ~ . ~ - - -