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Cemetefy DEED #468
Paid by O�MW Receipt No. .273 .. .. Dated.. Auyust 18 1 -81 Ged,rge W. Rairden
Sallie Rarden
List Price $82DO -00 ..... Maximum No. Burial :spaces .2.. .398 Schuman Drive
-0 Bastian Florida 32ia58
Discount , $.. .. ............... Total area in square feet ..t *,,.,,., aF � ,
Net Paid $.204a ....... Monument permittedF2a.t; ............. U 2' 2 ADDN. , LOTS 15 & 16, BLK. 45
& -R. issued with deed
(Data above this' line for City Record only)
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Cemetery .Census R:eport
'ry 2001 Copyrights 1996 - 2001 `P. ontem Software
Cemetery Census Report: Census Report Unit 2, Block 45
CITY OF
number
Location Owner Deed Nbr Site Type
Occupant Status
-2-45-01 Taylor, Harold 437
Taylor, Mary = �-- 14, y
-2-45-02 Taylor, Harold 437
Taylor, Harold E' '
-2-45-03 Romanrowski, Walter 482
Romanrowski, Elma
-2-45-04 Romanrowski, Walter c 482
-2-45-05 Muzeck, Raymond and Ethel 463
-2-45-06 Muzeck, Raymond and Ethel 463
Muzeck, Raymond M. 0 . K
-2-45-07 Muzeck, Raymond and Ethel 463
Muzechenko, Martha 0 • -2-45-08 Muzeck, Raymond and Ethel 463
Muzechenko, Frank W.-
1<
-2-45-09 Boyd, Lloyd P. and Constance 465
Boyd, Lloyd Preston o K
-2-45-10 Boyd, Lloyd P. and Constance 465
Boyd, Constance A. C7 ° ice.
-2-45-11 Erlemann, Gerhard A. 495
Erlemann, Maria Tschugunov 0 ,
-2-45-12 Erlemann, Gerhard A. 495
Erlemann, Gerhard Andreas e. K
-2-45-13 Curtiss, Jason and Erna 491
Curtiss, Jason Post C'
-2-45-14 Curtiss, Jason and Erna 491
Curtiss, Erna C" , K .
-2-45-15 Rairden, George and Sallie 468
Rairden, George W.�`
-2-45-16 Rairden, George and Sallie 468
Rairden, Sallie H. o
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FLORIDA DUAL NT OF
` HEALT
A /TVDC\
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
1. Name of First
Middle
Last
Date Month Day Year
Deceased
Sallie
H.
Rairden
of
Death July 18 2001
2. Place of Death City, Town or Location
Name of (If neither, give street address)
County
Indian River Roseland
Hosp. or
Inst. Sebastaan River Medical Center
3. Name of Medical
Address
Phone Number
Certifier Ralph Geiger, M.D.
13838 U.S. #1
Sebastian, FL
561 - 388 -0770
Medical Examiner NPhysician
4. Name of Funeral Home /DireeK)ispesal
Address
Fla. Lic. No. /Reg. No.
Phone No. (Area Code)
Establishment
1623 N.
Central Ave.
Strunk Funeral Home
Sebastian,_ FL
1228
561- 589 -1000
5. Check
Appropriate
Box
a. U The medical certification has been completea ano stgnea. r completes cert;lncate o, aeduu dka:vknNankca Lill*
application.
111
Lisa was contacted on 7/19/01
He /she verged that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Geiger will complete and sign the medical
certification of cause of death within 72 hours.
C. [:] was contacted on
He /she verified that
Medical Examiner, will complete and sign the
ical certificatio of 4se of death within 72 hours.
6. Funeral Director/ ignat F.E. No. /Reg. No. Date Signed
-_- .,:------ 1862 7/19/01
B.
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-01-0372
Fj A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
nNo extension of time for filing the death certificate has been requested.
13699i9iliff OF � Date Date Certift to
Subregistrar Signature Issued: }r 0 Due: �
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA
Approval Number: Date
Medical Examiner, , gave authorization by telephone to
Funeral Director/Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is
required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian Cemetery
MBURIAL nSTORAGE Date of Disposition 4�2 z /O2
CREMATION
Signature of Sexton 1
or Person -in- Charge J}
OTHER (Specify)
This permit must be endorsed by the Sexton or person -in- charge (or by the Funeral Director/uli
within 10 days to the local County Health Department to the county where disposition occurred.
DH 326, 8/97 (Obsoletes all previous editions)
(Stock Number, 5740 - 000. 0326 -2)
Disposer when there is no Sexton) and returned
Distribution: White: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Rs&trar