HomeMy WebLinkAbout1-09-24Ruby Anderson
Ruby M. Anderson, 89, of Wabasso, died Oct. 11, 1997, at her residence after a
prolonged illness. She was born Sept. 3, 1908, in Swifton, Ark., and moved to the
Wabasso area in 1916 from her birthplace. Mrs. Anderson was the owner and operator of
Anderson's Grocery Store, Wabasso, from 1944 to 1959.She was a member of the Church
of Christ and the American Legion Auxiliary, both of Sebastian.
Surviving are two sons; Robert M. Anderson, of Wabasso, and Richard M. Anderson, of
Sebastian; 12 grandchildren; and six great- grandchildren.
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FLORIDA DIYARTMQtI OF
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A. (Type or Print)
1. Name of First
Deceased
State of Flo!L da, Department of Health, Vital Statistics •�
APPLICA A FOR BURIAL — TRANSIT PERMIT
Ruby
Middle Last
M. Anderson
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DATE
Month
Day Year
OF
DEATH
Oct.
11 1997
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Wabasso Inst. 4815 86th Street
3. Name of Medical Medical Examiner Address Phone Number
Certifier
Nancy R. Cho, M.D. Physician 3715 7th Terrace Vero Beach, FI 561 - 770 -2664
4. Name of Funeral Home/ Address Fla. Lic. No. /Reg. No.1 Phone Number (Area Code)
Direct Disposer 1623 N. Central Ave.
Strunk Funeral Home Sebastian, FI 1228 561- 589 -1000
5. Check
Appro-
priate
Box
W
The medical certification has been completed and signed. A completed certificate of death accompanies
this application.
b IK Angela was contacted on 10/13/97 within 72
i' hours after death. He /she verified that this death was from natural causes, that there was no accident
nor other external cause of death, and that Dr. Cho will complete
and sign the medical certification of cause of death.
c ❑ was contacted on . He /she verified that
Medical Examiner, will complete and sign the
medical certification.
6. Place of Sebastian Cemeter In state cemeter Removal
Final Disposition: rematory,7 n /county: Indian River from state Donation
7 Funeral Director/ // Sign atu F.E. No. /Reg. No. Date Signed
Dire,peser �/ ;` —1862 10/13/97
B. BURIAL — TRANSIT PERMIT Permit No. 1228-97-0420
Permission is hereby granted to dispose of this body.
❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship
would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director /Direct
Disposer Report" will be filed with the Local Registrar of the County in which death occurred.
❑ No extension of time for filin the death certificate requested.
ire °'^ *fir Date / Date Certi i t
Subregistrar Signature Issued: �G �� S� Due: /7 9�
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA
Signature Medical Examiner Date
or
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
Methods of Disposition: Place of Disposition __D
& BURIAL ❑ STORAGE Date of Disposition �n 13F 2 Ile / 17 9'7
❑ CREMATION ❑ OTHER (Specify)
Signature of Sexton )
or Person -in- Charge)
This permit must be endorsed by the Secton or person -in- charge (or by the Funeral Director /Direct Disposer when there is no Sexton)
and returned within 10 days to the local County Health Department in the County where disposition occurred.
DH 326, 10/96 (Replaces HRS Form 326 which may be used)
(Stock Number: 5740- 000 - 0326 -2)
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