STATE FILE NO.:  93-021569
 1.  DECEDENT'S NAME:  PAUL C. PANCAKE, SR.
 2.  SEX:  Male
 3.  DATE OF DEATH:  February 24, 1993
 4.  SOCIAL SECURITY NUMBER:  234-07-3747
 5a. AGE-Last Birthday:  94
 6.  DATE OF BIRTH:  February 2, 1899
 7.  BIRTHPLACE:  Huntington, West Virginia
 8.  WAS DECEDENT EVER IN US ARMED FORCES?:  Yes
 9a. PLACE OF DEATH:  Residence
 9b. INSIDE CITY LIMITS?:  Yes
 9c. FACILITY NAME (If not institution give street and number):  1400 1st Ave. W.  #306
 9d. CITY, TOWN, OR LOCATION OF DEATH:  Bradenton
 9e. COUNTY OF DEATH:  Manatee
10a. DECEDENT'S USUAL OCCUPATION:  Self-Employed
10b. KIND OF BUSINESS/INDUSTRY:  Real Estate
11.  MARITAL STATUS:  Married
12.  SURVIVING SPOUSE (If wife, give maiden name):  Myrtle Jones
13a. RESIDENCE - STATE:  Florida
13b. COUNTY:  Manatee
13c. CITY, TOWN, OR LOCATION:  Bradenton
13d. STREET AND NUMBER:  1400 1st Ave. W.  #306
13e. INSIDE CITY LIMITS:  Yes
13f. ZIPCODE:  34205
14.  WAS DECEDENT OF HISPANIC OR HAITIAN ORIGIN?  no
15.  RACE:  White
16.  DECEDENT'S EDUCATION (Specify only highest grade completed):  College, 2 [years]
17.  FATHER'S NAME:  Daniel Jefferson Pancake
18.  MOTHER'S NAME:  Ella Unobtainable
19a. INFORMANT'S NAME:  Tim Pancake
19b. MAILING ADDRESS:  3420 Beth Lane Melbourne, Florida 32934
20a. METHOD OF DISPOSITION:  Donation
20b. PLACE OF DISPOSITION:  Anatomical Donation
20c. LOCATION:  Gainesville, Florida
21a. SIGNATURE OF FUNERAL SERVICE LICENSEE OR PERSON ACTING AS SUCH:  Gene Brown
21b. LICENSE NUMBER:  3561
21c. NAME AND ADDRESS OF FACILITY:  Brown & Sons Funeral Home
                                    5624 26th St. W. Bradenton, FL 34207
25c. DATE REGISTERED:  Feb 25, 1993