STATE OF FLORIDA
HONORABLE [state seal] DISCHARGE
STATE BOARD OF HEALTH
WHEREAS, OF THE COUNTY OF
STATE OF FLORIDA, HAS FAITHFULLY SERVED THE MOTHERS AND BABIES OF THE
STATE OF FLORIDA IN THE PRACTICE OF MIDWIFERY AND HER SERVICE HAS BEEN
LONG AND DEVOTED; AND,
WHEREAS, SHE HAS NOW VOLUNTARILY RESIGNED FROM THE PRACTICE OF
MIDWIFERY, THEREFORE,
THIS CERTIFICATE OF HONORABLE DISCHARGE FROM THE PRACTICE OF MID-
WIFERY IN THE STATE OF FLORIDA IS HEREBY GRANTED.
[State board of Health Seal] GIVEN UNDER THE HANDS AND HEAD OF THE
FLORIDA STATE BOARD OF HEALTH AT THE
CITY OF JACKSONVILLE,
THIS DAY OF
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STATE HEALTH OFFICER
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DIRECTOR, BUREAU OF MATERNAL AND CHILD HEALTH
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STATE MIDWIFE CONSULTANT
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PRESIDENT, MIDWIFE CLUB