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51-5'78
CITY-COUNTY
DEPARTMENT Of PUBLIC HEALTH
Fort Wayne, Allen County, Indiana 46802
CERTIFICATE OF DEATH
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This certi/ies, that according to the records o/ this Department
Richard Wayne bnne
NAME .....................................................
P,pril 25, 1976 61
died in Fort Wayne, Allen County, Indiana on .............................................•--......----....... AGE ..................--••---•-
.~___._._. Malignant melanoma
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-• ~~ • ' r, A M Hasewinkle
•-•-•••--•••-• ....................... -Place o/ burial Harlan, Indiana
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~~corded ~dt :;;,:y,.. .....-• .................•-----.......----- Funeral der
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C.a(~~ttiq~'oner-Re ~strar
Seal
Issued --------------•--...-......-•-•---•-••--April 11, 1977
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'J Registrar-Vital Statistics Division
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