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HomeMy WebLinkAbout25581'IiTi:KSON. ~I1EKti. ~~NAI(l. (~Nl.'W i~ANUON ~t ~I~~iN. ~~ t1. ATTORNEYS ANO COUNSELLORS AT LAW ~ P O ORAWER BS I.AKH.I.ANI). ~'I.Oltll)A a:~aoL 51'~334 ~~ - THE HEALTH A HOSPITAL CORPORATION Of 'ARION COUNTY ' • DIVlSIQN OF PUBl.IC HEALTH FEE TWO ~OLLAR8 1841 CITY-COUNTY 9UILOING - INOIANAPOL.IS. INO. ~uMN~ -~ro*osTA?i w+-oa CERTi!"IED COP'Y OI~ RECORD OR DEATH O!"' ~ 3 Mw. oR oe cws r $~d N. O•Brien Nay 28. 1977 ~~ ~ c DI-TL 0I plAT~1 PLACR OF DEATN. COUN?Y MARION CIT11. TOWN. OR LOCATION Iltd~all3pOZf S~ IJ1dtcVZd ~ ~ Felntt2e w~~ O warsie wum. O • M.. i~... ~....~....~ . ~w. w~s M~a. Y~N. sex June I ~Re p[ wvo+~c~ powT~ or s~RTM 8,I9~E 7I . . C~ Oscar td. Nughes ' Chr~stfe Btngman ~. FATN[R s NAMf MOTli[R's MAIG[N NAMf ' CAUft OF OEATN ~ ` ~M~wv~~ ~sTMr~tN ~ N A Card~opulmonary arrest PART f. IMMld1ATt CAUit ~A) coNaTfoMS. tI ANtr ~ ~%O~eSLZVC nc~arz raiiure wN~CN orvi ~~~~ To OUS TO ~S1 A~OY! GY~[ lA1 ~TATIMd TMt YNOtp. Dja~@t@S ~ttte~o G-v~s u-K ~ OU[ TO lC} 1 • ornae No~nncwr~ ca+anows co~iu~unMa to oun~ wT twt wcu-Tw ro rN~ nww~~u asw~ coMar~a. oivsN ~N ~wwr ~~~~ rA11T 11 i~lay 31, 3977 DATt OF •URIAf ccrer. No. oe ~ 3260 vOL. AND PAGF OATE FILLF' a-irc ~ssua~* Nay 31, 2977 Jan. 21, 1980_ B. Leitsch ~~ ~~ ~ ~~~ ~ ~ s • ~ ~/~ ~~M p~~ ~'[M[YEQY ~ F~rest Lawn • Johnson County, Ir~dfana~ ' tOCAT10N ~ ~ Re1ph B. U22o~n, N.D. w DEATM CERTIFIED 6Y _ '. " ' "'t.iRK ~ NOT VAUD UNLESS MA~HlNE NUNIBERED ~ AND SIGNED WITH MULTICOLOR RIBBON ~ :,~ .i^+~ ~~l - . _ -- 'it_-'3- _ • 1 ~ ~ .S __ ' - ' -""'_ _ __-- ~f~~'• . __~ ```\~t~~~/~~/I'~~ `\\~ ~~ -. - •- + ' :\~~. ~ ~~'~ 1 \~` t ' _ ~. _ ~ • r~l ~ - _ ~ `t~~ 'I~~ ~ ~`~~~ ~{ ~ ' . . ' . . - - ' _ • - ' ~ ~~tr~ ~wuH M' 0. ._"~ = . _ . ., ^ / i` ~~~` ~ ~.l~i~~_~1~• J'~~ ~~~.. ' ~ I ~Ii ' ~ ~~ ~ ~~f- ~ ~ f ~ • . } ~ ~~ ~+ ~ '- -= -, ~`::~..r, !.~ .. ~`~~~ -i~3~___. --,lii -'-iS1: ----_. .=-~'i:~-=:1 =~_!'~-' S~I~~ ~ 1981 f~:; 18 ~:'3 ~- 00 F~:: C tn[ ~.. ,... ~ ; 5'.tCC~= CCi;ViY.i~i:.. R('G~ R f ~1 ~ ~~t,:; CLEF.H Ci: ~CS ~ ^ : .? ~ . . , . ~ i ~ ; ~. v-~~.~ ~_ ~ _. OFF: R~C. 2279 PAGE ~818 s~`~ 348 r~~E 255fi , ~ . : .,~..~