Loading...
HomeMy WebLinkAbout0921 i ~ , n , . , 61~'~'47 • INDIANA STAT~ BOAItD OF HEALTH ~ sc~e~ x8~ rro. . . . MEDICAL CERTIFICATE OF DEATH No . . . . . . ~ attws~o-w~[ ..s. ,~u urr sE. D~~4 0~ Of~M ~prw. M• oq .~.r. ~ ?DE S?l+NI,EY HA1i00C1C t Mq~E ~ 4-15-83 ,,,R act-..~.r a...~ u+oc~ ~.rM uroc~ ~ o~. a?r[ or wrM... a. ca,wn or ou*+~ tOt r~w~rs..ew, ros w.~ MaAS rt •i~",.'~•'~•s . s. y ~ i x ~ . 2-11-1920 I4?RIO~ ~FE po ~.w~ w~....b~: Is 011 r.r ~ +.eMtMfX1a pt~. fOMIA OI~ lOfA11O~ O~ OEI.TM MOS~11~t OA Ot1E11 wfTfllltUM-M,~r~..nr G~ ~ ~~~~lP.+~ ~ h ~ ~1~tE 0~ MTM~.~~1rf • p*QEN O~ MIIMT COIM~II~ M~M~ED. ~EVfll WN~ED Sl1RY~MMG S~Olbf+~.~+ ~w w~.~..~ W~S OECEOf~ fVE~ ~ti V S 9~FCEAiED wwowEO. oNwcEO-s..+. +•wo ~aa~v * ~f r~iy~ppp~p/~ s~....... • Z~i~Aff ~ U'7. ~ ~O ['~fiCRILY ~M71 A ~S fOCWlECtMrtrqJNF~ VSIWOCCU?wTpM~tir...w~...r ~~MDO~~uS~EftO~IMOVSnn IND 309-12-0197 +y AC~CO[lN'r~ -RETIRED ~r MAI~?THON OIL C~O SPEEDMAY CI1T ev44 ;ES~OE1/[4 ~~{+~5 MCE.lSfO IIES4EIICE-fTAfE COIJIIf~' 0lt.TOWMO11lOCAf10N .tD sDt1fN , "r i_~lED M . - e:~r~~i(W GNE i!~ t! 1/t - ;'s - z3'4 Rr_f ~~O~E fAEfi ~YD MN~E~ 6 ~Ef~OlACf OM ~ t~~M• WS~OE Cnr LMf~S ~+++5s~pw - .y~.~. a~ ~P M IfI 1M 1'ES ? ~Y 13 OECEASED Os S?AJiM OES[il~f~ R rE5 SrE'CS~ ME~qt~ut Ct1~AM RIE~t01~CM_ Ef~ ~ 1f~ R! CI pD f11t?~~-IfI1YE rM~ roaaf W~ MOT~411-YAOEM ~MME ~~1~ W~ FA±iENTb FRBD RANCOQC Laura ASACltl?~r ..~wn-.~ aEUr~«v r..,+c ~oo.ESS .w.., o..~ e.o ~"~$.7~ 1 . V'r inia jiencock wife 1419 Main 5t. Vincennes,In ~..'~Ve~eran a Hoa ital Records ~w 1481 M lOth St Irid ls inc3 46202 w,.wi. cwc?ur~ou. ~rw~.. o*~a a,..w~ a~[.. o~ a~W?ran-wr[~w Norc ?«.raM o. ~o~.. a ~~sn,~,~ ~s. Hurial ~s Memorial Park Vincennes, Ind " N o~h ~.e.~...~ ru~tw Mo.~-,,..,.n.so.... a•r~, o~.. e.o c... a..o.. u.~ r., r'~ ~ v A ril le 1983 p. Dexter Gardner dc Soa, Inc. i Vineeruies. In~iana ~ !n A w r. r.~ r.+y r r WTE LG/ED w~r a. n~ ~qM 0~ OEATM - {n C ~.~r ~ _ o o c° n. ~ ~ 4-15-83 7:18 A. M C w~w a wrn mrs~ww ns. ~ w.. ~i? vi M~1RR C. GLU?ZIEIt, M, D. ~ _ W p ~u~ur. ~ooecu -wns~cw . - C3. c~ ~at lOth Street Indiana lis Indiana 462 2 N C N.~ IEAIM OIi1CEl1. 1WMf 04Tf ~ECENfO lOCUI NtNM pt~KM . ~ APR 181983 - _ 7l r~w~ntrM~ R~w~o~ra~cr~~r~irrro+~rrrr~l +.•.~••~•r.~.~a•- ~...e '~~~s ~ GRDIO-RSSPIRATORZ ARREST ~ ~ ns wi! b 0~ Y ~ c9MFOMR7 0~ ~..~.v ~.r• ww w rr ..-:x r. ~wG - .n 1 « RADII1TIOli pECI~SZS OP ~ BR7~IN ; wr h e~ r~ caMwt~ s ~~a9 . ~ .~.....~_~.r ~ :,=VEE • M l~i'i'A.STIITIC I+4~iIa~I~ TO THS BRAIN ~ w ?MT aa~~ sOrRAr cae~O4 ~ cr.w o+~s.~ r/ww 4....r.w r s.r ~w.. ~r. ~ r . wro~s. .f.wn ti.. r ~1 ¦ ~ t. 1R) 38H 0~000 Stafs Fatn 361.90 ' qEV.tpf77 ~ , ~~7 1~pT VALID UNLESS MA~-IINE N[)MBERF.D AND SI(TtED WZ'II-i MJLTICr:zt . - - - - _ . _ _ u - - ~-~.d