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Death Certificate - Bass, Hendricks Lewis_11/21/1961- .1: .�..�� L�i.'t.�`.i��i'. '!:1�1�1�:.-fi�i. .1-=el:!t:31: .l�tiL .11i1.�4S=- '�-�.If:�..i:. if� '=i: 1� �.i ;�i"l^•jil7"I!�.;i' 'i!j !' :!li ;Ir:��i�l:i(it`1 "'!' -�1 .li� " ' s' ;ii::l:Vit:- t �il�.lfi.l:;{:tf'iiti� :� � .l�. ii ��.� t.�i_ .1.. (�� i ��-:i� i' .i� %��. � . ' 1 . � '( _ _. . �.�.��.�..� - � - .� . � ' ' '�4-:1 1:;-�i— !� ^ a �st � it �i � % '' ' F� t1 � ..�- _1 4i - i ' �- :�tOCAL CERTIFIED+-••E—•:`GITYCOUNTY DEPARTMENT:OF.HEALTH � t� t � ! , _:; `; o,;-�RECORD OF DEATH`;������'"'�IC�ty�of EvansvJle�!,�°Vznderbuigh�Counry=•�_���:��-�'�� ��� ��r '� :1 f# - ��� s . _. : 1, � i;�:�4� � t: �.� . � . +1 : 1 �.Ir } :ilj�j ' i 1"� �.. � � . . �� {. , I i� ��� Evansville Iud�ana ,1 -. �. .. 1,� � r 31 �9 � � t ,�. � >>,� h �� ei-� � �'��I��t� �� '� t�1t Flj=ti�. . � ��� '11:� �h�+ a•_ ���� � ����ft 1'���5� ��it � i�j�i it :ijSt S � �j<< ii� t �� � �-��� � i� �� � ; . sl��������� t�L !t Hendricks 1+8W�S BH$g � � � +� �'� �� � � � � � 7�;�Th�s is to Ceitifv;that our records show� �_ �� }i� _ �'= _ {t � � ` .' `� t' died � '�t �..> �I t i t 1 I.,if_� ' 1. _.L i �-�1 J C�! ri::�� � tY ft t�.° ��i : .=���`fi�OV��EIi! 1 2 .l:�Ii�y5:�19,61�tl��'_;acCi�'��t'�."��_St.'i�j�Deaconess�,ti__;r�� i,�-'��t71_ � �ililji�� 'i i:�: �� - r:���moniL � j� �de�� U,t�! lI-ymri i�j(��hovrotdmth- 11� i� i�i����l strect,Lmyitalorrvral�.�� _+� �t�� rf� ' .'`' �r��.� it ;'��f�,��+(1),�'t Ma�; }�fl�¢ :ii Wh ��P�`tt��ll�`f��'��hfarriedi �l�ii .'il,l, �'� ti, rr �,i� t.�t1l i:J . �.. Age at d'eath - Sex - - Colo7�---.--_.-.---- - - - - ------ - ' 1p •1) i ��il 9mni� -i� ii . i :�t.��S- �111 - .�i:..l1�:.���� )iwntewheSher�mazrledioinnYle ��:�:��1:� �: -I �.:? -� .�.i1rl �! �t!il.�ti ` 1'i::��t� 1:3._ii�Fi '„�:t� - } � t � � r� � ' ;�{ i(l�:ri����i�3��.03����1� ii�:��il{�fi�:.' � ' � t�i� : iPnmary causefof!death'grveniw-as�i_?�^Maliglant,Lyaphoma� � ,�_i _�r _i r� �i � r� y, r-..• � . _ .. _� i ..{ . . .�. .. .. _ , . .i_ "' - • � r�� t�, r� .. ���^lii;:T>>_.��_ISlt,;s_�,1:;, �t;i�, i! �' ;,��„`_�;:�'s�i:!ii���:L �i} 1 '� t'' �• 'F :i' o - _ .• . e _� . � �_ - -_ S.� . . . - =' -"=-" � - y ' -� ' f � � �i _ 1 � %� L��t \" ( J - � � / i ) � ( �l -' � � - � 1 1 � i.i;+� i���3� � �.t � . J� � C� � t—t 11- f! � ll "! Cl_:...; ! i .S�'nedb �iJ G�y;SEoovert �4fI:!j.� �I '�1,''i':li��s' }! L,��IS �1!!,tlCi;£y_,1j;S! ��t� I_;�� �fl,_I;� .� !�� �. ��e�. } /. :,p S IevnA t . �1 .I .{ �� ��� }:i. 1 �1� /� 'taddrai' il .5 c( -� ���� - � �' � �. .� ! P re � !t 4_.1_ ! It_t._7t�{. , I{ , _» IR 1 1I !_ � ,. '_ � o� 1�ii r`i��"t�'t 't il`�ti �,�,,Y7elnu't�Hi11�-1i�itt�elill�:�li��tilj�+t ��� l�BrancHlt Iad��i '� l' a� ���' ��':i � -� •�Place of�bunal or removal � - - - •_ _ _ — _-_ __ '__ �--� - , E .� ���� }S 1 4. �i.: ! ' � 1 nameiofeemeter9.��! !� i= ����i:�li�'.{��l:::IYaddrese�ct '� �LLfrr/ 1t F'C ��: ���� ��l �}'J���1 lis� �t���tt �if t�:.tl� S! IIi�tFit�ll��ll��if��l�7:i1;j01.-�;�-.�{�i1F�i�l ��'a✓.'tt'Ziafi;�L'l�T��{ � C i•': � 11 61 I,aib � . Et. Branch Ind. :: � v Date of burial+ �� � s..i �� � o-t � t t e i . .> =�st � r_ J e Y � • FLnerel Direetar � • �addrg�,.... � -r.�j� :� �� J!� .�J f' t� SY ,� 1.d fl t t[� II! �,I JII It 1 III i{�� ��ti-.1• 1I i It i-: .� �t .�e � , t 1. r t( ; � �� s, 1 ! 4' � i. Ti� �� � ,1 't }i� ���" Signed'n�iirL��1I(. I��i�� : �` �. %�:�, . r- � . ��}y���..Secyla�iiil��.�.5+�".T���t��.L�i.-°+'"-Ib"'�=�w�`� �., : i �� �r �-1� 1���C-': �"'';�•�`�-:`:S. i� I S��+lF e i ' f1 ' I' rh It� �t il !•'�� .� 'r:. � ' Evansv'ille Iridianac �.� �- `''•f-�_t�..,-i_h �ll��zl 61 !{ !� 1 1� ii Nti [sEAL] :''��.'.�. .°o�` . . ..:..�I_...�.. •� � �rl�_yEii� ll ifvJ��l���r� � � -�-ahte � . ��.�i�rltil..(til:.-} 1�>17.��. ,�.i� 1': ef 1 ....?��.� � tl fl �- � �- 1 ( f�-1 i�� �!� �� �ii � F� �i ti 1 i�v 1 � ��`- � r _tt'•': : i i, �i 1 �26 ,1 Is s _t� 381 7� i t,.� ,�`-�,ti.d,i.t�. i, � ���i\OTE 'Recordcd'9ocallv mlBook�No '- "' - %-_'I:Page�No �! -- `� -i,�te i � i�%s -�.j'�1`.,g�l�� - ��.'�' . 0\. .� .� . _ �.i. ��.� � — .�r.�� .r:�.�: e- s��l.tl. '- �l ��, � � '�,f' ,s; �� ��.� � .f� - � �.e. ._ _ _ � ��" _ .r ��i� _ 't �y s. C����•�t� ;�•.�>•"��:' :1 ,1: :!! •r' '!"'i,_ :?:' I! '�!� ii':(��I1 �:I:'�l:�11� 5:�:1!'{�1" il�ir':7lti 'tj, :��..1:':i _�. . ::I._�•�i'.. Sf 1� 'i::t. i� i!'.i� _�: _f: _It. .t_ , fl.-:�. _.ii ! =1 .. .�' . .�ii�:jll��j.ii�.'!':�9il�jjii.�iij��.j�i�tl�ifi��}/i.it_�iiiij�j�it[}�17�'�1:I�i1i11l1�?-i�/i11� h '.il'_I:t�il;:]� 'II' i]?�' � �1.�7���;i