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Death Certificate - Bloodworth, Jeffrey L_11/9/1990, OFFICIAL COPY MARION COUNTY HEALTH DEPARTMENT � - 222 E. OHIO ST.-INDIANAPOLIS, IN 96204 v� . C�RTICATE OF UEATH '.• :al No . .......................... - - - - - - State No. ............................ � - x (PE/PRINT '�ee�o-nuc r.sr wae uat � se. o� asourNrn,o, .,�..� IN J.._,-. E �. ,cooP�,),�en�l r� e�-zs-89 x :RMANENT � soeu.eewwrrmanc� sir.a.��.. r 50 NIDEP�rF�P Y wocn�o.r e.o�c � H�w�n r ewiw�.ee�e.r.�as..>sart�ea..n = LA INK _ , .^. � U6 �1�4DfORCE4� � 'ei noswiu ❑ row.+ ❑ cw�c.nn O oo� oncn O w.wr�o. ❑ n.w.T.. ❑ w�.�so.+» GEDF T e r�tanrru�tum..m..� �.+�/�..w+ 1� air.twm.M�OC�rqpaa�rn ua caxrtvoso[�rr� � No��vn v iv�k�s�T�l S iT L iNOi�ra.Pe�.�s /7�tRioiv x. �o .uwiws�.iva-w,r �� summwoeowae i�. ncc[or+n�eunuuoccw�rrow ix awn or eusr�ssmwe��r c MnMWrwOMp��C• 1IA�.O��1��rA I�r�btldMYVN�O7e1dwP'YV�I .� °"°`°fee"'" hi A r�P!/ wflSS °v�'°'"°°' AcTi G�ASS FAcTiRy `o IY RO�tMCF-61�tE �]0 CUUMIY lie GiV.tO O�ILOCAT1011 1b !1 l I.MOi /n� U G i.9suti AurJSrkuT 7 IL NSDFCIi� Iy i�101 lip L��.00E 11 WwSDECFCFHIdH$VYICORCAII IS MLE—��✓iNM�� WiSilv�wrof ISpch�avn-/v«w[IrLWw BY��.WM��c W.<�n Ms l�w �cl B'�lo � Vn 1 Yyl a Nu �17�3y �.. w ,TE 10 OLCF[EM$lOUC�tId/ M n �w �c bA irteM�v��21 CoYp�U-�w5�li :RENTS �l. f�tr[nsH�utv.a uaw �..e ie MureFnswut�r.w wa wn.+s�.,...�.r - I.� I.I WO ThF �' OSS ;/�/S �0�1MANT IY�PiM�YM1614YE1! :'' �� . i!q IMlNO_ 9519�/wCI.1iM�� �IYYRVIMnC�.GYefo�n.l��lOCu61 IR ��- C R1,P� (� wo T'li ., • Kf?Na�o e4'�v.esTAeT /�/U Y7(.�9 w�iF�� 7y r,FIlqDpif116Y091bN ]00'OI�iEYIOR��a ,�&1�/iw�d��wwY.nrsrY.d ]OC IOL�iIpN-C�atp�91A I �. O a.�r... O a.mo.� nd, e.. mr n.�., .� � ;n ;POS�T�oN ° °°+°, ° °°»„�°"'" — s T. Ttir+ss ��ne� � /ifitu9sTR OT i.uv }�. NRdfyMEquOOFGip� ��e IKfNSEwY6[R t] 95 I�CEnSCMwryFNMfU�ElUtNO�E � , ta «w.l -u..t r/�P p ��-.�.�-� o� /. F�/ �3eo� so — 10NOUNCINC �a,�,..e.xH�oq ». reere..d.nw•rao.e.rn:.n.,a n.w.m...rd.�..�+.a :m i�t['+sewuarH ix o•r[S��+FO ... IVSICIAN ONL '�"' "'�T"� °'^"`" ` . . ) au+n ar. rr.� � io..rc...m.aw.m �/(`� i)\V�����1� .t'js' YB ]�.}! MU9f m cAr uw� M Ern SC'�MV �/�d fp < �. CQ��liEOGV ]� I�EOfUF�IN � ri Wi[FIONQMCm tWAPp.v�l ]G W�SG�SEfRfEWSD10ufDC4lA�lOEWGM0�i1t1 .� w*.w.�o S S� � � ) S t�� � <...�kTl - pq�HLF6 Ol�tN 11 V4P1 I tnr m. etir Mru� a tuVksa� ev swa W Crn Oe r�w wr M naM d avro �uN u crac w.�i`�> ' 4ve.m�� I��l NOC\ s Iw�� I�Y� LW oIYI ar+ Cw m r[I� W HMN� bl�'V�� 1�,�11 i� � Na� ►iw1�K.H y l�i�.�v�-w, o�.�.,ao�.� i4�Ed/�iF C�UM 6inl tti .n a�rr s m+e� • rWSqna�M� dL O�o� �S�C0113[ HCEO�In_ i ',��_�'. e«siwciwws S ��►,rtu:t.� � �U�Jar�\�"� �,cL�c•..,.�^ _ Swuwwry.aca�ami� e i��,b e�� OUE O IOR �9 � CO3+9fp1ENCE � �j ' u�ur E�+r �WOfN�rWp uscm.....a.wr ° ' w.+�wa �.w� OuF tO fd1 AS � C WSEO�+�GE Ofl ,..r�o e a..n� iasr a .t AUSf. OF P�I 0 OVr�+iK�n <�Mmm Ca��EJMp b 4O� W N ��w/lF0 n N WYtiYp c�� pu� n PM 1 $M W 15 I�N <U10�5Y }pp YhFE 1UiOP'Y F�ION(i5 ffrcowao� •v�i,eir cwon io F EP7H �r..ala Co�lFlbrvorC�uY O OFOE�Ini�r�oM � -- �t/J ,,_: . . . __ . _ ., — - �� a Cen�rEn ' . : � - . ;�� -`. „ . �� �•il�'-' iiC:�_':I; ti� �..,it _. 's . - .. EE �cr.�+>+. OCrnrvvwcwrv5ituw(nn.��.�Mro�..�arar++.�avero�!+�eswvn..ve«w..a�vod�aa, � -•�f�"��a ' ?oawaTr�.+�a.aeioc.�.�amrnscww.>w..m..r..a . ....'__.....____........---......_.� �•''.•' . - �STRUCTIONS a+� � . ! .___ ..__...._'__."..__.__.._._...__.___...._......._._..__......_....._.._._'__.._......_ �.. . ...__.._._..._.'_"____.'_"._'_""'..._ ew __e]uwtiW ,va GEntt rrvG vnrSiGUN �Inrsri mn rmancro aw� r�a c.r�+o eww r awu :ERTIFIER � •.;�. i•n.e�am�yq/Pwwww.wr/rrm..�eow.�aa.oi.u�..�.�.+em..rr.�a ____'_._'.—'_L�—_...�____.'_.._.—_'_'__'__—___' ._._..__...._._..___—'______ ❑�EDIC11 EIIY�l1 � t01101Q11 ❑ ME/�LiN OffiCEP On /r 0�1� d�/Wv �^r�OA n �1 4��. OW� o[wr�G �I II� ew� Cb. Y�tl G� �tl M b M cM+�41 YN wnr w Ood ]c S�UUtUR �ID TI(lF Oi C61iVE11 Ac L1LEN6F NuuBEn ria D�it Bt]IED IYer/� O�. r�l l�,r/ Y,,,�o �., ui ���5�,��' 1-�, _�i e'„� �p �y�( �M 1001F85 0/ fE1190i� MNO CdRFi[D f1U5E Oi DE�TN OtEY }il l fyp�/H.O IEALTH �� �rHOFrcueav�.�ue � �/�, )FFICEfl » «uewrt�aou�� a.. o.r[avau .un iuea �.. .uunr.�wonc� - ' I,Iprqqtirwl NNM trw>ml �OAONER OR O ,wrr ❑ � NEDiCAL Q �we.. :%AMMEH USE ❑ e��s O c� b r ar awc� o� wxw.-u �. �. r.a i«vr. atc. ONLV o � �..� �.� « SNIM�/RN Sbd Form 10110 (qI10A�1 ����'�T" J} p�iE fIEDUbrI� Oq. Y�'1 uno n � foao f�a Jtl LOC�IpH ISCM W WiEI O A// R\� NnM.C�Y V IOr1 u�l SI