Death Certificate - Bolin, John W_5/20/1994-•-•-•-•-•-•-•-•-•-•-•-•-•_•_•_•_•_•_•
i : 00759 �
i� VANDERBURGH COUNTY HEALTH DEPARTMENT �
Room 127 Administration Building - Civic Center Complex - One Northwest Martin Lufher King Jr. Blvd. I
' Evansville. Indiana 4 7708-7 828 I
i CERTIFICATE OF DEATH REGISTRATION i
���jis �ertif ie8, TMAT ACCORDING TO THE RECOROS OF THE HEALTH DEPARTMENT •
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� NAME ����N W. �BOLIN
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i DIED IN VANDERBURGH COUNTY INDIANA ON MAY O1 �EAR 1994 •
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i� TIME OF DEATHOZ 7 14, �,. M. �', �. MARITAI STATUS MARRIEU SEX MALE qGE G�� FiACE��I'T� •
I SOCIALSECURITY31�- �, , DAIEOFBIRTH 04�0���193� I
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PLACE OF DEATH WGLUORN 6AP'fIST� IIOSPITAL' '�
I PRIMARY CAUSE OF DEATH GIVEN WAS ��EART. DISEASE-SUSPF.CTED CARUTAC I
ARRIIYTIIEMIA, ARTERIOSCLEROTIC 116ART
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IUISEASE, CORONARY AR7'F.RY DISEASE I
• PHVSICIAN OR CORONER LYLE BEARD i M. U. AUiOPSY NO �
IPIACE OF BURIAL OR FEMOVAL[}LACKPOOT CEMETERYi 'COE� IN MANNER NATURAL DISEASE !
IFUNERAL HOME LAMB-BASIIAM CIIAPP.L� OA}�LANU CI.TY� LN DATE OF BUPIALOS�O4�19�4 I
i! • CEF7TIFICATE NUMBER ' '
OR VOLUME ANO PAGE OOOOIO%G . OAiE ISSUED OS / 17 � 1994 �
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►� VTNDERBURGH GOUNLY 11 Lill OFFiCER � '
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