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Death Certificate - Ballard, Grace E_11/14/2003L • VANDERBURGH COUNTY HEALTH DEPARTMENT !) ±_ j_ !-� � Evansville, Indiana CERTIFICATE OF DEATH ��ji8 �ertif iee THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT ► NAME GFtACE E. BALLARD DIEDIN VANDERBURGH COUNTY INDIANAON TIMEOFDEA7H OH:OO A.M. MARITALS7A7US �HIED socw� secuairv PIACE OF DEATH DEACONESS HOSPITAL PRIMARY CAUSE OF DEATH GNEN WAS �'1`�AL F'AILUHE, PHVSICIANORCORONER ANDREW PIERING� M.U. SEPTEMBER 27 SEX �'EMALE AGE 65 DATEOFBIR7H 05/17/1938 AUTOPSV NO VEAR 2��3 ance WHITE PLACE OF BURIAL OR HEMOVAL NORTHVI�,W, ELBERFELD � IN MANNER NATURAL DZSEASE ,,FUNERALHOME STODGIiILL FUNEkAL HOME, FT. BRANCH,IN DATEOfBURIAL 09/30/2003 CERTIFICATE NUMBER ORVOLUMEANOPAGE OOOOZO91 DATEISSUED 1O�OZ�Z003 NOT VALID UNLESS SIGN[D 8 SEALED _ �blia `�L.i !!'v�;/_� ,���''� � VANDERBURGM G HEQTM OFFICER — N.D. ' C�j�l - csoo �( � oay- c�oo �I 3 � � � � � « NOV I L�'LU03 %� / C, j////�J� I `� n/� �'V ,Q-:��µ "•I'�!',? .�t1�TnR /D GtR50� ��'