Death Certificate - Berry, Frederick C Sr_10/17/2003` �l
�' VANDERBURGH COUNTY HEALTH DEPARTMENT 006648
Room 127 Administration Building - Civic Center Complex - One Northwest Martin Luther King Jr. Blvd.
Evansville, Indiana 4 7708-1 828
CERTIFICATE OF DEATH
c'�I�i� �e�tif ieg,
NAME F�DERICK C. BERRY SR.
THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT
DIEDINVANDERBURGH COUNTY INDIANAON
TIIdEOFDEATH O%74O A.M. MARITALSTATUS �RIED
SOCIAL SECURITV
MAY 17
Y�,R 1996
SEXM�I'F' AGE �� RACEB��
DATEOFBIRTH 09/04/1925
PLACEOFDEATH ST. MARY'S MEDICAL CENTER __`
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PRIh1ARY CAUSE OF DEATH GIVEN WAS CANCER-NON-HODZ;KYNS- LYMPHOMA
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PHYSICIANORCARONER EDWARD FOX, M.D. — -
PLACEOFBUFIAIORREMOVAL S1�fTD HILL, PRINCETON�II'}��-
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FUNERALHOME _ C�LVIN FUNERAI. HOMR
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CEflTIFICATE NUh1BER
OR VOLUMEAND PAGE O0OOO9EO
AUTOPSY NO
MANNER NATURAL DISEASE
DATE OF BUFiIAI � 5I z1� 1996
DATEISSUED 03/19/2001
NOT VALID UNLESS SIGNED 8 SEALED
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