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Death Certificate - Burkhart, Thomas Wayne_1/19/2001��:i � r, -'i� . . � �/�l - 002�'7—oc� : VANDERBURGH COUNTY HEALTH DEPARTMENT 003225 Room 127 Administralion Building - Civic Center Complex - One Northwest Martin Luther King Jc Blvd. .., Evansville, Indiana 4770B-1828 CERTIFICATE OF DEATH �/ I, LA �ir C L�Lf L Q� �� THATACCORDING TO THE RECORDS OF 7HE HEAITH D[PARTM[NT , , NAMG THOMAS WAYNF BURKHART � .. .. .� .. ,� � .. DILDINVANDERBURGH COUNTY INDIANAON �Y O.L �yEqq z000 .� �� i TIMGOFDEATH O2:OS P.M. MARITAI.STATUS �'1f+RRIED SEX �'�'F' AGE 59 r+nce ��ITE i� SOCIALSECURITV DATEOF�IRTH �8�20�194� „ ,� P�nce or oenrH . DF,ACONESS HOSPITAL Pf71MARV CAUS[ OF DEATH GIVEN WAS ��CER-PROGRESSIVE LYMPHOMA n DIFFUSE,LARGE CELL LYMPHOMA „ , � ! . . � . . .. . ..��i� :;��:.,�- . � . . . .. . . . . , �i. =i• i� ,: , PHVSICIANORCOIIONER DANIF.L� SHIREY, M.D.. nuro�sv NO . . I�� ,� � � :� I i, PLACE OF BURIAL OR REMOVAL .ST •�RY � S� MT . CARMEL � I L , MANNER NATURAL DI SEASE� �� ; �=� , � ;:.. � �� FUNERALHOME COLVIN �FUNFRAL HOME, PRINCETON,IN DATEOFBURIAL 05/04/2000'.' -'�' �.i , CEf1TIPICATE NUMD6R Ofi VOLUME AND PAGE �,' . .� ' OOOO�.O�% . , DAT8155UED 01/10/2001. � , �� „'� ,�'� ;, ." „ , NOT VALID UNLESS SIGNED 8 SEALED . � , ��'.^/fcl� `�(. , � =�l.;t_'J.: (�7.' 9�+:L�=Z��T� t�l/� _._M.D. VANDERDURGMCOUNTYIIGAC�HOPFlC[R