Death Certificate - Burns, Doyle E_10/31/2011!/ANDERBURGH COUNTY HEALTH DEPARTNNE1dY`�?D�.31:20
Room 127 Administration Building - Civic Center Complex - One Northwest Martin Luther King J�. Blvd.
Evansville, Indiana 47708-1828
CERTIFICATE OF DEATH
��j i� � e� t if i e�, THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT
NAME ?�vLE E. BURNS
DIEDINVANDERBURGH COUNTY INDIANAON �Y 31
TIMEOFDEATH 09:13 P.M. MARITALSTATUS ��Ir'U sExM�LE AGE ��
SOCIALSECURITY DATEOFBIRTH 11�15�1925
PL10E OF DeATH DBACOPIESS HOSPITAL _
PRIAfARV CAUSE OF �EATH GNEN WA5 �SPIRATORY -FA?i,URF
CHRONIC OBSTRUCTIVE PULMONARY DISFJiSE
PHYSICIAN OR CORONER DOUGLA9 AATL•ER � M. D. AUTOPSY NO
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PLACEOFBURIALORREIdOVAL PROVZDENCE CEM., FRPNCISCO,IN MARNER NATURAL D;SEASG
FUNERAIHOME COLVT_N FUNEFAL HOidE� PRINCETON�IN DATEOFBURIALOH�O4/2001
CERTIPICATE NU4IBEF
ORVOLUAIEANDPAGE �0001.706 DATEISSUED 023�OH�2OO1
NO7 VALID UNLESS SIGNED & SEALED
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OCT 31 2011
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