Death Certificate - Church, Laura Irene_9/6/2002I
SEP- 6-02 FR? 11�56 AM WASH. �WP. ASSESSOR
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D A V I E S S
FAX N0. 812 254 8641
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C O U N T Y H E A L T}i D E P A R T M fi N T
303 E. Hefron Street
Waehington, indiana 47501
(612) 254-8666
R$ C 0 R D O F D E A T H
P. 2
THI3 IS TO CSRTTI?7C
that according to the records of the Daviess County Health Department,
LAIIRA IRENB CHURCH
Died on 02/09/1997 at 6:35 p.m. Age at Death: 95 Years
Daviess County Hospital
1314 Grand Ave.
washington IN 47501
8ex: F Color: White Marital Status: Widow
Cauee of death: congeetive heart failure
Signed by: Walter E. Carnahan, D.O.
Washington IN
Place of burial
or removal: Montgomery Cemetery
Oakland City TN
Date of burial: 02/12/1997
�neral home� Corn-COlvin Funeral Home
323 N. Main Street .
Oakland City IN 47660
Signed by �aCX�' J�, �1 r
Health Officer,
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unty, Inc
S E A L
Washinqton Indiana 09/06/02
- Addrees Date
Recorded locally in Book No. CH-2a Page No. 186
Record 41 on 02/16/1997
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