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Death Certificate - Clayton, Willard Russell_8/24/2010�� INDIANA STATE DEPARTMENT OF HEALTH CERTIFICATE OF DEATH � • � � • O�� �� .•�• Loai No............ ........................ tata o............................................ i.om•.�epwm.lF+�uas..i.u� ia.wamn�nirom.n�vn,t) x.sc� l. rm.aor� .. mi.o�ov�P���ria'1 Willard Russell Clayton �rlale 10:35 PM January 23, 2010 s.smus.ornN� s..ro.-m m�rm.ir.. xvu.,wnn I m�uw,w s..i.n.,w, �.muaemryu+a�DM*.a) ,ulonMasc�.a.roa�cu,:ry� 84 � � � I'^'° December 6, 1925 Shawneetown, II. c. �.snus.wmearam.'r ia.uormomar.an�nuo� �a.uoonom.�.asm�.wa.o�r �ro.ou� ❑Yn NoU�kmn❑ W�H06vc9mryDCC�+'+wtWVM���O0caa0n0.�iv.al ❑HwMefd7�0aWeh�HCixO�L�9namM.p4iwmCaeFadhO0TCI54eoh) tt. Hart/ Wms (II Nd W �NOr� 6�� SOHMO WmOV� Deaconess Gateway Hospital u.uraru.nsm..'na caa. i. n n u.m.nusmnwrwaa ,m Newburgh Warrick ��� o�.e�s��moo� YMVYed D iln'CMaCM � U�imvri 15.SU�wqSpu�aNm 15a.(YWJapr+Ya�lnlNane 16.DoW�l�11uWOm�pM 1].fiNq�^ ^�aPy Ethel M Clayton McReynolds Livestock Buyer Meat Packing � . �.o- m. � . . t . o.n - indiana Gibson Princeicn :x. s.e.i.ner,mo.. ,m..a.n�. ,e.. mcoe. � .: . 610 Kennedy Drive I 47670 �r" ��' I ,, . �m � �„� ,. . Primary 12 No White n c.rr.nml�..ium.�M n.�ntumw.uw z,a. ca—. uam�u,�Fav. I Henry S. Ciayton Hattie J. Clayton Baker Ethel Tillie Clayton I Wife o� 610 Kennedy Drive, Princeton, In 47670 I �$. l�fdCB d 1�6PJ51:911 15aMevvtl WnYVt ]SC.RanpPq�mlNmeqCaeetsY.U„wbY.OmrRao) 35c.Lemran- . u�M1NtlSOY ��°�`,'""� �°vi°°'� E"°"`"°' Columbia "White" Church Cemetery Princeton IN ❑ �ISU=ki zs. w.. cw,�w,�.a, n. �.m.�c�,..,�na..o�w�.a�mnColvin Funerel Home, Inc FH83005671 =" `"�°'"m'•"°�°Nei°` °Y° �"° . 425 North Main Street, Princeton, IN 47670• FH83005671 TID hC S�wlmum. Pc lianteNUnMr(pLimvsa�� ���Y���.� FD01012933 caue m UeaN (bae Inswctia.0 Ma Ezamplaa) 23.?artL EnarT�aChaTdEvm[s--Oiseasn.Iryu.ies.00omd�b�����+�YCa�reEThe�aan �oNaEnerTermirelEvercs :.pycxcr.me Sun As Camec Artest, Pespremry Arzesl Or Ven:ncubr Fi:r.Aaum W¢touc 51v�'vg i tre Etialogy. Oo Not AbSreviae. En;er Ony Ona Caiae On INenal: Oreei ALine. ACElWEiEonalLneallNemsary. �J,.�'-�'I ('o�eaN I:.ine6x:e Caux �Final Oiseax Or ConGi�m RaNNg In OeaLh A -(�' ll� ✓✓� Lm �� f w� 1��/� o.m�oa.ce..o�ew � Se�uer.�alyl"u�Can6Gms.ItMry.LeaGngToTheCaiaeLis;eaOn - � � ! � e A EMerTM U:Ce`yirg Ca�ve (0iseaze Orlrywy iha� Ir.Catetl o� .. v �e Evenu Re�i�ig In OeaN) Last C r o� •�owe �. r �uv n M1a JCgn� U�GT�cy f.rva�n I � Y �.� ,�8 " ❑Ya �NO I I 3f_Oaila�vnUw mvwa oDrm] o' R4FV.vY: D.M+naOfO�R ' I"J'�nOR�vry OUm+� IOti1R9✓�WinGMYe�Orle9�'J4ieepCk6iOWIR�i'H9'P.rl�`�NPnQCmdb�� yy�NVIOWeafeOm'alO�+�+��MOYM^ ❑tMR9�19/RefaYOWR��tYVPebeDaC� Qll�mnrtReW'1W�fniyPalYfi Q-xC�Of:vMlb&Ql-caN 31.Da1� �WYINa@ATIYaY) 35.TMd4�+Y � ]6.RaaOlv�aYlEG.Oawwf��fan�.CarnNCOanSY.PrurvLLWOmmMee) JI.Yl+YNWV4i I ❑Yn ❑Po Td. leesnOlY�uY-StlY ba. GYCYTwn I �BC. SY4S Wm!s I IDc AYNO. I.u3. up�.w�e —� I YA OwmCaXwvlr�/YOanYI � t0. YPranCaaOn4VY.S[m!Y ❑n...aoam oA�.m ����.,omers�+ I.i. sm.vs. av.�,mc.+r�o�..oi m: -� ax. r�ow�a+ra»� I /, �—�^ , �(�,yi.Gd '� Cr=mw�n•�O co�r� �x osw , � y� ...��a,a.ramos I es.aa�eeaneaa G7. Name, P4trts Ana Lp Cade Ot Pdson Certfy�n9 Cxise O( OvzN: Dr. Magbool Ahmed 421 Chestnut St., Evansville, IN 477�3 G I 0:> �3Y3 /-�� � O a6.M1�veIF a�5rwhwYr. I �].'Nm: I �d.5(naLatlLOdHeiNO ar ` . � n . � !AN 2 9 2010 SbnFmc�. t �I•r.c.*o-csur[::n ..>.e, .r.e.+!non.ewa,.rvr�.m.un.�...wwr.u�..re.mr+rv�a..�ac�avsw:nsscc[su�xHSi¢.r.�ame�4�r.�-ia (7��J) . ... . . . �u / . _ . . . " _ _ . . . . . . . . �