Death Certificate - Clore, Michael J_6/26/2007de- ��,-�q- ao3-000.�oq-oas-
VANDERBURGII COUNTY IIEALTH DEPARTMENT 01423
Evansville, Indiana
CERTIFICATE OF DEATH
��jis �ertiFies, THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT
"^�^E MICHAEL J. CIARE
DIEDIN VANDERBURGH COUNTY INDIANAON
TIME OF DEATH OS : Z4 P. M. �RITAL STATUS �[tIED
SOCIAL SECURITV
PLACE OF DEATH DEACONESS HOSPTIAL
MAY 2O YE^R ZOO7
SEX �E AGE C3 RACE �Jf-fI'I`E
DATE OF BIRTH 04/27/1944
PRIMARY CAUSE OF DEATH GNEN WAS �pRONER-ACUCE RESPIRATORY FAILURE
CRUSH CHEST INJURY MULTIPLE BILATRRAT"
RI B FRACTURES M01'OR VEE{ I CLE COLLI S I ON
PHYSICIAN OF CARONER ppNALD ERK, CORONER A�T�PSV NO
PIACE OF BURIAL OR REMOVAL �y�J,l� HILL CII�iETERY �.MNNER ACCIDENPAL
FUNERAL HOME DATE OF BURIAL
S1'ODGI-IILL F[NERAL�h1E, F1'.BRANCH,IN OS/23/2007
CER7IFICATE NUMBER
OR VOIUME AND PAGE �"'� �ATE ISSUED
"-�900� 06/O 1 /2007
JUN 2 6 2007 NOT VALID UNLESS SIGNED SEAL D
w �����. %d
��� M.D.
. ��v� ITOR V DERBURGH COUNTY HFALiH OFFICEF