Death Certificate - Dougan, Charles H_1/5/1994,�,�.�.�.�.�.�.�:�.�.�.�.��.�.�.�.�.
, � : - 19272 �
I VANDERBURGH COUNTY HEALTH DEPARTMENT I
. Room 127 Administration Building - Civic Center Complex - One Northwest MaRin Luther King Jr. Blvd. .
' Evansville, Indiana 4 7 708-7 828 I
• CERTIFICATE OF DEATH REGISTRATION •
���jis �ertiFies, THAT ACCORDING TO THE HECORDS OF THE NEALTH DEPARTMENT !
I I
� NAME CHARLES H. DOUGAN i
� DIED IN VANDERBURGH COUNTY INOIANA ON DECensex io �EAR 1993 .
� TIME OF DEAiH 6.54 PM MARITAI STATU$ MBIIlEQ SE% Male qGE �� RACE ��lie i
o e
SOCIAL SECURITY DATE OF BIRTH MAl�C'H 29 .1923
IP�ACE OF OEATH DEACONESS HOSPZTAL '
� PRIMARY CAUSE OF DEATH GIVEN WAS Cancer- SMALL CELL CARCINOMA OF THE I
LUNG
I '
� PHYSICIAN OR CORONER DANIEL SHIREY, M.D. � AUTOPSY NO •
IPIACE OF BURIAI OR REMOVAL I.0.0. F. CEMETERY MANNER Natural Disease i
IFUNEFAL MOME COLVZN PUNERAL HOME, PRINCETON,IN 47670 DATE OF BURIAL 12/13/1993 I
ICERTIPICATE NUMBER 00002331 ZZ�YS��3 '
� Oft VOLUME AND PAGE DATE ISSUED i
I_ NOT VALID UNESS SIGNED 8 SEALED �
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