Death Certificate - Day, Eric Sammy Joe_6/8/2007�
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JUN S 2007
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GIBSON COUNTY AUDITOR
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VANDERBIJRGHCOURITV HEALTI�DEPARTOIAELdT ;_I;.�l.. ;'(;,
Evansville, Indiana
a CERTIFICATE OF DEATH
��ji8 �ertif iee, THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT
r�nME L'RiC SM9NY JOG DAY
DIEDIN VANDERBURGH COUNTY INDIANAON
T1ME OF DEATH 2O: OO . M. MqRITAL STATUS nJ VORCED
SOCIAL SECURITV
: CG OF DEATH 715 LOUI S I ANA 5'CKL"ET
• PRIMARV CAUSE OF DEATH GIV[N WAS
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SE% A1AI•E AGE 36
DATEOFBIRTH O%�O%�19%O
CORONER—K@SPIRA7'OItY ARIt};5'1'
MEU[CATION 1'OXICITY
PHVSICIAN OR CORONER ��NALD L. I;RK SR. , COKONER
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YEAR ZOOi
w,cE WFII1'13
PLACE OF BUFIAL OR RBMOVAL WALNUf N1 LLS, PG'PERSRURG, IN MANN[H ACCI DENTAL
FUNERAL HOME CORN—COI..V I N PUNE2N, HOME, OAKLAND C 1 TY � f N OA7E OF BURIAL Ol�O I� iOO7
CERTIFICAT[ NUM[3LR
OR VOLUML' AND PAG[ O00OO4OZ DATE ISSUED
03/28/2007
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NOT VALID UNLESS SIGNED 8 SEAL D
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