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Death Certificate - Dougan, Claude Ermil_10/4/1961�- �_I. ��4� :�� -:.i�:l-. �. '�� "'� � i .i_I. . .i-. ��. .i:,�il:�I.S�: :' _t.:i. � ' ,� : a.j � � °,i.� t �i;jl�r�lr =11�,I�tEii- i � t, � !i �v� ,!t� �:It:.i:d;!'�' t�it }�i�. �.t _y!� ,,',',J•: : ,.. � j �''." � . �.'�.1 ,,�r 'ii �� . �a.:•.'7 � `d� t! � .�t t ..{ �'� ..� � li � ,��u��i �a\�� '.,�:�{�: : . LOCAL CERTIFIED��`� ��CITY,COUNTY DEFARTMENT'OF' HEALTH' ��, +i {4 { ��'-,,:. , ; i: �a; . RECORDjOF DEATH? _ ary of:Evansv�lle�� andecburg6 Couuty.t i' : r j�j 0 ..9 p � i� � �. ! c . .� � I�.�e � : � ii � l' - EvSnsvJle �Ind�ana� �° � � � � � � +'. �J�� tt � - , E �.,: : , ,, .:, t:; , , � -, A -� � ,,: „ , ,, e , .. . ...� , .. � u...t) i.. � 1 e �.�r E � -� Ii 7 ' �� `�i �i -�.' . i�..'�� .i:. ! °c � 'This �s to Cernfy th+at�ourjrecords`sliow 3� _ `� Clau'de Er'mili�Dougan_i f" ��Sf�i � �� li'��'+d�ed jf� 3' � 1 J i.. l. SI � t. �� 1� 11� �t S��\ � 1t aE �� 15•��S ! 3: i�\ �-- �� 1 i�� .,.�os ,� SePt_'�..�'.. '.23!s!_tt'_,..1961.:�.�.;'at�$_15�P.k_I1�1 :��t �:St�.FMarys..':`.� 5.�.@e.:i! t`,...t�� 51�t ;�i � C.. � 3�IDOVN � _ .fdnyi �� *!,.9ear5 it . lhovro[�deatht �.E��7�-_ . ( t �•eQeet.�hosP�tal�o�r¢is3r . Iv�� rl ��'�S I t 1� I!. 1 + ! il�. , s t � . . '.. '�. .'t� �. i � 53i ��'�. t M.Bi�=r i �' � � e ire. f. �. f' �r t. 1t' �� . i ��.t�i r � eL � �r �i ' 11 5 7 � Wh �� . l�arried � + � � t � :Age at death iSec� _ Color _ _ - i� �� ;� � � (3 i ley�'� 1.,i FI' 0 1. 7 �! �� -. F IWnte�whether mamed or s�¢gle � 1. 1� � ' t4:. � . i�!' � �.�� c "� ,ti ��.� ��j�t �1111 f�2 ft�= ��`�l�fi(�i�� i! F• = i at .� -t .� -� �.{�. r.:�„ sPnmary}cause�of death?gnen ��as �S�yocardial infarctioa,�,acute� thrombosis anterior � ��<I�� ! � � •- � .., :. : .. . .� : • .� <�i:. .. �- . E ._ d8SC0IId1II �t �i.t� -1 �`r!e �u�Y Ii ' �i . )i�� 1 �.i�.'it� .: . � l �. F ��.-4t j��° 1�� "�� .�f T _ _ g coronGry artery Tiy�ertensive Cardiocasoul r`aiaeaqe � . � � . ' ._ 'f .s�- I 1] �.. F _ . ,.. - _ __ . . I � 1 l .� .. .i. �S 1 � i'. i . �t `ti.�p J ��Coicorant�t%�=f. <<! � -ii�� i��.tt�t E"5 ��11-C1t �4�� t��l �Sb � l�� 1 j r`�t `i� - �i. !:_:. , I 1S�gil,d.bj .� +ntisei�Lv!o�oir f��dE° .: �' �I� � � I i. SI��t`t��'�t� -l�eda:esd �.' � f� c� j' . ? .'' 7 �� . t � 5� rS,;UT eon � ��1� � �«v t �� <�� i � il'.� •� � ii.•�� t � y ��..� ��.� ' ''. t �� il f � � r � ' '� �Sour eon Ind ° � •� . � Place of bur�al or removal = - �_ - � ' - � � � v� I�� 1!1 : � fl�:l 't � l��l nemeofeemetery �� ! !-'1 �' 1 11 F li eddres i..�...� . �2 .�-ii'- �.. .:.,�t�� M):.�.i � � P� � � � .�e�� i� il.�itf�� .��1� �� It �.: [u i 1 Ir , t..f � } srtl�y�11\ [`+ �'lt j . ._ yE , �9_26-6i �;� cora_ _> >_ �, � +� oaklana cit `� { _ �� Date of burial �� Y�- ;�d� . 1:' �. r4 7�� . �E�t�Fis�l� � I�"FLneinl D�m�/t�7 � Ii /(�i- f.-� � � . �i= i' r:-.[d�� y�•i ��i:� cf� J��.1 ..,� \5/' �f � ij a / �,�� )�rs /Vii�i(/7�/YY�Y�� ,> > '1 �� .r�1'� �V' �t�" �.' .S�gned � -- � 1- t �yi:�"c`R _ � . _ _ .- _ � • _Secy S2 S3 ._ . 1. zl t Ii��.' � - � ,.— .. �� . �- r , { ti �� i{ i � �t 1 � �� ' 4 �t .S 7t JI I ! �t 'f + � ��If Ev,� . � ti fe �i � � << 1� 61 ° f �1 �i °�t u [SEAL].t' i .. ansville, Indiana �,i �r' ,�� , ° ,�, 3 ; "_', ' � :°.t,� �t` -` ,�., � �� , r : ;� ., .. ��ra� \`.. .. ,1f�! �i � �;t;�� ° r�� C � �rl \J ii e ��1� - �}t �� }! �� '• j��JI;_ir � i� I,. . �NOTE Recorded'loc'ally �n,Book No!a � _20 ' � _��Page No. �339: � �� ,i,, t�� ii��:�{t�1 �': E: :_ �,. .,. -� - - - - — - .;; ... � i� �r .t' i :�:°!i .11, i'� fir � i.t 1 (1� �� S�� - i � fi.l� ��ibr t' �f �1 t S.. � �r � -� ., �' 1 t• i .. � � � �� a,f t i F ._ F. i � �a ,/rs-�.~.1.� ,.t . {��i?(/tt:'_�(t� if::.t ..�:� . � _. .�i..�l��t. ��i..r..fi:n. .ia..!�:.. _, ..".. .��:�r.