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Death Certificate - Gleim, Chester I_8/27/1996,, ..,,........:: . _. � � =i` ` -= -' :'VANDERB�GH COUNTY HEALTH D�ARTMENT 07771 -' .;::` -}_.!._Room�72Z Administration Building - Civic Center Complex - One Northwest Martin Luther King Jr. Blvd. ' =- `'�-•� ` �� - - - Evansville, Indrana 47708-1828 . . : _.... _ . _. � 7:- - [ - ' � _ �'-' : .:CERTIFICATE OF -. DEATH. REGISTRATION ..-��. i-'.=:; ��. � W_ -.,�`` `I �l�S � _ THAT ACCORDING TO THE RECORDS OF THE HEALTH OEPARTMEM � � f _ ._ _- -:, - '� � � ^ ',CHESTER Z. GLEZPt �.. , ; t r.. . . -.�- . 1_' . . . . :._ _ - . ..' _„_._"_NAME-.:-.. . � . . r . ; . . . - . . . �. �__,I.'"'+ " ""_1'__.: .. . _. .. . � - . .. :'"__„_""' .' _';,"_.. .__. . ,� , - � . ......,.: ... .-. . :. ..' .:� : � ..� ._.�.__.._._I:.__:'.'.:.'l .... . .. . _ •• � . - - :-: '� �-:'-. . JLZY 2 i 1996 _ --;-_o��N VANDERBURGH COUNTY INDUWAON ��R ::-- ,<_,:.-:. , __..._ .. , � �.:_ ;, �°.._-:: :, :' ;; :: :: . . . �� . _..��TIME�OFDEATH:.O%:27 P.M. r.,u,arr,v.srnTUS '��IED SEX `�`�LE AGE 84 RAGE w�ITE ,� �'��-�`'�.SOCIAL�SECURIN DATEOF3IRTH _�, c_-!ir�':_•.::_. •..-:.' ...:. . . . � . . _ . �- ��" :`-�'- - arnrc no nc�ni DE.4CONESS HOSPITAL -��r _:�:_ _rd.---� �--- -- . - - i - - "-.'' _-...� : � � .- .�= :. - -;-'PRIMARY CAUSE OF oe,an+GIVEN WAS �TRIAL-VENTRICULAR DISSOCIATION _.�._ _ - '-�'��-,��PHYSICIAN�ORCORONER RICHARD WAGVER. M.D. AUTOPSY VO " � ' � _ � _ . � . . � � :�'.'..�.�..^..'._.;- � . . . - ..��i::.-�_:•��PCAGEOFBURIALOR�REMOVAL ST. PALZS. FT.BRANCH.Iv '�:_ _' _' - . . , . - `-'�;��FUNERALNOME � �� STOLGHILL FL?dERAL HOME ' - -�.CERT7PICATE NUMBEA ' ' ' - •� ORVOLUMEANDPAGE QOOOIGZS ' :-i _ _:.. _ . . ` . _ . -_!�:'-:�'...c. . . . ._ � . MANNER ��TUR.aL DISC:aSE DA7E OF 3URIAL 07 i 30! 1996 DATEISSUED �)�/;j�/ioy� NOT VALID UNLESS SIGNED 8 SEALED n ,�' . ` l ��` ' �� /1w.L L� :,i._._: ;:.-.�6�L:CG�L'✓� y. ___—_.:!.:�—"'__—",'___"N.O. VANDEri6URGH COUYI' 4ETLTH OFFiCc.i .�