Death Certificate - Gayer, Jackie Lee_7/23/2010�, _ �
VANDERBURGH COUFdTY HEALTH DEPARTMEPIT O 7
Evansville, Indiana �►( �� � ,_
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CERTIFICATE OF DEATH
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ruME 3ACKIE LEE GAYER
DIEDIN VANDERBURGH COUNTY WDIlWAON S�'!'�� 14 y�, ?oo�
nMe oF oennn-i 09: 24 p. M. �RRAL STATUS M�RIED sEx MAS,E AGE 73 w,cE �ITE
08/08/1931
socw� sewaRV oa� oF eum+
P,ACEOFOEATH DRACONESS HOSPITAL
PRIMARY CAUSE OF DEPSH GNEN WaS ADIJLT RESPSRATORY DISTRESS SYNDROME
LUNG SURGERY
PHYSICUWORfARONER T-mMINZC CEFALI, M.D.
?LACE OF BUFIAL OR FEMOVnL WALNU'P HZLL C�SETERY
FUNERALHOME COLVIN rUNERAL HOME, PRINCETON,IN
CERTIFICATE NUMBER �
OR VOLUNE AND PAGE OOOOZHSZ
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AUTOPSV NO
MANNER NATURAL DISEASE
on� oFauaw� 09/1H/2004
DATEISSUED Q9�ZQ.�2��4
NOT VAL1D �JNLESS SIGNED 8 SEALED -
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VANDEPBURGH COUNiV H iH OFFIGFR
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