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Death Certificate - Helsley, John Frederick_2/21/1984� , � �� LOCAL CERTIFIED -- _; GTY-COUNTY . DEPARTMENT OF HEALTH ° e RECORD OF DEATH ;_.� ,: •;�.:c�ry of Evamville— Vandcrburg6 Cuunty e� o - N- 18263 v . _ . Evaosvillq Indiana � .. .. . ..�.c�.["�!. ' ._ . , . o _ i _'��i:• - . . . °a - ::,.. ^. ; � . . 7'his is to Certify, that our recordsshow_______.sFQHtj_.k`R�D$gZCK_HEL,fiEy_________ � - �.:._.. . . . . __ . . ---- died i _: ' - :t �-: {i.�_. . -._ . ------ � .:.- , .-� ..,--.. . . . . " o ----- �IULL' 22.797�_= 7=- =' :_'-- at _6AI1_------- ' mon�h . 'r d,9i •..,i'. ~ Sd�.-.::; � . "�hour o! dmth """_'___'_�iPC.�LCOi1BS�5_'__""'____"" d ' •' . . - I -.. "" ' '- - ' �trce4 �+wPital or tunl _ . . o ' '.''� ::'�:( .`�` ` � ' � . , ' � Age at dea�h-_-- 38- Sez-_t__ Mal�tace---White-------------------Mlrrled o' � ycu..#�..-.. .-nv-- " �-� --------------�--------�---- � : . I' . _ P . meri4i st�hw . . . ptl ; . . , .. : " Prfmary• c,uu of deach given w•as Pneumonia-Sguamous _cell_carcinoma_ o_ � `� - -_ • , _�_��ng_ e • � --"' __ ______ ________ _ . . ____� _ , 6 . _ _________ ___ __�________ • . ____ ____� A � � . ,-- S1�ned by Bentsen 'Evansdille ln`', • ' � ° -------- , '- - ------ --- vw��.o.9caeaaou �:�'F- ; :. --- -- , . ----_--------�----------- � -- � o ,.� .. . �.a_...' .. .m.m .. ---- e Yla�, of bun ! o emor I� � Montgomprv C'A�oto .�. ,, � . _�° � � r . .---.- _d ..a,.��n�_Citx, In r.� m - . s ' ... t r.{. � idF '� ? ume o[ oimsNry'� � -,..� i � ��ae� ; a i "'_ . _ . : 0 3.;. ' _ . . .. .�� . i . ... •�r�i.ad�..`..� *� - -i, �.. r:E m . Dace of Bunal Aug 1; 1979 °`-'• Corn Mortuary __ Oakland Crt In, '� ' -- ------ �� :, ��.�.::-: ' �yn;,�a� ----- --- - ------- --- - --- ------- - - . - �, , .. ,...: i: �`� , . .aa�, . .. C Si �ned--- � . . _ ' �-_ �eBistrar. � • � - " � o° . � -----�--f`'�-:=. .-- ---- ------- - . � . � ! - . � �. • � .. - -: .� . _ . E91Q11SilLL � 1l(�Uli!(1' '+'��•— """.Zc�S= 8i"""' CSEAL] ' '.p. - -. ... ,• • - �� :. ., _ ,r !;-_ i: �• ; -m� NOTE: Recorded locally'in Boo� No.' -4-`1'--_ Page No 48----- Reg. I�o342----- ' FEE j2.00 '� � IWfY�to�tvnnol�e�.e.. _. . .. �a ' . y . � . ' . _- . — w..rua�aauual . .;}� . . . , .