Death Certificate - Hurst, Jimmie D_1/29/2004VANDERBURGH COUNTY HEALTH DEP/
Evansville, Indiana
CERTIFICATE OF DEATH
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MENT 07101
��j� �erttFies, THAT ACCORDING TO THE RECORDS OF THE HEAITH DEPARTMENT
w,NE JIMMIE D. HURST
DIEDIN VANDERBURGH COUNTY Wpq�.�qON JANUARY 08
TIN,EOFDEATH OH:ZO A.M. �qqqITALSTATUS �+�IED SEX �I'F' AGE 73
SOCIAL SECURITY DATE OF BIRTH 12/09/1930
auee oF oennn-i DEACONESS HOSPITAL
7RIMARY CAUSE OF DE4TH GNEN 1W15 �� FAILURE
ISCHII�fIC BOWEL DISEASE
PHYSICIAhORCORONER ���5 TOPPER, M.D.
FLACE OF BURIAL OR REMOVAL DECKER CQ�ETERY, PATOKA, IN
FUNERALHO,V.E COLVIN FUNERAL HOME, PRINCETON,IN
CERTIFICATE NUMBER
Y� 2004
w,�E WHITE
AUTOPSY NO
NJJJNER NATURAL DISEASE
DATEOFBUflIAL Ol/13/2004
ORVOLUVEANDPAGE 00000147 DATEISSUED 01/23/2004
NOT VALID UNLESS SiGNED 8 SEALED
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VPNDERBURGH COUNTY MEPLiH OFFIGER
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