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Death Certificate - Johnson, Jewell Giles_9/30/1976a, �%�_ • � � . - _ - _ _. - ., ,s �. . _ .,. . -- - . -. - - --�:-- :�_- _tc; __ - . _:r:: -� �� .. .,....__ - - -_ - . � . - , t:= _^_, .-- �:.�,: ; _ ..��:.;: -=��• =, LOCAL CERTIFIED -� CITY_COUNTY �EPARTMENT OE`HEALTH � � P.ECCRD 6P DEwFFi !._ - c;q of Evamcille �Vnnderbargh Conm� . �7 �� , ;: ' _ r_ ' r _ . ' ' _ ' ..' '� :Eranaville, indiani _.:_ ' "' _ � __ ' 1V • � . , .: ° . ' . '_ ' . . __ . _ ' � _' .:" • • . . •: �� _ 878 _. -: . ..- :� ._ - _ . - - _� , -- : . , ._=' � : - J�I�Li, � rTr.FS JOHNSON - ' : - �_ �' _ - ._. _ _ This is to.Certifv, that our rtcords show______`_' ________ �-- '�--- `� •� ,_. ------------------ JAN. - - . _ _ , , ; . . �: - - '' - t _---- 1e - �•d.� �� _ �.: -------------- �- 1967. . . ; '9;30 P M Deaconess. . ...._ _ . �i: ,• ---------------- - at------------------------------ .. . . . _ ' month .. Ea) �' ➢ear _" � "6our of death .. . ..:,..... � . �tmt. hu0iul m tvr�l '_"____'_____ . ""_" __'" ._` • " '. _ . .. _ . __ •: __._ t• `_� '_"_ " ' ". '_ .�_". ..--__i�`..�..'_ .'_' "_.11_..._[ . . � . ' �_ -.. -° - . .. � ..:— :: _..'293ITiBd __ � : ,-'.' --' . �: Age at death- 5-- _- Sez_:t'idle--_ Coloi w'h• ------ - � ---. t-._'': --- --- ... . : _.. ---------------------------=---------------. . '_ _' . ."". , fean -� . _i . ' _ .' " ' ' ___ -' ,_'"' , '""� ' � __ i te �heLhv m�rried or. �iuYte . . . . . '"' "" : ..� m � � . . . Prima caux of deach. '.�" �oronary�:insn£fic'iency�:=- Coronary artery� disease �- _ _ __ ._ ,`3" _ g�ven.waz----------'----------------=-----------------------------'--------�: .� ' '' -- --' -" •--_- .. ... , _.- - - - -- -" . . . .._ .'-' ' - - - - - - , .. .. ... .. ... .. . .. .. . � .' - - - '- . ' — - - - ��: _�;� . �:�__ - - ..___� , . __._. •---' . .� .... _._-1 •>:- -- -- - - � -- � , � .. .- �_ ..- .. � - .:.. ... :. `.-' " ----------- -' �'-- _._ ._... -__ ,_---'.; ' _ ...'. -_.�.. �._.. . . . . . ;' , .:.-.'."�, _.: .:,. ';` - - - ';��: -i- ---=-=--------= --_-----=---- - _ " Signed�bd�_-J.�H: Crawford---_---?.:-----_---_.. =:Ci^ �i�. --_ -_ .�':f=.:i. ,__ .- �`� � ' � : _ ,.t � � ca�aKhn c�� ' - � - _ � — � � .aar�. —._. , _.__ � . r .. Yark I.aun ` ' � Cit � — - _ Place of burul or removaL ' - . . --- _ ' p t ' ' � ` :' - S i -. : � e . , . ---°-, . name � emeten . - � , . � - - - ..mxs. � . . 1-11 6'] :.Alezaiidera � West. Chapel , __City ; . ; - v ' � •': Date of-6una1 "_---------_ ' . . -------_� .. .�_ . _ - � �-� -: . : �, .. ------r------- - - - — - -- .Fbee+l mreemr._ � . � . �' . .�.i." � �_. . � ..; . . • �/ • �� .. n '(¢ .. Signed " /l. � i�ltC'zR/h'�' �f%�l. _ � � � _ 'ae'° -` f � _'t - . f .: .� . �yt�i : =: � _�. _' ___ '__"'_ _.. StiaL — i : .Y ..� . '_""__'_ ""'�l .' � . . _ . . . � _. _ : _.v . � - . . �..� ��_.�_� ' . . . , � �.--:-::= �- _ t� � �� !: �. :ei. - • Evc�.�svuUe, Ir_�iana � '_ 9 14.-73: °_— ! , ` , r • �lZss.u.� — , � : - . . . . ... . .. .: .,: a.4 , 'R�"y. a . �t, . � _ '_ • -. --- --• _ � . . ` ' -- ._� _- _ _- � : -- � A a ,�3: : : �f: A'OTE: Recorded-locally.in Book �*o. 3� ------- -- Pag° N° 5--------- �'--: -`.L-t� F'EE $2.00....: .'.._• [t�t ' . � .' ... _. . . _ ... . . j � _� _ ' . •� •�• . . . _.: ��.1'�'. . ' '.1�1't-L1-�:�= -:_il.l�.i: ':i-31:i-r-i-._t�-^T.C�'T..��ft-r!'Ti i ITr" )'1=1 1': 1'1-1-1 : 1 1 1 I 1 1 1 �1 "1 1 �1 • P'-- n_r: