Death Certificate - Jenkins, Russell L_12/21/2004'
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VANDERBURGH COUNTY HEALTH DEPARTMENT
Evansville, lndiana
CERTIFICATE OF DEATH
��jis �ertif iee, THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT
w,ME RUSSELL L. JENKINS
DIEDIN VANDERBURGH COUNTY
01 �-o i353-�°..
12903 �����
oEC 2, Zooa
GIRSU COII TY AUDITOR
INDIANA ON DECEMBER 02 VEAR ZOO4
TIMEOFDEATH OH:19 A,M. MANITALSTATUS �RRIED SE% ��'F' qGE $S qqC� WHITE
socw�secuRnv 11/14/1919
DATE OF BIR7H
PLACE OF DEATH DEACONF.SS HOSPITAL
PRIMARV CAUSE OF DEATN GIVEN WqS INFARCTION OF SMALL BOWEL
PHVSICIANORCORONER GREGORY MCCORD, M.D.
PLACE OF BURIAL OR N[MOVAL I, O.O. F�. �$ICKNELL � I.N
FUNERALHOME COLVIN FUNERAL HOME, PRINCETON,IN
CERTIFICATE NUMBER
OR VOLUME AND PAGE 00007.44'3
AUTOPSV NO
MANNER NATUI2AL DISEASE
DA7E OF BURIAI 12/06/2004
OATEISSUED 12/13/2004
NOT VAl.ID U^NL[SS SIGNGD 8 S[ GD
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VANOEFBURGH COUNTV HEALTH OFFIGER -- M.D.
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