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Death Certificate - Keeker, Henry W_8/21/1989c� 5 ��,..:-���- s<�� _�. �.a� �.. i. � �� �. �oca� ivo. ...........1 �V.G. �: _'.v� �: ^-�. — ❑ � i � S n r, r. ' J �t -. n n (h N Cl • 'J. `C C !- j ;n � n � � .. n r. � r. I% Y' �� r. c c � m � , ❑ r. - �� . n � � m . ,� n v r'_ n:.� 0 0 n'� = � r� z � < � � �: �i H O C� Z c - z o r•• .,1� > � � .IDIANA STATE BOARD OF HEALT'' CERTIFICATE OF DEATH '� StateNo . ............................ �.OECE�SED-NFN.E ffcaclAkale.L+ul Henrv '�V. Keeke: �. TE<i LPSi SERVEa W >US.vE:ET:�NI L'S.<RUEDFOaCESi I�iO 5:. iPCM11TV NiM� (tlnW ns's.�M Cr� Wen bn .-0trl SYelborn Hos�ital ic.ucwin:5r.:;u5 u.SUF'/Mnc500u5E (SmtH W.J...... .'" , �;arried Olive Oneil Ily. Fc9'JfKCE—a:RiE IIa CON:]Y T„,;;,,r., I Gibson �k.21GCO0E ll!.IKS�OECIiYLINRS u.CIiIZEY.OF 4': No ❑ Yes 1'M/ i COUMTF.Y ,�a �:aFA�, I Us,� ]. SEX .L ii��E OF OEniN Male 4:OOPjti1 UVOEfl 1 YEAI� $C. UNOEri 1 D�IV 6. O4iE OF 9IHTN IMO. D/y. Y�1 ' I. Non�, o.,. ��. M,,,�., r�arch 6, 1920 HO$'hT�� 4%NWU�t ❑ Ewa.r Je Uoitorute�ntwnv.�m nue. 2, 198 Indiana orMEa ❑ n�.wq Nos. ❑ om.NSOertrl 9c CIiY. i0'N\, OH IOCAiION OF DEATH Evansville I1a DECEDENi'SUSUaLOCLUVqi�O.u(Ge4rqN.wY eo�. w.q max� d..w.n� ra a, no� uar..vwi Butcher Coal hiiner 9C COUNiY0F0EA1M Vanderburp �}0 KWDOfBU5WE55N�5iBY Coal Industr, :)cCIiY. OYfR.ORLCC�PON .!b �PFEiPN� y BO� SHA Haubstadt . R �IIS.�Va�DELEOEMOFlJSinMCONG:V) 16.PFCE—Pmercan4qwn 1>.OEQOE�65FDUC<itON � pdno ❑ve: a�ym..o.cere�wn 0�c;.wmi...m. tsoearr�7'�Wrtw.a.<a,�a.�em Me+kat FuMO /LCm n[J - lSaedY) ElemnvuY/Sevatlary 10.1 D CdeO� 11.� w 5' 1 'r!h i t e P7�A � Y. � 19.F?iFn'SVAV{ffvs[MS2^¢L�sU . . 19.M02HEFSNAMEIHAMbda.WqmSvvmd °,`� Louis Keeker Leitia Deweese r� t]J�. LtiiOMlu:i"S NPME ti)a�M� ]Oe. MnRWG eDOPE5515v��� iM ^M�oer> (i'.rNON� Nune�.. CaY r Town 5u��. Zm CaCel tOC. F•4uen�Ne o X�! 0 ive One�.l Keeker Rt. 2 Box 88A Haubstat IN 4�6 'rJife � J �y � 1b. MEiF.OD OF 915i051i1pV ❑ Erua-beM 010 DAiE AND RGCE OF OISGOSI:ION IN�ms N ttnelery. nemrtuY. w IK LOCOiION—Gy o ienn $uu < n cn ;I t"�, e,.ai ❑ o.mroo� ❑ n.m.o-.,u,amsa� I �m..d,�a /1 UgUS �: 3 s 1.989 z �� ❑�,,,,,� ��,,,,,s„�,,, Burial Barnett Chapel:Cemetery Elberfeld, IN ✓: r�. (n ' < n y�^� j 21�. EM3ALM.EH$ NAIAE 33? EMBf�lMETS LICENSE NO. ]]. K'd5 OEPiH flEPOPiED i0 COflOfM1EP� � ��? i_ Z210 .W=15on Jr, FZ088000b2 �"° �"' an�Q�4 < n H 1:a..sicu=ru;.EOFFU:+ea.�ouic�on �•e. �wu�.,,�e1nBEF 'yimpsori-p�o].kman�F'71.� t'LR3��1871 �""• � ' 100 E. Columbia St. Evansville z � � '� �/Ui,n-,rLi1 � . �ie �07�1 FDE1005141 T na ; .,., � �' T � �� y G: p6. OFfli L e� m� enasu. W�niaa. w<omycauanr a caus<e ue aau� Do rc� mer roupmdc m�m�, aoci n cuGu< v muvnwy �C �.�.,� n 1 arnst s.^.oci a neart lulu�e. �ul omy c�.e ovse on e n wa. � O � � � N� � :n r � ! IMMEDILiFCAUSElfNI � � � �✓'r v� 1 i��� �� �/• �'T K� r+se+u w�ercnon DUE O(OF AS A COM1SEOVENCE OF) � ea�i�'nCetN � o n° i` > I� r--A�i � \ 1 1 C f+ � �yp;�a,z. J�ny, w�.k� Oe.e DUE iOIOB n5 A CONSEO EhCE O�l. Z H > � n �e .+uneeu�. u��e. r� �: 7. �, m: L's vMMhy c. �~ ( f wv 4s� OUF i0 fOP AS a COt:5E0UEUCE OFl n+ O : o r z i r-. r. r; � f- H' P�AT d aie� z:qn!¢m� c:.V+rons � CwCmenz ronm0usc� m eeaN M no� p�rv�ously smea e+ Vm I ^ r. 2 � y i �:S O : : � � � � = o°( 1). w�5 OWEOENi IOB+ W>$eN>UTOPST G(VE(f�ANi OH 90 Dl�VS GfN�RMfDi GOSiGP3iUM1 IYef d na11 n.s w �o� � / \ /�� `v� �/.. t, J r�� 19a CEniIFlER � CEHTGYWG PMTSICIPN io C.e Ean ol ny F.wMeOSe. een'd ucwrtE �� Ne tine Ca:e. W p4ce, u+a Cue �o N� �f stnM ACPmm�� wer.�i Bei+em O�fel �M Y.1� � V � xee w�en[ <uroosv rurov:es PV<RPBLE VWOR i0 COUREiION OF CPUSE OF DEain+(r�� c..ro� Q `1 C � = �Y (4:e-iMly ❑��,THOFFICER OnNeOaasduu++w+UW/wYn�AP��nYOdrvwLdu:loccwreEatN�4maC�b.arc':be6ntlduUONec�uartiluauleG ttu) z! O CO�ONER On Ne oaxn cl eue.vuan ana/o� �m.sau4��� � mY aov.on tleam occurrm u Ne �rne eau. •w d�ce. sro Oue �o Ne c�v.Hxl n�a c+mn �� su:m � ti '? t ? � }9J SIG��iUrc:.N� TIIIE O: CEfii1F1E(i (� =� r. '. I ( /l � � 1. � �t'�L �'y :2 ::TM, nKD <JUPESS OF PEPSOti Yl40 COViLEi`0 CPUSE OF OEa}N OiEM ]61 [Tyw/1Mt] h q1i �� Akin �r.D. 421 Chestnuz St <� . . . . . .. _ Z° ( v.ne<e:no�icexssicnc�ua=_ e +�� .. fi � < o % 4:-•'..� %�'�� �E��-a�� .2�'-c�' y A'"i„��� ..-~. y i A �J' .'EaO:OE<iH N�.D�TEOFWAflY I]:1iwE0F (MxiLL/.Ytul WNrIY � j i ❑ Aatu:�i ❑ ie.+G�:rq p � C N+^s:'G�4en 29c, btE�ICPI UCENSE NO.r ]9tl DniE 51GNED IMmN dy. Yeu1 Z�i J r J� %,'J y7 • rt(`'- - cb n_ Evassville, Zi� 47713 3ac WNflYGiwOF�rii ryes w MI N✓1 � .�CCACM �<e. CIS.CE 0' LYJUflY—A1 �OmC.lurq {Vtet 1�[�aY.O!I�ce Z O r �5_Ybe ❑Guie'doe eW:mO.ev^.<SxNrl =� I Ds:e�mmea (: ❑ Hcon�. :G -t �z. onrE rrtEO u�owi ar, r..�� AU5 � C lil� ]�d. DESCFl9E MOW WNPY OCCUFFED J�I. LOLAiION 6veM �N NumGer or Pw�l flM� NvmY�CC%w io�n SutU � r � ]�^.OAiEPflOKOUYCEOO:GD(Mw+AOey.Ye✓) N�N.CiOflVC'+1CLEPCCIOENTiIYOwro) tlyessDeHy6�.'rr.paesenpecpeEewurtem . y. � • � i � ' N �EA CEFi ' ' ' SEH06�C0: S;a:e Form 10110 (R2/3-89) � � i � �