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Death Certificate - Kieffer, Raymond A_8/10/1981? � • THE HEALTH A'"� HOSPITAL CORPORATION OF M^ ION COUNTY � ` ' '• �r; : � DIVISION OF PUBLIC HEALTH � ' `� `f"� •�:- N •.,;}�h� , FEE OC:E OOLLAR --'.}�,�% ��, �S'� t �J } IB41 QTY-COUNTV BUILDING - INDIANAPOLIS.IND. ,� .-' j{ XQ°��^ ^�:tosr•rs w.oa ��. 3:. . ' . CERTIFIED COPY OF RECORD OF DEATH OF �'� ? I f} :u�"� , �, �.' �:- . . . ,.�,_. � s � � �:`�� i . - � ���.�!,_ �� ; NAM! O► DEGEI.SE - � ' OR D[AT '� //� } � � � _ �� __ \' �' �'�-[-. �OF DEATH ��NTY MARION CITV, tOWN, OR LOCATION ��'� � � 1; , .�u..�n. �.uu���_ ;. � COLO �I/ wioow[o N[Vd Y�I111. ❑ I �ao. I ow��•�ns�. � rin. �, Oq f[AQ �eeiio Drvo�CtD QDAT[ OF BIRT� �O / � 6E ��y��`' ! " ' `t.. /��: � �� q rr�!; � ..� FATMER'S N CJ�J���TH[R'8 MAIOCN NAM \' �•"�L :� '� •I � ('•I'�• �„t. �wr � �v,.� ectwru� ti�i. : � LAUSE OF. OE _ <;r � •po ND� 5{ f /'' ' PART 1. IMM[DIAT6 GAU6E �.�.Ga.ar�,� f • .. � . .�.�• . � y. � .. . .. coHOmoHa v .nr . . .. , . . __ ... . _ �.`d, r �l8:. � OUf TO �Bt j 1 WHICH OIK Ill�t TO xl.% =. .eov� uv�• �w� � �. _11y I •r.nHa TMe onou. � � . ' . � —_' _ '— � �+ lvina C�us[ ua:. OUE TO lC) � ��,s,�Tj�°, �_ _� OTM[11jiONIRIC�MT CONGR�ON� COMT41�U11N0 �O O[ATH OYT NOT �LL�TW TO TML T[IIYIHAI DU��6L COMGRION OIV[M�IN ��Rt 1(�� •Y� � - � '.-. ' � -, i- _ ._• _ ` � . ;1� ' VART 11 . , . 1 iF- • (j // � / ' ' J ��o: �, -• DAT[ OF BURIA�/ O /•� ` � r�.. '... . CfMCTlR � LOCATI �n'�� ,-f- i�� � � 'f ^ �• • _' CCRT. NO. OR ( I,� /.G,.. �/�/J ' � • ` [ � /�' �/J/y/� U' '� t.'i 1, VO�. AND PAGF \�'L�'�f �- D6ATH C[RT/1[ , ' ., "��!'!�'�A�`.LLL�" � �ti � ` ' � � ��, .:� ..f� � � � "`l� � .,^ /O � �'�� . � �,:<r<;•�r'.,. : NOT VAIID UNLESS MACHINE NUMBERI=D ' . �a ,: - OATE IIL[D� �n�<,L,� y � p �•� ��'i'' �3} AND SIGNED WITH MULTICOLOR RIEieON �� , t �•� Q _ a _ ..r. . �l�-y�y��,�'z°, � � a�, , . � '�'' � j . DAT I UC� l� S . 't� p � � � {� � � r,r� 1n � ' �=I � ��jy411 �11 1 ` ,`.i ..1 h'1�}� � 4 t �: � . � `IVMDCNCO - .�[�i . �, . NI (� L. v 7J � . � t.4l� ' , �� � 1�11R ,lt� i�r i �.�� ��.. '-� �r.. : . . �, ( ,�Y 4 ." _ .... � . 1 ,' ;r, , > t . :� . . _ i ` ��— ._ .�� % J �' � z i�- �. ` I��Wr�r �itt={) i? � � r}�. 1 `� � � 1 iAL � `� � �� � � .� .�5 •� � J t i J� �} �i.�- 4 i ) i t,. �t ' ♦ � •.�- �. ' TMRU a 1 � j j . ��. <� �YJk',�y` �i� M�d1'f �ryy��,w 4 � � „' , . )f�k; � .+-�,}. ,.� � 1' = �r�.}`Lq.� jy"Y�l�IR'. �Ajti'4l, 7^ ` . � � �- t� � 1 . �_li� •{� `� �� � �' � _ }. 'ri � � `J �,�1L;_{ �jls ' `4jY �, fit1 �- )+ � . . � � . . � ' 1 J� ' i^�v.0 � i � � • .r � tl �i� -� r� f i, �k o o � .��. . y 1' �' . , ��i�,� � ` 1� �� � � 1� I ' 0111[C7011 01 �V�LIC'N[AITM� � , r�� • ' ���I� � f}. .��; . : ;� �CI�w.I i • � 1�{l ��', � }i� ; � ... } ��_ f . � -� . : ��tA.r Y i• �.• � — ��i ' i�t. .'c ' .ii%it'1'� � 11'R�t�4 y3J.Y���{ti. : t�.�i � _ ., i 1 . ..�� �i� . � � 7�_^�r . . '� � ���:7. � Mcr�:: .<LS+..�mw�'rwr,en..-� ��� i.. _ .. .�++�...�:i�l.� - .e:F .�.. ��+.1 �.i' . . . . . •. , 7 - � - ' . " " � . . ' , . �' . .. - , ' . - , . ; . . . - " ' � . . . . • ..`_ ' . " ' . . . . , . . _ '..".- ,-- .. . - ' . .' .' .' . . _ - . . '. "._ - _ - ' `:I _ . � . . i. . . . . . . . . � ._.. ""'_. . i. . : • � :` � . . � . ' ' . , . . . , . " f. �� � € . � _. . . . � . � � �. ' � � � ' ��' � . , . . � � � . . � .. , . ' , � • - • � t• . . � . � . . . ( �• . •4.� o. � � �,� ,' , . � . . . . ' : v(;-i • • "., - . . � . - ' . ' � . . .. . `.. . � ,_ ..p _ . ��. ' � .. � ' � � • . . . �� s..�... r �� j � ,. .� ' � ' . � ' � . � , Y � � 1.i! �1 � .S i . , l . . . . . ' ' ' . . -'j i_.: „t'.. .. � ' . . . � . . . . . . . . { � ry � � . ' � . . � ' �.d-1^Li�. Y� \�-�', •1��i � • . • . . � . . . ' J R `r �. i . i . . . . . .I� .a ' .. , A� i r �j . � `#`� . . . . �.ii..: • . '. . ' . ' , ' . . 'I' .. .d..t. ' . . '\.,:� ' i ' � '�1• � • ' . , . . � �