Death Certificate - Kiesel, Carl E_9/28/2004VANDERBURGH COUNTY HEALTH DEPARTMENT
Evansville, Indiana
CERTIFICATE OF DEATH
��jis �ertif ies, THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT
�E CARL E. KIESEL
09183
DIEDIN VANDERBURGH COUNTY WqPNAON SEPT�ER 18 Y�, 200?
TIN,EOFDEATH O3:1S P.M. Mqq�TALSTATUS 1�RRIED SEX �LE AGE 41 ��E WHITE
SOCIALSECURITY DATEOFBIFiTH 03/31/1963
PLACE OF DESTH DEACONESS HOSPITAL
PRIMARV CAUSE OF DEATH GNEN WAS TRANSITIONAL CELL BLADDER CANCER
PHYSICIANORCARO�ER DANIEL SHIREY, M.D.
PLACE OF BURIAL OR REMOVAL STS. PETER & PAUL. HAUBSTADT, IN
FUNERAL HONE WADE FUNERAL HOME, HAUBSTADT, IN
CER77FICATE NUN6ER
AUTOPSY NO
MANNER NATURAL DISEASE
DATEOFBURIAL Q9�z1�'�QQcj
ORVOLUN,EAIJDPAGE OOOOZHHH DA7EISSUED O9�ZH�ZOO'i
NOT VAIJD UNLESS SIGNED 8 SEALED
,�-� 4 . �, _ �� ���/t�-,
ALD.
VANDERBURGHCOUMV ' THOFFICER
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