Death Certificate - Kiesel, Dolores P_7/19/2000- VANDERBURGH COUNTY HEALTH DEPARTMENT 20496
Room 127 Administration Buifding - Crvic Center Compleac - One Ncrtinvest Maitin Luther King Jr. BNd.
- 6ansville, Ind'�ana 47708-1828
CERTIFICATE OF DEATH REGISTRATION
_��ji� �erti f ie8, THAT ACCORDING TO THE RECORDS OF THE HEAL7H DEPARTMENT
w,ME DOLARES P. KIESEL
DIEDIN VANDERBURGH COUNTY WDUWAON � 2� � Y� z000
TiMEOFDEATH 04:00 P.M. �R�srnrus ��IED SEX F�'F' AGE ��' ance �ITE
SOCIAL SECURITY DATE OF BIRTH 05/30/1929
PLACE OF OEATH 19501 BLPERS ROAD
PRI.NAHY CAUSE OF DEATH GNEN WAS ��T DISEASE-ASYSTOLE
CARONARY ARTERY DISEASE
PHYSICUW OR CARONER EDWARD MOORE � M. D. AUTOPSY NO
PLACE OF BUFIAL OR REMOVAL STS. PETERS & PAUL CEI4ETERY MANNER NATURAL DISEASE
FUNERALHOME WADE FUNERAL HOME� HAUBSTADT�IN DA7EOFBURIAL O%�O�.�ZOOO
CERTIFlCATE NUNBER
ORVOLUMEANDPAGE OOOOZ34S DA7EISSUED O%�O��ZOOO
NOT VALID UNLESS SIGNED 8 SEALED
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