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Death Certificate - Kieffer, Dona Jean_3/20/2007� Y `� l�''� � STATE OF WYOIVIING . � � ��� :� � L ; � � ��=_ �`��� � , • �� � DEPARTMENT OF HEALTH` l'J������� ��— �''���y��� : � ��p�c� �/3 aoo� ��, � D.EATH CERTIFICATE cni5� � �� �'I�� S � . _ Decedent: State File Number: 2006-002502 �"p �il��s°"'' / i Name: Dona Jean Kieffer " � �,,..� j; Gender. Female- Social Security Number. � i1� �� ' : Date of Birth: May 17, 1932 Age at the Time of Death: 74 years �`�Q �R�� � ` Date and Place of Death: � �°OA��v G+b tt0. � Date of Death: August 16, 2006 County of Death: Natrona �'��p �°D ( City of Death: Casper : -.. � � � : . l Additional Decedent Information: - ' . � � Place of Birth: Dixon, Wyoming ; Residence: Casper, Wyoming ^ � Marital Status: Married ' � Name of Surviving Spouse: Robert Marion Kieffer � Name of Father. William Lee Humphrey:>" F•, �� � Maiden Name of Mother. Musetta Myrtle Cnsweil '` . ° i Informant: Robert M. Kieffer _ , �_ Relationship: Husband , � Disposition: . � F: , . � Method of Disposition: BuriaP = ;,� Place of Disposition: Oregon Trail Veteran's, Evansville; Wyoming 1 � �, , Cause of Death: \ A. `` Z � The immediate cause is listed on the first line lollowed by any undeAyi�g causes. Interval: � (a) Respiratory Fatlure ' ` 2 months � (b) COPD ' Other Significant Conditions: CNF DM type 2 Hypertension, Deliriuin: � F - f= ' -'.',,,,.i ,. .. . '." � i�Aanner of Death: Natural Death ' n�Time ofDeath �03�50 °:> , j < _ t , ��±� y •_`w E -_a � . . ' ! Certifier: � , c. � � f �� • ' � Name: Jay A. Swedberg M D : '� Address: 1020 S Conweil Gaspey. Wyoming' ��:, . • � �' , :. ,, .� - . . _ , : ,. . r .:. ^ - Date Filed: August 23, 2006� ��' -' _ � L- � � '}• .1� i �.�� . y � � 'm � ...�ii �3.� "N� . . �. , 1 �:f t ' � � Y �' � 4 PlI �y � {� � ( _.� S i . - � =.;> :__s. .�—�.y°. . . - _ " �. 5. ;...' . . _ . � � �, . .. � ;. .. . _ ._. ��r ::- M .�- � � . �... � .'/ _ � �: , , s- � � � .:' �:.1 . r, _• t aa/ %`� 5s'r''n'� -t;� l J , , _. � � ;: i ... � �,i( ,'/` �.lh -7 l ��1 4 � y ' �� Y `A� � y ��`YD ' .s, "� -�•. - ,� _ .� � 5 9 : � . : s. � i .. .. :. 1 � Z ^»,� r . �.� � �' � '�'i.s �'�D��, r.•��''c f ' � � - � - - . _ .�,s� �s �� s.,.� z, ;� ;� " ; � , ? � 3 . ;•� . . . , . }:u. t . . � ti ., `- 'b \ .. . __ . � ',„ " >�. .: ,= `.i , . . � . � �'s? a- � '-' �.�'�� �",°'t?�� ' � �e � . � . vf-a-�..a-� � I n :.�ns !:;44��T-s ?' � �. , � o�nu u �'.; ��� 3;16 8 2 2 ' ' .� � }�. � � � , � �. � �, � �_�y Tliis is a Vue ce� Ka;nn of L�e Eocvment on file m Ne al`ze of Vrtsl �(/�, �} t � ��� Remras Semces C�eymna N�9 �"�/,�'� �y �.- - °� � :� , ,, �,� r ' `� � � 8rent� She2rC MO M.P.H. � DATE ISSUED: Septem�ber OS 2006 "}? '� �`� � , ti' �� - ovxeor am S�a:e t+eain Ortrcsr �`<k? f �� : XS ��_r Ilv.copvu.n�alNWez.peepuNm��iL rn Mbaidn i�'y��- ��� y._. s. . >,r-J'= . .. _ ., ..' `:.. . , ,_ ., a ,. _ . %i'�,� _ d:+��