Death Certificate - Krueger, Ronald C_4/9/2012CERTIFICATE OF DEATH
EDR No
State
635599
FwceST 10.1/ DeaN Qa� N A Flosptal: 10a. If OnT OcarteE Somewnert OMU Tlian A HosP�
❑ Fiosyice Fat3iry � Deretlmts 4ane ❑ Nurs'vg HomrAag�rerm Gea FaoTiy
❑ rn � r+o ❑ u�ww«n ❑ Inpatient O Emegency0cyartment0uqa0mt � DeaO onNMal p�,�,ls�,)
WEST SHORT ADDITION
� aww O crema:;on O oau:ion O Emanw�e��
❑ RanwW From Sb'1
❑ or.� �so�nz
�va O�
FUNERAL HOME, NORTH CHAPEL, 4200 STRINGTOWN ROAD,
�MaMeC�MameO.BUtSNSa� ❑DivorttE
❑ YMOnetl ❑ Nerer MartieO Q Unk�am
❑ V6 � NJ
cause ot oeatn (see msvuctons mw ezampiesl App`p.rjmate
24. Part I. Enter Ttie Ga�n 01 Events - Diseases, 4Qunes, Or ComO��� - That DireWy Gausea TTe DeaN. Do Not Emer TemJnal Evenis Intelval: Ome�
Suc� As Cartliac Mest Respirdtory Mesl Or Venviwlar FlCnOaUm Wittrout Snowing The Etialogy. Do Na AD�reNa:e. En:u ONy One Cause On To DeaN
ALine. AtlOAtlpiWalLVfa1(Necessary.
6nmeCiate Cause (FUial Disease Or CoMition Resulnrg In Death) A. CAR�IAC ARREST MINUTES
e� a.
Sepum6aly list Condi:wu. H My, Leaaing To The Gause I.istatl On 8. HYPDXIA MINUTES
Line A. Entar Tha UnEe�ly'v�g Cause (Oiseaza Or Irqury TTat W Uate� �� �
TTe Evenis Resulivg In DeaN) Last C. LIGATURE $TRANGULATION MINUTE$
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❑ 1'O$ ❑ PIC08EF/ Q NO � l�(I�'tlPVll I 0 MM�T�� WfnOSYr � R�T�11im�pC�n � MA9v�BUIRY��V.C��EdI�bC
n �,».�..�,�.40...,,,�e.e.�.., ❑ �.,.».P.�w«,�....._
AM
MAIN ST
ELECTRONIC
LANE
Yes ❑ No
y,..e�..,..V..���.�.o..a,..,�...,.�.�... �Yet ONo
33. MamcOfDea!R
p Nayre� � Hatitlae ❑ ncdam ❑ cm3�q �rnest5aim
❑ Ya � rw
pa`�sm.�
�`�`+ ATfEMION ESTATE: T1ie Sooal Sewriry a is Earg reQueste0 Ey this state agenty in ader ro pursua msponsi0&ry. Distlosure is vdun3ry anC Nere wiA Ee ro Ge�Wty fa re5ua1.
NRA-20
(710.5)
1 1 . 1 : 1 1 : . _ 1 � 1 . 1 � . 1 : � . . 1 :