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Death Certificate - Lamey, Rose K_2/7/1977l2F,CORD OI' DF,_1TFi�"-,s,� � . �l ,. � -c�. . , �� , _` ,,,' .' / r ' -- . ,, . TH1S-[S TO CERTIFY, tlint ou� _�December _ __3__ , inonw a�i>- shou'--- –_ s� �DFPAP.TIIF.NT OF I3T::�IiT; CI:'1'ON,TNDIAN:\ � � � - . 1 , � � �. ROSF ff. r�1Sri�Y � . .� c —. _-- . -- —_died _ 1:9?;A�� , _ i _ AM IIaubstadt..—Ittd. ynar lioi .' calh strcet, I�ospilal, mral�_ .�ge at Death-65 --Se�-- re!nale _Color---- ��'hite 1•7arried year, �crite �chether msrried or single Primary cairse of death given wns_ __Metastatic_Melanoms _ Siened by. ,Robert A._Royster� MD _ Ey_anspille, Ynd._ phpsician or wrnner addresa �-. . � Place of burial or remo��al_ St_,_JameS C�me�flTy ____—H3ut�stgd�: Tnd,____ — � � - -� — name �uC cemr,lcry - � - �ddresx Date ot buriaL 12�7/'j0 4ia�B-- Puncral �Director SPAL �'� P.cea:•ded locall}' in l�ool; No. __�;-Jl .., _ �>--�' . : _��. �. l NANE OF _ Princeton, lnd. 12/1�/� address n�ro..� i'a,:r No.__�.fl _�5led: � 9 _-�- --� ' __. _ ---- ikl� I�FALif-1 l�R[� !-IOSPITAL CORPORA790P1 Of M1ARI�i�1 ��UNiY t�IVISIOP! OF PliBLIC HEALYH FE�.rw�aQL�a�tc iH4t CITY-COUN7V 9UI�DING • IMpIANAPOLIS. WD. yuuoen nnoto.ura NADG � �Et�i1FI�D �Ot�t�' OF RE�ORp pF D�Ai'i-� �� • � ;�� Victor Lamey Feb, 3, 1977 ATG OP D�ATM 'PLACE OF DEATl1, f.OUDIT.� k1ARION CITV, TOWN. OIi LO(;ATION Indianapolis9Indiana � �s une:e � rn. n ceem a na. m11@ WIOOVJ[D � �ieven nerta. ❑ I noo. I oa�e I nr.n. I e�n. sEr �ianrt�ee ❑ o�vonc� �DATE OF DIRTH 1v5=1901 „6E 76 FATHER'S NAMF Peter Lamey �fOTNER'S RlAIDEN NAMF CpUSE OF DEATM PARTI. INHEDIATECAUSEIAI Cardiopulmonary arrest � hyootension Veronic IMTEQVAL OETY/EE�1 COe1DIT10N5, Ip AflY�DUE.TO ,e, �entral septal defeet \YXICM 61VE CIDS TO ♦OOYE GU�C fpl 'OiATp:O TnE UHOEI:. �r�no c�uce ursr. DUE TO (L� Acute myocardial iilf,llC41011 OiHER GIGHIFIC�Ni GOMOITiONG CONTR�OYTIHG TO D:ATN OUT 110Y RELATCO TO TME TEPn�NAL OtSE�Sfi CON�ITIOH 61V[N �fl �A!1T �(p) qRT 11 �' OF BURIAL Ze)�%�i CEMETERY_ St.�.�{e$ LOCATIOM Haubstzdt,Ind CERT, NO. OR =e Y1 ' .VOL AMD PqG� _DEATH CER7IFIED OY David Lee IVallaceot1eno' � DATG FI4E0 � 2�7�77 � oars maucn 2°�°�� . . . H,Chade�ieI: e�e�xu l ! �cµsh� f;��� FS � �•a- °r � �?.�� i,i �� u ,. �:. - . ' •�. �.-.� ,�' �j . '. . � • — NOY VALID IJNLESS MACHI�:� tdl1AA6ER�D AND SIGRlE� �"JITH AA4Ji.Yl: AI,QR Rf13RL�R1 --- '_�"- :':�.=C�- .�—�� . _ ;�.; ;i–'���1_^`. �_ –.�I ' , <= • - � ;:- . , . , ;_ _.,,...r:t�.; :�,�. .. ���1.. ' • .� – -- � �i : f {; �• � .,I : ;,� � • , . --' � `/ ��