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Death Certificate - Loomis, Ralph E_11/9/1989VLY � :, ,...; �., -.•- �'�" "' y, `''' —�IANA STATE BOA�LT� Say�eoo9S ...�}�_,��.�- _'-- Oo�-ooGd� —� a ij. �.J�.�'.... CERTIFICATE Of DEATH State No . ............................ � !�'E4fl L45� - BUS.A0.uEJFpppESl r No � : F4C�I:vNM£flmi .; w 41 N -I N.RiIILR�$.4iU$—AM ' ' Nara AW�e1 WCOneO. ja�.e.roe (soe:e 1 � ��iar I�. FESiOENC"c-4AiE f/: M:DOLE lFSi Si. l.GE—JL &flMty 50 UNOfF 1 YFPX SC UNOEX 1 V. ' IYmO Mwvn� Ory! Xowt �amne� 45 nos�t<,� ❑ mwu.v ❑ e� rrJ n:�ne�l a.su �onico�ocn�n�u,.d�r.� ' M Dec. 19, 1986 DATEOF01PtN(Mmt4 ].OWirw�apElCey�mSUnaFaeq�Comvy WY. Yur) June 10, 19,+3 . Michiqan IOiMEP ❑ HN.«w ��. ❑ n..m.M. � an., �sw�ay� ii W 9c.GITY.IOWN.OPLOC4ilONOFDEniH � 90CWNiVOFDEaiN Vanderbur N, SUflVrvwG5i0U5E lb DECEDENT'$USU>LOCCUPPi�ON I]E KWD OF 9USWE5$/N1WSIPV :�d..'aa.c..m.w<niwne� �G.a�+nee��.w.eu�sevn�mertd.v�.yu. � . po �uae.e� 1 � � � J ce Pinkston Busines�wner Motot Re air . I]�.COUYTY �cC1iY.iOWN.OFIOCAiIOV UG.SiPEETMI0NUM8EF tcSiJELi:v ULFAFM LIAlli$) f Yes d nA 'es No �ainER 5 K-u.E [F�u ALea'n bs0 Glen Loomis LVFOPH<Nt5 K4.v.E (iype/PrvN Joyce Loomis MEin�O O� DISPOSIiION 1]q ZIiCOD: 47648 8>w ❑ Cee.vven ❑ Per.+mylre.�5:au D�oruuan ❑ Oxr15pecJt, I � SIGt:?iUx OF i1;�=P:.L d CiO� � >� n '� C H � :� �.1 .. � n O p "J � o �: � C, > " z (_ OF: _.n }]�. io4��0[s10f N. Wa50.CEDENtOFn15PnmCOPiGwi �5. F4CE—ener�unWw ' 16 OECEOENiSEDUCAiION 15eecfy No w Yex � H ye; s�'( �ay CuMM1 84ck WM�. Nc. ' �SpN Mf� n�ee [omplefeC Me�aart Mnm RuM1 tt:l a M1a ❑ Yea lSOLe[✓Y) Elemelwry/Se<ok�ry 10.1]) Cdr� U.� v 5 r 1 SoectY WIIItE IZ i0. MOTHEHS NnbfE IFru l.�pOle, b4ro�n Su.vmel Irene.Zehun I�5� MdILWC ADDFESS ISVttf �nC NumGe/ d flur�l BaRe NumOer, Gty p Towh Sb(e Irp CWeI 19c. Re4lonstvp 706 Kenned Dr. Ft. Br nch IN.47648 �Vife ]00 DAiE FND GIPCE OF DISPOSIiqN Wune ol Ume�ery. brmatpy. w I 30[ LOC4ilON—C�y M iewq SYb nnn d,:.� - Sgnae..e rM Tue < Y /� /w ]5. O<iE P2CNOVNCEO D'�D $Ip.LICEM1SEl.VM9EP ]I.NAN{.ADOflE55.dNOLICENSENUU9EHOFiUNEMlH01J.E '"��•'°•A Coivin Funeral Home,Inc.FDH3005671 FDE1012933 425 N. Main Princeton, IN. 47670 �E�IN�Yma.Oat�.uNP4bNb0. 1]C �I�ENSENUMBErI ]4 DPiEyU1ED IMmN WY YuA J�,,,,,��i Jan. i k, 19k9 4m0 I]6 WPS CoSE FEFEriFEO i0 MEO�CFL E%aML�EP/COf10NER+ ;�•,°^" 'ies :ec i E,uv c.e ersusu. �.W:,n. o. ca=�uua,s cai c.vua n. eea.� oo �o� eme, ne enee e� nyna. �ucn.. u�auc w,esoM.w.r . a�,o.u�ne un:t ano0. w nem IaL.e lnt eN� eca c�'vse m ea:n Ne. hn•tl Ba-¢n Onunw De�N °�<:E�~�SE�w� HuZi.ip2e gCuizt Fonee Inrwti.e� Imed.. ,� n a�x.� �� DU'_ i0 (OH>5 A CONSEQUENCE Ofl rna(�S�,c Ac�i.den,t ioa.q u:s c+e e ouE To (oR u5 a cG�SEpU'_:+cE oFr � � :Erv<eUNOEAYL\L ;-1 SE <D�wase a yurY c. n ���� �„��ay OUE i0 fOfi a5 n CO�SEOUEnCE OR � hu9�^euWLPSi � . � I i E Uner ary*duav mM.:am ca+uihti+G 1> ee�0 Mn m� nsWiuq m C� w.GerlyY . um� Grvm n Pan l ]&. lYnS 41 AUTOPSV • � ' vEHfOWnEO> .-J ryo a ro) O � Yes c z � CEPLLIEa Z ❑CERilitt\L�NVSICIiNIV�ysiC4nceiWyvipuusedCeet�wMnem4�mp^.yv[�mNfpMOUx/EO��a1I/MLOmG��:lOGem)JI H (enect mY �.__ . i 0 N1 E[A 0.� f.nY �-'bMpQe. EiaN C[c:rtrt0 Cue lo N� Cauie(�) �M mlMe! �t al�le0. ]00 wc12nV�Vr�iru�wv <VPR>8LE FPIOH TO COMREi1pN Oi CeVSE OF DEI+iNI f Yu n m) v�s ❑ PFONOUNCNL49DCEfliIFYINGPNY51CInNfP�yvWnpoc�ponpMVpOUN�nECeNyvpumedEnN1 Te11n0�sidmy'vro�leOps.CUPa eM�tL`.eYmaEala-�MpbU.NCEVrbL�euuu(JaMmamaupneE — .r.,� ❑ ucOtCPt E%auIXEH R COflOM1Efl ❑ HEaLTH OFFlCEP On Lt� Wsi� W eymniWn �M./w N�esY�liM n f.nY eOWOn Gf�N IXcW�eE �� L�� Ilne. 0�1�. vL GV [e. �M 0u� l011i� c�u�N�) �M rt4m�! �� NIlE. / � .. �:� S�V+viUFF nn0 TRIE GF CEPiIFlE�/ .�. ./ l: n� / n I/`� . _ / i9c LICEVSE Yl:l.!'J:R I..aO. D/ � �E /�0?�OPES$ OF PEPSON WMO COMRELEDfAUS�.�A[ DERTN IITFM"2)1<T�yi)HiM �" harles Althaus Cproner, Civic Center Compl� � Q�:alwsl ❑ GenCVp �y Inreni�eum Ly PtMe�i ❑ 5iecee � ecNa nc� ca ❑ n .xoe �•'xm�ea r:_ c..�yJ %�.� % � . J �� w � . J�� DniE OF INNflY NT TImE OF �]�c INNPY AT WOFRt tMrLtOry.Y�ul WJUPY �YUe�rol Ne.0F5CN9EHOW WNFV ORiE SC:ED Gluci OaY. Y<r)� 7ec )9 198& 2�25 P I NU TKa(�{�.tc Aec,�den-t Ne. PLf.CE OF WNAY—At M�+a. �vn m�a bawy. 4ca NL �OLATION ISo-em W NumEn a Pvtl floae NumOer. Cay n io+n SutN °"°`"°"``SpeJ'U.S.41 Non.th IU.S.41 N. a,t Ru�(��.a�i (Uay SBH�6�OOa Sta;e Fo�m 10110 0ev. 10/Bl our�l�o i