Death Certificate - Memmer, Clarence W_6/21/1977�
: LOCAL CERTIFI�D
`�RECORD OF DEATH
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CITY-COUNTY DEPARTMENT Of HEALTH '
Ci�y of Evamville— Vanderburg6 Couucp 17Q O/' Q�
, Evansville, Indima Lr • OY4
CLARENCE W . MEMI�SER � _____ died
This is ro Certify, that our rernrds show__________________________-------------------
JAN. 9 1977 - Deaconess _______________
--------------------------------- at ---------------------------------------
month day r�'�r hour of denth �heet, hoeo��^� or runl
Age at death---65- Ses--NlalE Cnlor�'�---------------MdY'Y12d --------------------
�evn
.ori:e .�hr:her �nnrricd or vin¢le
Primarp cause nf death giren �cas___RUFJtUY2d� dbdOIi11ri31 aortic__aneur�sm________________
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----------------- ---------------------------- ---------------------
R.F.Carlson Cit
' Si�ned hy � y -----------------
-------------------------------------------- .aa.a.
➢hyeicien ar}�i{
Place of burial or �emo��,L__ Immanuel Lutheran_______C�ty____________ __
--�ome ot «me«.r ---- .aa.e.
1-12-77 Volkman Elberield,Ind.
llate of hurial ------------ - -'----- ----------------
Funcral Dirttmr eddrd
Signed ��'° ° �• �%9�-------Regiscrar. �
----------------� -- '
1-17-77
[SE.AL]
� o Ea�unsvtUe, Indinnn ----------a.li ---------
I° NOTL: Recorded locally in Qook No. ----------42- Page No. ----- -------. FEE $2.00
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