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Death Certificate - Monical, William_2/9/1984r . . ,..=. � _-a..: _..:_..; ._:.a�',:_�s��.�,. • C�RTIPIE9 COPY Jf .A DEA'iH R� -7RD _., - - - ._ . -. -- -.._ _ . . �� I.s wlnn 'fiMlbfNr�N\' . rw,. a..cm�: • W IY. Y Tr ��/u' ��ppup� Ia. pWTpVCI�OM ' - srnre or auuas ��: •1Le RcWSTRATIOH � " ��� D15TRICT NU. � pEWSrERE� MEDIGAL CERTIFICATE OF DEATH NuMeca � � r[�TTsEU-NAME ���+� •���o.• u�� $E.< DATEOFDEATM � William . Ftonical- z hfale 3 November 16, L83 � MKC-Iw�l��.�u[w.�M[IIIC�w RIGIMONOLSC[N 1GC-���♦ VMDCRIICI�N VNDLRIO.�Y OI�T[,f01FTM1�O..0��.����ICOUMT�OIOC :r.p��w. [.11���[�I�1 ��wr�0�� I�w�l aa. �hite sb. 5,69 So�• ,• sc.�• , s. April 12, 1914�,Wabash C� . f0��. t��.0� w0�0 C��Tw�CT wYY�[w MOSYIT.AI ON OTnCN IMSTITUiION - w��l l�� n NJ��t�� �•G�v[f�w�a� �l[ufl�wr������ �� �b• Mt. Carmel ' ��Wabasl'. General �Hospital - �a. In atie V'�.NO��INTMI��wO�in " CIT12[NOIWX/�TCOVNTN� M�NNIEO.NiVERN�RPIED. •MCOf3llNVIVING5�0USE1���0[w���a.�� , , [Ceuw��r� � WIOOwEO.A1VOMC[O�Vlc�r�i �������������� �8. Illinois 9. U.S.A. io.�Married- SOCIAl3CLVR1iVXVY0C1� V�Y�LOCCU�AiION RINDOiOUSINES30NINOVSTR♦ �Z t3a Ci,vil Secvice ��y Post Office ••••••••••••• RESIOCMCC� • �wow�� [w .. ' v. oww.�w�.0 � ���w�c�w M1SIOOCITV ���• 1 ' � ��� � . ��� � ww0 U4 O. ��"��•��������� 105 N. Scott Owensville Yes Iba. 14b. iC<. ' ..............•. Fw�nER - NAME .. .�nar � .-•e. .' c�r�oe�. ..-.. - -un MOTNER -MAIOENNAA ._ i� ¢•," � .�. . . "' Monical � �� ,s Arthur---- ,E. .' •• rVfONM�Nt't SIGN�TUI�E � y � NCI�iIONSNI� M11lIMG 1�DONCS! na. � ' h � j'Ytm � � ._L� , nb. Wi fe � ' i��c 10�5 �N.� jQ OEGTM WPS CAUSED BY: �c. � ONE c •ow ��� O�OTI IMM[01I1TEC�USE � � , ........ . .. ,s , _ ... .... o� ... coxwna.s. ir mr, i........ WMICM OIVE 1115E t0 " " i�wEO��TE GUSE 1�1 $TITING TME UNOER� Ib .....•••••••••• LYINGCAUSEIAti. O� ............... IC CLRT 11 niHFF516lLfICAN! J.............. 5 .............. o� m.... , ..... x : .............. Of ............... 21 a � �i /�l — �-i? "Y� /?�l.�t� j� � ) •5 ♦ EN�TION.II �NY M/�)01� ��. TME I�Ontw.O��.• NOM: �V —�� ' �... ..e...o<.. o INC � .00avea or c[wnr� �_��� iTLMO1XG �FYSICI4N If OTMC US.W�NVCTCR�N W/�NONCI1TC30!lCPVICC ,...,.a� ��. Yes taa. WWII COVNT♦ 6i�T[ �sd Gibson ��e Irtdiar:._ E .��.� • . �.�. irace Olive Bier 1���1[i�nowO.Oww.i.0..[�1�0��0� .� ���.tl/ Scoti Owensvitle, Ind. 476c.= 1. ibl. ..v Icl I .v...• a.....+o o.+�- �eran[ws ConwiFrtlrc ro( O�t��M ort rw� we4nn �e uua[ 4iverv �r. v��e � 1� 1 �_� � �.� /!/L •HC[NT�GICP li���o��w�ni• :r�c..s.<no.:.._. e[e.er[vreaene...i:..��-rvnre ��o�.�o ncro:uu..u..�. 1• . •. : � . . 24a gerill':= '� zyy,Ohensville Cemeteryl�.ic. /VN[NI�IMOMQ � . -N�ME . ft�t[�nXOrv����wOw�.r.0. z5,. Holder's�Funeral !iome, Inc. 319.5. Main 2� IOC�I ze,. � �" ot ♦VTO�SY 1�[s�n01 ��a.T �ra�+w-c�.� i9a.N� 79b`�J I MOV N OC OC� in �'� 2id_4:20 A. •a: T�n.cs�cnco wo....o.......� � . � _ �// IILIIMOI�IICCf�SENVMSCw 'G��'�}L1.0 �G/ �T2a � / ��/ - NOiF. 4 �N INIVAV Y.�S IN`/OLYED 1Y MIS OCnli� T!L 4'CF(':iP 4"�+T 9E NOfIFlEO ��-.,'�_.��.�. . oN. ira� o.......� Cwe'nsv.11e _Indi�na�2ao`l1.-18-1983 Owensville Indiann 47oti5 - 011iif o� Vitnl 4.00wL FlEGISTNAR ynnrn. F...���� „ � � iGR� �m on nn o�. nuouo cu�o�c.� 1 MEREBY CERTIFY THAT the foreyoing is o��ue anu correct r?py o/ the death record (or the decedent nomed at item 3, ._ ond �hae this rernrd wes es/ablltbed and� lilad in my' office irt; occordonce k'ith rnc pro�ision.- ef ehe I�����s swtufas. DATE %�^�� i � 19R� � � - — SIGNED— h�T'=�"0 � /G�v,in ...n.� —' � �\ �- _- - . ' �iL. �g:�El .� • , Illinoie.�.O.�FlC`.ALT.YCLc ,�esis:rar AT _ - _ --7� ����.__� G."w ��.re�i� �-�e.t�.�e "'C',F� � 1�r..'��i�'.� TA. urir���� mord af �1:fa CoU+ 1� w��^�^��> e�'d a�u' ��° �LWNOIS DE?.�RTNEi�CF ?U6LIC NEALTH st �ns�7<Id. nff�. � U �iavnn �r� autbor:sed W m�k� «rHfle�tlon� !rom mVN� cl :he or:�in+l r�rord. TTa 11 inWf n:+b.eea DrorSde thnc t6� :ianiion of � dn�th reeoid !Y Ne D^,::-rta�oee..v-c..M1��,.Fi..:ih or t9e ina: re0iatr�r or :Si s:.a:;:r ci:::: c�n11.0e Vriuis facl� �viJ.nce I.: el� tt.rc �r.d.pL-:n c! V.e f�:t� lAaraiv eu�..l. Yc �OIA (1961 .n�i�ion) � CUNEAU Of STAYISTiCF, -� II�INOL.^EP>:kTn/El?T OF f•U'tCiC Hc'ni:�ri -�Sf f.::;GF!Fi.D � `\ ` �.� � r . . . r-, /, ' a'..l= . r l =Y.�:A ' • Ll t