Death Certificate - Ours, Earnest M_11/9/2001VANDERBURGH COUNTY HEALTH DEPAFiTMENT 004213
,, Room 127 Administration Building - Civic Center Complex - One Norfhwest Marfin Luthe� King Jr. Blvd.
, Evansvilfe, Indiana 4 7708-1 828
- CERTIFICATE �OF DEATH
.� � I, I� �G.r C- l� L Lf L Q�� THAT ACCOFDING TO THE RECORDS OF THE HEALTH DEPARTMENT '
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_ NAME �EST M. OURS .
�� DIEDINVANDERBURGH COUNTY IN�IANAON JANUARY ZZ
TIME OF DEATH 09: 36 A. M. MARirn� srnlus
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MARRI$D SEX �L'F' AGE �$
DATEOFBIRTH 08/OS/1922
PLACEOFDEATH ST. MARY'S MEDICAL CIIiTER
PRIMARVCAUSEOFDEATHGIVENWAS SEPSIS
URINARY TRACT INFECTION
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PANCYTOPENIA '
PHYSICIANORCORONER�`9.JAMFS KRUGER, M.D.
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PLACE OF BUPoAL OR REMOVAL � � �• OLIVE CEM. , MT ALYMPUS � IN
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FUNERALHOME COLVIN FUNERAL HOHE,.PRINCETON,IN
CERTIFICATE NUMBER ' •
AUiOPSY NO
YEAR ZOOZ
RACE �ITE
MANNER NATURAL DISEASE
DATEOFBURIAL OZ�ZS�ZOO1
ORVOLUMEANDPAGE:' ,DOOOOSS%' DATEISSUED 01/30/2001
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VANDERBURGH CAUNTY HEAITH OFFlCER
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NOV 0 9. 2001
GIB/�7TY AUDITOR
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