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Death Certificate - Overline, Clara Alena_8/23/2010� � i� I � � lIANDEFiBU�iGH COIiNTY HEALTH DEPA�iTMEIYT 08527 Evansville, Indiana CERTIFICATE OF DEATH �his �ertif ies, THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT NunE CLARA ALINA OVERLINE DIEDIN VANDERBURGH COUNTY INDIANAON NOVF�iBER OS Y� 200� TIMEOFDEATH OJ:IS A.M. MARfTALSTATUS MARRIED SEX FF�WI�E AGE 68 MCE �ITE SOCIAL SECURITY onre oF awrH OS/13/1939 PIACE OF DE4TH DEACONESS HOSPITAL PRIMARY CAUSE OF DEATH GNEN WAS ���STI C AST�OQY�I�OMii PNEUMONIA PHYSICIANORCORONER MICHAEL TITZER, M.D. PL4CE OF BURIAL OR REMOVAL HIGHI,AND t�[IQ�IORIAL CII�tETERI' FUNERAL HOME SHORT—CUNNINGHAM FI7NERAL HO,� CERTIFICATE NUMBER AUTOPSY NO MANNER NATURAL DI SEASE DATE OF BURIAL 11�OS�200% OR VOLUME AND PAGE 000O217J DATE ISSUED 11 � 13�Z00% NOT VALID UNLESS SIGNED & SEALE�/� � � � .D. VANDE URGH GIX1NiY MEALTH OFFlCER r` r