Death Certificate - Pauley, Waldo_7/17/2000�-O�a�s
�
oo�- oa�o�
p�aocn
pOS�v 3
pv Slo y
�0,5'14
V-���
� �576
Dl%S l�
�pSi $
DoSBb
0 oSg �
3o�-oa4�y
�� - �a3so
,J.��a _ ppOSB
VANDERBURGH COUNTY HEALTH DEPARTMENT 20789
Room 127 Adminisfration Building - Civic Center Complex - One Nathwest Martin Luther King Jr. Blvd.
� Evansville, Indiana 47708-1828
CERTIFICATE OF DEATH REGISTRATION
��jis �ertif ies, THAT ACCORDING TO THE R[CORDS OF TH[ HEALTFI DEPARTM[NT
w,M� WALDO. PAULEY
DIEDIN VANDERBURGH COUNTY INDIANAON
TIME OF DEATH 0�.: ZO P• M. MpqITAL STATUS WImWER
SOCIAL 5[CURI7V
PLACE OF DEATH �GINA CONTINUING CARE CENTER
PRIMARV CAUSE OF DfiATH GIVEN WAS �NAL FAILURE
SEPSIS
COLON CARCINOMA
PHVSICIANORCORONER MARK MARTIN/ M.D.
JULY 10
SE% �r'E AGE 9�
DATEOFBIRTH 04/10/1903
AUTOPSV NO
VEAR zOOO
ruce WHITE
PLAC[OFBURIAIORR[MOVAL SHILOH CEMETERY HAZLETON, IN MnNNeR NATURAL DISEASE
FUNERA�HOME COLVIN��FUNERAL HOME DATEOFBURIAL O%�13�ZOOO
CERTIFICATENUMBER '� :
ORVOUIMEANDPAGE 00001400. DATEISSUED O%�14�ZOOO �
NOT VAI.ID UNI.ESS SIGNED 8 SEALED .
�cnw � . �-� ��,,�-��'l }� ;
� M.D.
VANOEFiOMGH COUNT { - ,�rH OFFICEH