Death Certificate - Reibold, Mary Agnes_9/26/2002J
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VANDERBURGH COUPITY HEALTH DEPARTMENT
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Room 127 AdminisUation Building - Civic Center Complex - One Nathwest Martin Lu(her King Jc Blvd.
. ' E�nsvi/le, Indiana 47708-1f32Q
CERTIFICATE OF DEATH
��ji8 �ertif iee, THAT ACCOF7DING TO TM[ RLCORDS OF TME HEALTH DEPARTMGNT
NAME MARY AGIVES REI$OLU
DIEDIN VANDERBURGH COUNTY INDIANAON SEPTEMBER 03 yEAR 2ooz
TIMEOFDEATH 0�:23 A.M. MARITALSTATUS MnHRjP:D SE% �'EMALE A�E i6 qq�� WHITE
SOCIA� SECURITV
DATEOF�IR7H OS�OS�Z�JZb
PLACE OF DEA7H DEACONLSE�i HOSPI�PAL
PRIMARV CAUSE OF DEATH GIVEN WAS ACUTE: HYPDXEMIC R�SPI}tATORY F'AI LURE
PNBUMONIA
PHVSICIAN OR CORONER THOMAS ANDERSON � M. D. AUTOPSY NO
PLACE OF �URIAL OR REMOVAI. S'f . MA'P'PHEWS CEMETEkY MANNER NATUR,4L DISEASE
FuNer+n�HOMe" CORN-COLVIN FUNERAL F[OME,OAKLAND CI'PY,IN DAl'[OFBURIAL 09/06/2002
CERTIFICATE NUMdER
ORVOLUMEANDPAGE � OOUOZ%�}6
onr�issueo 09/09/2002
NOT VALID�SS SIGNED 8 S[ALED
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