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Death Certificate - Seals, Paul_10/25/1978
• � . . . . � .�. . � . . . ' . . ... . . ' . . ;_;` .;;', . . . - • .. .. . . . .. i_.�{�,Y._......'.�::� � .:��,.. � ' � . . . . . ' � � ' � . . . .. . . ' , . ' . ' • � i . . � . . � . . . ' • . . � y�_��-_ . . . . . .. . . , . . . : . { '� �.�:�l��.i� ���� �I�T .. .�� . • . •, :' . i�u iN w�rH.Irr:;vRir6� �:r te�::tf. vq,e••�Nr. . - �. _:. . � ' - -; ....,.. .. r. --..- � � �. STA7E OF it11;.015 ' ;:`:- '':� . : � " �. , __ . :,.Tf F� ' , . . . . . . . . . ru�uu F . � , ' . �. SfG:SiFATIDN Q^ OTATC O� ILlIN01• . ,���Y � ❑q7F�CT NO. JJ� a • • � � W . . . REG��r[,;[D ���• . CORONER'S CERTic=iCATE Or DEATH~ � . ... . 4CR - ., � - _ UL t L - .. . .. . .. fII# �, ...i�pyMTY ..:. . — �. .. ^�•..�• -..+✓�.(•.�.. .: ._.�4Tt.itn%1M.Oi�W M INf1O[[I iii 1. �:c-:.a...'':.., _. ' ._.,. _.7:A �:, -Z_._" � : � ` �'' t � ' � �. .: �. � .�run.M .. i �i4ur �„a n,u��n . . �i.n. Gibson-.. .u�0�aensville .��c.no .:;i.:. ' °-� �c . ���� _ww,� . . �,,�� R: R:....l�l.- __ . -. � :......, AWIHtri G:aiU<N NAb4 �.iu� r�oa� . . C1l'.IllOflt �.: 1.., .:,•`;{�.,:• .:: ' .��.:: �� �...._, . .: .. -. .:: ''. w� + .. S�-ils � �„ .... . ..•.. Veronc�� . . CokPi •'� SiGnn7URE � FEtAT1015MiF � MA�L�NG AGORESS unu�.no w a ti r. o, un o� cm,K �»��;,,� .� 7C.:1+.?.2Q� ��--o :. ; -wife ': � . .: , , »n „ R 'R ��1� Owensville;•Ind. 47655 lE. - DEATH WAS CAUSEO BY. ... .I�w�u owr OhE uvu ru u..i �w w. �u. a.o w� ....c....n �.•u... v�ar �. •; ,•:-- •,.C�O`riilfa'"t� .�,_�„� .�..»... � �� . •�,•�!.i_ � y.:Thrumbusis, pcute, Severe; Lubar '� • .. „ 'ro�PneumoniFt RiRht llcute .... ..... . ... �. .._. :i�;;i:' -.•'' .' . ,•,i ' . _ wl�o.aw��co..uw�..ua� � '�'1 '•.12�:i?Z'3. ca.wrrorf. v un � = � . . •i . ^ , . ; � � �1 . . p . e ��' MNSN CNN �IlI TQ ' I�I � .... . ' . �1 ^ A ] .:.I � . .. � : �.. �..wqut! Goa rol � � . � .. .. . . . . . . �.� �': �.� , �..1'-:.'4 �r.r��.G rwe UMMS-'-' OY� i0.011 N A CWYMKI01:" •.. - ��\ lri^�G GVS[ Wl. . , •- ' „��' . t,. _ �+, t:' { _i .� /V F t i� ,�t.e�. .. .., � ': . � ��.. : ':. .., .. . -, . . `:aj. ' - -: . •:t y.'. .•d P.iAT II. OTMiR AGYIGICANi CONDITIONS .cn.o�� ����w*rc ro m�+s w� ��a �e m u�u' dv�N iw r.�r i w �� UTG?SY � � - r��. v _ . , � .. .. � . .. � � �- � . !:-::. �' Itt5/N%. : d •u ti mii...:�.w �a: v wr. r suK�or eo..¢io�, ' : DATE Of INIURY�!�wtK onr, rw) MOUR ' ' „ �^ ` _�;. � �.. �,.' ^ I Oa. eS ' � � �196. �e B � ` �la.urao'w¢uq . . � '� .:� • �'. � :.:...� . .} �...•� ' � a�uiuNiw�iu OCCURRED u.n.r..,iw�n�.��i..�ruu«ai.r.•�� + ,� � , . ....\'., . -; :.. • ..... . ..•,,zoe. � •'� -i .. - . _ Y AT WOMK � PUCE Oi IN ' • ��. .':...;. . '"'M. � 20d. . . . •. .. . - . •• • nn ro1 IURY �r raw�. rur. tuur � LOCATIO Iun. v�� w toww: a iM. W iw. nsT. M: tawTr: Il�rp - ... . ' . : IKtGt�. aqcl /wtawf� lrC IMICUq ?Oe. - � '.:= :'r :770f.�'.'`:..:.'..�: '..•�. :: �.�2• ..1�..,.�. ...{,'•-=::+.........:� �����cL"::. ., ' .. : .:�::.::�," .:..: ..... ...��•'�''� � aan�r THAT w MY OiiH�ON, C�f1D oror. wr �r.V�fnG.n�a �`� TM DiCCDENT WA$ pFONOUtaCED DEAD ON ! •`ID•09 TM[ INQUISIiIpN. TMIS 0[ATM p[CUPC[J pN 1X! D4TC • . W�M pA TW � AT Af Tn( PUC( -.. .:,, ilo. Anp W[ TO TNE Uu5!(57 ST�T[q �•.D Tr�T - _ _. .. ' '. ' - - � .. . ' .. cro:ca�s sic-y.1u{te // �� e. D'e .: ,•: 2 1976.. .•_ : E z��.4�:�50 ��p : M_' �f/� �/�/ (��J ��;' s:��.:.�:�: ..., ..�.;.. • DATE SIGNED �»a.ia o�r. :�.q �� �~ �"��_[� \_L1� ' . . � ��.�r: •...:. . ? ]1a:� i��-t.-y'rc<L. /•`� ..�' '•....i.:_.r':,;., ��': `�' nn�� ir.�... . .. ....�. :�'� ' co;.c�ia•s HYSICIAMS SIGN URE ' ' � .• IiG +�'�-���-.31;.�'T97u � , � - � � ��•.;' :'.1; . •o�icsieNe--� • : —.—,— � . �MCwrn. Dwr. n.� � � �,.D �...,, ._, � ' : -a-� ::=::':..,. '.: : ;.. . .•w . : _•• . :.,::=.. ; z�e. '.,�:..:.. . . 12-31-76 ..... '.. - llUR1At. CRCMATION......:CEMETERY OR CAEM1 � ' - . .. .. . PCM.O'UL IvtoM : . � ., � . _ . - Y-"'N'�Mf . ' L TION an w rown ttwtt .. � c.., . ,. . . .. .: . - . � a,m.��. w,, , 7:�::::,.:.. No_BUT1A1� '•iZtD.�� .:'•j,{ '''.. . ;t.:.;�,.,;': '��:..�:^..;...,t.. __ . .,.,.�i:•.. ... ., .. . _. �a!r!��.. FUNE2�L MOME . N� .' 9tI!'Y� '. '_' '' IlL�S `.:��]�-:�Si�,4�.l;'•C.:�.�7,d.l�Cr 31,1976' �� •. . . fTllR M uwu oR a r. n un w towH ._.. ._ rtwtt � . � .�sa. Holdeis Funeral Home�� 3 S'. fMain St �` O�oensvil�le � Indi.ana �47665 �� � � Nr+EeAL DIRECTOR'S SIGNA7URE . � � . . � . 1��ILMf1AL M![CTCt'1�ttLM�1 44HSf K�ra4 � '-. � - .. � _ ` Ao�n f r iic�l rs ;- :. � ,, 15h.� � . � - rd �.. i •r":llh.1 .._ ... ..' ��:•f � �OCwI RcGISTMRS S�GNAT E "�/� �25c. �F/11�� .. .. .;':.'',' °` it . � ` f - � � i � e:r `��•: , Y.a���� DATE R IL BY,LOCAL REGISTRAR�r..,..�.,,. 1'0 � � : � ' . , / .. , .. . . �/ "r "VR30t 1l11 � . � ' j� ' � �'.'�/ �`�..•;� ( 7 IIIInaN D�P�r[mtnt�ol PuElk He�llll Oftlte o/ VIUI R�cvrQ� IM�ro orr nN u. i STewv,�D cta:u�GrO r .� . .�' a.. 5 [ . - ��-�v._.r.,�+ � . � , � � ' ( /�, l �" 1 ] .. �:. '� �. . ... .TI . j �a 1u� !, . �s '���.^�Y� 7�„),.-i�-•••-V��..�r -'� llATE_ _. _ �� � ����7.f� ' � 1 :� . � �� y�- � - .�. 1 � � �1/J l ��� � �) i �. , � ; . 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