Death Certificate - Schmitt, Ralph O_8/28/1979l
LOCAL CERTIFIED • 'tITY-COUNTY DEPARTMENT OF HEALTH
RECORD OF DEATH c��y of Evaneville— Vanderburgh Couuty
. � . Evamvilie, Indiana
RALPH O. SCHMITT
This is to Certify, that our records show____________________________________
N° 2618
----------------- died
----June----'--1-__---- 1979------- a�7-_25AM-------------- Deacone��
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. month d�y year " hour of deet6 ��tree0. hmyital m mr�l
Age.at death__59___'Sex__Male Color �ite _ Marz'ied ___ __ _
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)ean - .. . write wheNer msrried or �iva7e
Primary cause of death given was7akOb_CT2UtzfEldt_d1SEa52_________________________________
----------------.-------' ------ ---------- --------- -----------------------------------
Signed by ------R,A_--@7sl.4ner ------------------------ — �lt�'--------------------------
Dhnlci.v opX'X7f� �d� ...
__ y_Cross----------------- -Ft,--Branch�Il?a�-------------
Place of burial or removaL______HO1
e�me of eemetery addro � �' -
Dau of buria��4 _79 Stodghill Funeral Home Ft. Branch,.Ind:'. '-
--------- -----------------------------=�=
Puneral D[reetar add� : �
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Signed ------- - ----- - - - Registrar. -'. —
Evansvil ndiana -------S—s-Z�.-----_ [sE''L�. _ .—
a.k
NOTE: Recorded locally in Book No. ______ 4_`� ____ Page I�`o. _________ -___. FEE $2.00
