Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Death Certificate - Sermersheim, Leo_12/5/1979
i � � l 7 � i 1 i � 1 � LOCAL CERTIFIED RECORD OF DEATH CITY-COUNTY DEPARTMENT OF HEAL7�1 � City o( Evan.rille— VavderburgE Counry �7 Q Eran�ville. Indiana 1� • • I� LL•:O FiERSC[IELL SERI�IGRSItEIM _________ dicd �I�his is tn (:�iti(y, that uur rcrurds show-'."'--"-'-"-'-"'---"--"------------"'---' NOV. 15 1979 �ti lborn ---- ------ ---'� ------ -- c ---------- -------------------------------------------------- mantL d�� ye�r nour o( dcuE �treeG EuD��•� or rvral A�e a; death__ 68__ Ses----Male Color---Whlte--------------------Married --------------------- >�.n write �0.th<r m�rriN or dnQl� . Carcinom� of lun with erosion into eso ha us a� Pnmarg .au>c uf drath �,�eru ..•:��-------------------------g-----------------------------P --g--- _____________loe_tastn.tic_ to__livez-�ar.cinnma._of _pro�tate_______________________ F J .Arakel.Jr. CitY---------------------------- tiigncd Av '-'-------------------------------------------- ----- v�nieian oc�"-3flf��r � �ddrs� Pla,r „f bur;al or rcmuvaL_____Walnut Hil.l Cemetery___ ____ Pe_*__grsbura, Ind __________ �.m. or �.��.�.n --- . .aa�w U,c�ofb�rial_ll_18-79__ ______Curtis_flaneral_Home______Winslow�Ind__ ---- - -- - ---------- ean.�J oIr«�u. .ear�. $i�nn� -----'`�1.`�`_1.��.-'�t-�.^�i��/-J�-f - Re{;istrer. ' Y /�-30-79 6a�nnsvill�t�I/1CIlCli7[I ---'------------------- ISEAL] a.�. KiYI�E: RKardcd Incal�r in I3nak No. ------ �c � ","- • �� ------ P� . 1-------------• : ;w -f FEE $2.00 .- . � ---°-��} �� ....._ - " J' .j _ g.�•= c�' .. � � , ��� � � � � � i t