Death Certificate - Siekman, Ivan W_6/2/1994� �
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312-335 383I
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THIS IS TO CERTIFY
that according to the records of the Gibson County Department of f;e,lt.h
IVAN W. SIEKMAN
1-i EC ;-] 1_.T li
Uied o❑ I I/?°/�939 ::t !?;ni1E,�n
H��rne
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Buckskin IPJ 47647
Age at death: 7'i Sex: M Color: Whfte Harital ;tatus: ia�;ied
Gause of death: Ce�ebrova5r.ul�r Arteriesclerosis (3 caysj
Essenliai Hypnrt.ension i10 years)
HyE�erl ipemia (2G yearaj
Signed by: Jer-ry L. Like, U.O.
Box 188
Elberfeld IN 47613
Place of burial St. John's Cemetery
or removal:
Buckskin IN 47647
Date of burial: 12/O1/1989
Funeral home:
Corn Mortuary
323 N. Main Box 278
Oakland City 1N 47660
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S i gned bY -------------------(/---------
Gibson County Health Co�nnissioner
S E A L
Recorded locally in Book No
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'�Ul�- N 1994
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�UDITOR
OaY.land City, Indiana _ 12/O6/89
Address Date
11 Page P�o. 103 Filed: 12/O6/1983
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