Death Certificate - Sanders, Elizabeth_8/26/2011535328
CERTIFICATE OF DEATH
EDR No OOOOOOZOHBrJ� State
10. If D'aN OccvrtW N N Nmqtal: t0a. If �ta'.li OavrteO SomMret_ OPd iF.dn F I105pital .
❑ Hosyice FaaRry ❑ DeceEenCS Hane ❑ Nursvg HomeAmgtertn Care FatlGry
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6167 NORTH STATE ROAD 65 HIGHWAY
:s. oKeomr, ee�a�
HIGH SCHOOL GRADUATE OR GED
ROY
� ew+at O Gar.utron 0 Donaoon O En:onemmt
❑ Rs.�wal Pnm sa:e
1�7 OP�c ISOw1rF
❑ MammO r.�amea.emsm�'•ea ❑ a�orma
� vnawrea ❑ r+e.ernwnea ❑ waw.m
PATOKA
MAYWHITEHOUSE IWHITE
❑ ves � No
� Y� � NO DOYLE FUNERAL HOME, 520 S MAIN ST, PRINCETON, IN 47670 FH70400010
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BARRETT W. DOYLE BY ELECTRONIC SIGNATURE FD29500009
� Cause Of Dea[h (See Instructiona A� Examples) qpp����e
28. Pxn I. En;er Ttre Cnain Ot Even;s - Diseases. Iryunes. Or Complica�on - That Direqty Causea The Oea:tf. Do Not Enter ierminai Events ��:vr21: Onset
Sucn As Car�iac Mest Rapva;ory Mesl Or Venniwlar FiOriAaUm Ni�sou: Shoa'vi9 The EUdogy. Do Not Anbr.ia;e. Enter ONy Or,e Cause On To Oeas
A line. AEC ACa'�:inal tines H Nttessary.
ImmeCa;e Cause (Final 0isease Or GontliUon ResN�ng In OeaN) A. fARD1AG ARREST M�MlfiES
m�u .raw,.vars
Sepuen�alty List ConEitims, It My. LeaEing To The Cause ListeE On B. ISCHEMIC HEART DISEASE m 6 �FMS
tine A. Entu il�e Untictying Cause (Disease Or lyury Ttwt WtiateC ��� �
T1ie Ewn(s ResW.in91n DeaN) Last C.
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D.
�an 0. Er.xr Ot�c Sun Srx•tCOrq:tims Con:nEUam to OeaN But Nw ResWEng In ite UnOMryg Cause Giw� In Par:l 25. Was M At.opsy PeRmmM? � �� ��
CHRONIG KIONEY DISEASES, CONGESTIVE HEART FAILURE,HYPERTENSION,SEVERE AORTIC STENOSIS,OLD � yyere Fu:opry FvMi�g Nvaiade ToCOndre iTe Cduu Of DlY,h?
nGE ❑ Yes � No
31. OiC i o0acoo Use CanTdf.e io DeaTi 32. It ienale' 3l. Alarna Of Dea'l�:
❑ re»w+.�..�>d... ❑ n.w+.�:.�..ao�.. ❑�a•s�.tia.o�.r.��.p.�.�o-nvo..a � Hayai � hmw�oe ❑ na+cent ❑ aeno-.�g imaa9x�m
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685 VAIL ST
VIA
❑ Yes ❑ No
Qou.�so.a.r
3395 q77EMI0N ESTATE: The Saial Secunry # is Eeirg repues:etl �y ttvs SUte agmry in or0er to pursua responSiEtliry. Discbsure is vduntary xM U�ere w�l De no penalry for ref�ul.
IVRA-20
(7lOS)