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Home My WebLink AboutDeath Certificate - Simmons, Ezra R_10/13/1987� �.i:-. . . .i.�, : _,,:, ;. ;. F r } 5 � �AI6 �. 1: � }�. ... + L .. . . , 1 . � . 1 S yry � � y `'?P! �T " �' � � 1 t . 7 A�it � \i ! F . �' "�°��;j�; 4�� LOCAL CEt�TIfIED",,� `�;' Y'COUNTY, DEPARTAAENT�OF,.HEAC�i i �$ ; ii� ,ti� �� RECOAD OF DEATHi��` � �' Gry of Evamvdie Vander6urgh Caunty �� d Q A n�� e'lisi}. � rjl �-: rs :.. i Fat '`.��tLT ,`EoeO]v�I,t'IOd�dOa �F.� �5 �ii��(�p�' � �fC� , �.� ' �v � +'; � E4.,�,.� � , e � . xsd i �2 . s 1 ' �� m -.F i�..�.� N �� i S r u r y�� -zi �x �� `�i ��ir� r.. 1 ,�• }F �' e�`t �r , ' , ;� � `S , EZRA �R SIMMONS : �t� �: tt . �'t Th�s`�s.to Cert�fy that ourrecords sNo�v f= °t� � _ __ _ _ _ � dmd ,' '� �,�? �.:,. t ,. t . , . , �i , c:r '-• � � i , t • _ �! , , � , , � Welborn Ba tist. � � , a. ��;; �' aUG ,i � 18 't- 1976 at +" ` � _ - , ;, � 1. , ^ � .. � �[ cxt �hmD�tei. or. ruzsl 1 F� ._. o r, I�. mo th , � "t� del � its r-� . i hou [ de t6 ': i�. ' i��. "F r i � i�l��t.� � :- ^tl - � 4 � � . �1 � ` . . , ' .. _ ` _ . t� ,,-� Age ac deatk 6_3 Se�le Colo� �; Married - -- - f,�� .. :r . 9�ean . -_ t . r i; . I 1 �. ' r t h he m r `; � F� 1. .. C : - _ . . or _ '_'_ � e e ned . e n¢I< �, ( � � t . Hodgkins disease stage IV B � �¢� tj'�. d Pr�mary cause of death�g�ven was - E� v j{' I;i. r� �'� � ti S. e t.' �i w � i( !. ; 7�. S� r , . . . r� l4� 1 :) j i � K �� f 1 � :_.s� "Jt . t-i -i t t .�y .,` .., _ , O �1 . __ F�fl _ ` . . _ _ __ _ � . C � �. �� ' � o ' :" 'J. O _ Wrlliams_ � : , City - -_ -- --- m '` l. Signed by i., - � ..._ .. .aarm, �. �.. n♦ � }� � � Y .t Dh3lfc�aDi� ,t ` S ._ i�" . _ ��', � '- ,� �,_ t Oak Grove � �Grayville, I11 _ � J � _ ' , , _. � � . . -�naar�. 'G- ;, � i� Plaee.of bunal�or removal _ _ � , , , t e+. t � i '�. � Y : .t . 1� . .�. ne e o[� «meters : �' � a� � • � r � �`� �-I ` ' � Grayville. I11 , ' ,�i j, t' � Dam;ot 6ural 8 21 76 StuYm ,�-- , � -- - - --, --- � � Funernl.Dtree or< nddra� .- t ei :ryi a�..� �� -� �. �yr � �a(�� fp ��ia Lr>� .. � _ 4r . ...0 p �� - �-C/`��'�1 71i a � . . ��:, . . P� ' � ' �' 'Reg��trar .. F �� Signed - , - � t r ". � .. ' . �' Evansville ` Indtana � � - * ` � � s 24 76 , , - [senL� � �. � A � . �. � � � . . � � �� .. ' d6i! � 1 . . � . �1 .. _ Y ; r . . f 3' . t' : . �-} x•'': � :4 � .` ` ti � ; �;� NOTE Recorded locally m Book 10 ,4L Page No ,; ____ ;. � FEE $2.00 ��:� -: � - � i .I�.�~ H99�H0➢DR��d4GHH6H�Dfl�DHHHOHII�EtIP�HDHBHH��H06G��Il0�QHHHO��QQ@�➢UQD�9�OH�OOGBB�S�D9GGCH��96HQ��DIi9H09NE0 . ' i - S ' � . � s.p.. � �. r itii .�- l fj. `.!i � r. ' " ri.,'; ' � i � ��. -�. � ' 1.,� li.. `� • —_ u . ., - �:— ___ . _ *+. ., . . _ . _ � . _ . . . _ . } ' .' ' f. ' . . -s. ; ' , � i. � � . . . _ ` • �1; � . _ � . - . - . . �r � .. .i � . . _. . � . .i . � . � ' . L _ . .. F i;• � .� '� . ' .... , .. � � � . ' � . � � ��. . r. � � � � c._ �� .'i . � . . . * J . l . Fj��. • . t . 4 ` ., . . .. •wt le• i.. 1. • . • L_ . � � �� . . . . . � � . . . • �_. t � +`t! _1 }� / , 1 � t .!R y _ ! i'1``t� . :i . • , • . Y' `.:!] - . i �-, 7 L. . . , t� � . , .t. � �''• 1. 1 1 . . . � , i� � , � ;� � ` �'�`�� i,i �.'} .• , �. 4. I �; . . � , . ., , . .�ea.ssaes�.c�amta . . . _ .�... ..r.� . .. .. .. _ :_i : . . . . . . . . . . . . .. .. �. .. . . ' .• .