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Death Certificate - Day, Doyle_3/8/2013 . .. . ..t._. .. .. . t may•ATTEIR1017 MATE The SodalSeo�ty*is be"A re9ireneE M°te cr,Det.�er a Crow In INDIANA STATE DEPARTMENT OF HEALTH : ,pua ws ,. :d.w4 m arom .sI oUf« . =F• , 7 CERTIFICATE OF DEATH State No. c t:Local No. "°' ME R S EN DRS SERIES ME CONFIDENTIAL PER x1647.1ao iRUNT I F"'E m Male LMe I SIX x TEE ODEA N s OATS OF DEATH awe a N) Doyle C.Day Male 09:35 PM, JM14ay 15,2007 0> -NLm=1 NF-NT besocometa1 ZZ w- YUMAN, can APP./r.w.2.9 _ NI bay [OTHER ❑ *Z 91 -YES 1946 Iloaaru ❑Nom... ❑Da O Maim* ❑o>rs..v" _-n a FAf ITY NAME a.a avow d..semabbe. N CRY.TOWN OA LOCATION OF DEATH s.COVEN OF DUTY y 2117 „n Gibson General Hospital -• Princeton Gibson 2 to O L0 WARM STATUS - .I StavrvIG SPOUSE I la ceCEDOCS USUAL ocasaLON N]..Ara d earl IA AHD OF 041SIEQ.'a.Smr DZ� Ma Orr CSAMOR Vr.pro Raa.asa era.Inc aa.d.wyu.Or ow awn g O.O Man'Lee-Dicus Inspector Factory ', -n la AtCIE STATE IA COUNTY' 13c CRY.TOWN.ON LOCATION th STEET AND MAEFA 2yti 0 O 2 Indiana Gibson Princeton 1102 South Gibson Street M ED pro Y]. m CODE is ta>WE CT'tars It CITIZEN OF IS WAS DECEDENT OF WY.NIC DIF!?F• lit MCE-Macao rasa I>DECEDENTS ECVCMTCM mn_ Cne -A Y.. mar COureRr III Pt 0 Yer a,..wary CNA sad.Mtn NC LSacha*Fp...Eno a d A 2�z-, 47670 1>s wAF.an .m war.wa.:N) :sways 0 .+./So PRIM ICa.3 a.aI•7 CA-0 rt. o v. White 12 3 5 m y It FATHERS Nall Mat MSS al 19 .OTHERS NAME IFru WO*Alwyn Suer. m ?,o o Herschel Day Pearl Beck 111 C D m as/.I 4ANTS NAIEITUp..HN rA MALSC ADDRESS(Ser�w Maw a E..Am Maw.Cho'ran Sea Za Cnitl ION Roca-. ft m > Nr Mary Lee Day 1102 South Gibson Street,Princeton,In 47670 Wife O- TI. .1100 O D6NSTICN ❑Sa w a )M DATE MO PLACE O OSPOOTIQ1 etaw d arab..attar.a sacLOCATON_;haTe:a so, ®s.. ❑Cram. ❑N....e® . Sao elOw* May 19,2007 Princeton IN 0 to y .Co........ ❑O ma...0 - Columbia "White" Church Cemetery C D ION a 9eM S NME m BeAIIEiLS 11rENSE NO 23 WAS OMT«UEMNrFD TO CO 'PWEa �`°• M1farkRWalter ( FD010130I0 yyN. ❑Ye. my CA m Ti. 5161ATLFE rE FERO. TOR Ne mem FMMaI M.NA.IE AXRSS AFC LICENSE Naha OF RACIAL 1101E so Z tot X n ` Z it' FD0IL0 010 Colvin th Main Home, Princeton,eton,IN 471 m m, 425 North Main Street, Princeton,IN 47670. ~ •C C7 b PART I E..oo await 2 _Fy .91•••l .Ls. as 0or w wake war.....wawa a....saar......•.a•a.r weer. Z u....l.a..l.aMaL�aiiti .1/ ,( I G x O Li SIMLA E CAUSE ch.� . &-As-i-Ro .1.7-°ES-t (WAL-- salt-E ED(I`1tc �e t•.51, roll 20 �OLOm'" DoE TO(OI AS A CONSEQUENIX 041 A m Z F maw O 0m e m Tn Caftan I s o.a s.• aE TO MA AS•COREQLENCE O) la Er weer as jO a N dewy Cs 9891m1 OIE TO MA AS•CONgpLECE OF) 2 a ll2 Oy-2 PLATO bow Vat. . a.•Cond.r atop yq/�,tot'"abbey ard a Pan: )] WAS O[4IDENr 2b WAS AN AUTOPSY RD WEIE AUTOPSY Md=.S z C O 1 '` r ' `. VI-)6707) I "3 CS) )S O.w DAYS PM/ Avaaaal W.DN TO }- POSwJN)W (no.. , ce1ElETON OF CAUSE m� ymrt4-1.3. SpJ la p4/I A( Fck tWt na a.w OF DEAN,OW a..l oe m - No No No Z00 ]A.CEPTEEr1 MCaLM'.O ncRMN Tee.tr dry E...ss as cans.n.e..eta w aM4 w sa o a.rae.'U r RNA 1 �y eel ea ❑.EALTN CFFLL4A O.0.es d aasara a.ga...aaa.a ley was am cans A WI an as w ANA sae ae a.Y oath)a sea S A• n, MM ❑cadet Ono.ea.d sala..aposa in My Cana ae cc..4 no Its is as d.a to an r oats/..seer r ere M / 2 M. SIaFATIAIE MO TITLE O more. < �//� Mc MEDICAL UCMSE NO Ma DATE aDEO 0.Yard y 1 r//nEO//(f/ pre Q ta1� 02-� MAY at _,c77 1218 22 SD NAYS AFC AOdE$$OF R160N WOO CAUSE Of DEAD.01E1:0 1U1e.HH.a ` 2 2 Ramesh Patel MD 105 N.2nd Ave-, Princeton. IN 47670- 0 II.`(ALTh COMM O4A lIE - s1 MT FILM(Met NAY.sal 1; ./ i- idol/era., • RI 2 33 Haile OF MATH 34.DATE OF WY Se iEE a S c rIM{AIY AT wool. w OESCIBE iou Halm OCCUPIED 3� .p uv..L W ran .mass -I µNretl ❑a.... ..a...,. S ❑AC[ve 1...4.99. 14 PLACE OF INJURY-.re..Is' ma Nary.eK4 Sa LOCATIQ419.44 a.Maas or ea Fa.Mroe.Cu o ion Sims ❑Sao ❑Cowl A.a Nw.N(SF.(M Orr • ❑e.e.e• r{r N E49 °.TE POOPOU .D DEAD Woe Oy varl }M 90,01 vo1a:tE eeemnT,I YN a sal F yet moor/Row Naar.NY.a R %t tx i' S03106-004 State Form 10110(R5/1-99) IVRA-20 (7105)