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Death Certificate - Shake, Curtis_5/6/2010FSSUED BY MARION COUNTY "°"' T" ^°^"^''HA�Pd'� � INDIANA STATE DEPARTME�F HEALTH :� '4� CERTIFICATE OF DEATH - °.�� OU5543 ,.,. Locai No .................................... LOaweri)LeY���mel.vu.�ee.lanl ia, iNnlauwn�0� ��'•1 �.Sea r+�s G. Shake, Mal2 _.seon .c,qnc-.>s a.Ape-rn u.us.nru, w.uw,��n. �a.ae.r�mr w.u+m��. r. r..aerm�uw�rAayhu .e..,� .., �,a., Fe 2 1 P 19.YCe�'d0[sfean wa�y¢aC 1 JOe�O e]SVVr✓�mCPnTanwM<fp�R ❑ Yn fd lrA.r.r.n Q Yi+.kH � �a9Q I Oar.�v! Qla:[al [ 9c:c On M1ti�y ❑ F�a:e fx:itf � Oe�ece(� Hre � �Lesn9 Nmo' 11. a[4Y�:��e11'ttY�iC.20n.G'vey1MM'ANa�:l�1 St. Francis Hospital C UY d lvm. 9mJaf Li Cc4 Beech Grove, Indiana 96107 n. SrvrvNpSOOawaw.e. �v. It%TqGrer Ton a Shake Toler 1f. eWen.e-9�1e IN. CeuNy Zndiana Knox �s. z•��,� �_mee 1310 Forest Hill Drive ia. ..K.-v,_c�,m. m. oK.a�ma�u.n Some College, No Degr e No . rmr.u�.�=a.we..taa.� Gilbert Shake Tonya Shake Wife Marion � Management :. �,x.,., vincennes StateNo ......................................_.... nedOnu � �I�INGU�ANniWay(Yea l�ItiRM � Auaus� 3 2C I White :�. �:... H,�. ��.,�. ��,.. �.�, hlary Alice Shake a ,. � . . .. r. ... , a. 1310 Forest Hills Dr. ncennes, rs� ow,��e.a.saK�co��:m ❑Y.Slwc< OIMal.�arc0 Ol'N:_-n i�. r.naaie���ranxwwy Aircraft 97591 � °va ��" K�emeyer �] Bvi�l Gmave 0 Jvam � ENm2r.c�v ❑Aea����= Eastern Indiana Crematory Lewisville, IN ❑ ac+c�=ca:sr :s.vn.eaxee_+,ceer _>.n.m.t,eee�ve:..x,n: .,..ar.aq na.r...mi�.•s...era:me Vincennes, IN ❑v° �'" Goodwin Funeral Home 524 Broadway St. 47591 3006910 S)C. IF.CUnaf::«il5fne[LItCf<e: � :h. tke seNVm.fnlql�emx�� .� r�, � � FD09000039 e.�.. a oe�.n �s.. m.e.,,���e�. n�a e...�.n�.,� 2B. Part I. Enitt iee Cnai:01 �renb—pi�msm, hpies.Or CenO��-���=�s—Tel �i�e:tly Gusec The pe�J:. Oo Not Emee Tvn�.i�i Evmu Appmsina�e Su:n As Gr1a: Mest, Respi;a:uy nrtest. G Yenviacbr F��Grib�ion W,tMV:S^ew'mq Tbe ElicicSY� Do Hot r1ECreNate. En(er ONyOne Uvee Dn In:mal: Om. R lL e. AEE AtltlOCn�l �jflef HNe:tsiin'. T09lil:l 6�.rediaieG�vu(FN�IOiseaseO�COnEiicnr�er�l�nqNOe:m � M`'�f'Sys�'r' ,1��°i �'�/�"�— Ztw.Ge4. Se�uen:�a0ylis:COntiJcns.ItMy.Le�einSTOT.;ebcseLis:e:On - �" a���'NL���--✓ �ig� 2 ��°e�s LneA, ccletTneUnlemM9Cause�DisnseOrLjlryi�a:L•.tJ�rtE �/�/�� (� 'A•� [�..e.../dn^� 1 � U TneE•ent�Res�:sqli�eal�)!�s� C �� ���1��I- %��' � (w�� I Gvrele� a.,. ..��.� ❑YeCR"J!CIk0..Nm�n OIY.RayaaWti>:utvpF�gaYU�mv'JIC<s.��dRtyvl9J!!qa�CLL'ial"J.��p?. ��y�p-��¢O�mcyOPepyFa;av. OIbRTni,elcrqvl�ICa�fielYV&beD[�m ❑V�Mntr?q.vJlHenRCPNYm ❑SeaROf,nlltb0aun/'.m Y.�'tOlYquYW�`�+C�Y�`'eael ..neOIUM�Y J6, la_�plquryl . �k'�NaMm.e.CmY':�9m5nr. r[�aara�u.Waol44r�1 ]]....rpy4Vh�l �Ya Olb X.tm�pmIXdMY��le Y�.C�)IX:.+e Xa. re�>.�v-oer Yc.A:1.Np. +e.Kk• ]S Oeu�.�e ue�. tlP^QivreC . Y ir��4m.frn Fµ�Y. `+W<AY: IOu�srtkvav piuwKa O�m..+-r❑Cm�n'�I i1.5qnun�.O1P Cef.'p+S�au ]�aN' �:.CenL�IC��tnpilyOnp � L Cm:rcg P�riw.n 0 Comtt i] 3c AOlks 4. L:mfrNmOe � 411aT.c,Add�sRfpZoCadeOtFacstCet�.`j Gas OeaR1: f� n�cl.+��' �'H� f7c�M1� .� �5w ALF.i�4,�x,� sr p9ir 9lorda O/038s�5 9 g, �t �YS�YhemlSeMCeRa.i]a: I a].'�.n. AUG ;t 5 Z009 i