Death Certificate - Terry, George W_11/9/2000�
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VAIdDERBURGH COUNTY HEALTH DEPARTMENT 24998
Room 127 Adminishation Building - Civic Center Canplex - One Norihwest Martin Luther King Jr. Blvd.
Evansville, Indiana 47708-1828
CERTIFICATE OF DEATH REGISTRATION
��ji8 �ertif ie8, TFIAT ACCOfiDING TO TNE fiECO(7DS OF THE HEALTH OEPARTM[NT
NAME GEORGE WILLIAM TERRY
DIEDIN VANDERBURGH COUNTY INDIANAON
TIMEOFDEATH. OS:O3 A.M. MARITALSTATUS �RRIED
SOCIAL S[CURITV
r�nceoroenrri ' DEACONESS HOSPITAL
PRIMARV CAUSE OF DEA7H GIVEN WAS SEPSIS
JULY 23
sex �LE AcE 61
DATEOFBIRTH 02/08/1939
VEAR ZOOO
RACE �ITE
PFIVSICIANORCOl70NER THOMAS TOPPER, M.D. nurOrsv NO
PLAC[ OF �Uf71AL OR REMOVAL ANTIOCH CEMETERY, CYNTHIANA, IN MANNGR NATURAL DISEASE
r-uNean�HOMe HOLDERS FUNERAL HOME, OWENSVILLE,IN DATEOFBURIAL 07/25/2000
CERTIFICATE NUMB[R �
ORVOLUM[ANDPAG[ 00001530 DAT[ISSU[D 1��Z�j�Z���
NOT VALID UNLESS SIGNED 8 S[ALED , ,
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M.D.
VANDLR�UR HC UN�V .IIOPFlC�R
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