Death Certificate - Tolson, Clarence_8/27/2008�
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VANDERBURGN COUNTY HEALTH DEPARTMENT 11839
Evansville, Indiana
CERTIFICATE OF DEATH
��jis �ertif ies, THAT ACCOflDING TO THE RECORDS OF THE HEALTH DEPAflTMENT
NAME CLARFr�CE L. TOLSON
DIEDIN VANDERBURGH COUNTY INDUWAON JANUARY 22 Y�R ZOOH
TiMEOPDEATH OG:O% P.M. rMRRALSTATUS n�igp SEX Mp,j,E P.GE %] RACE �yf-]j'j'$
SOCIALSECURITY DATEOFBIR7H OS/25/1930
PLACE OF DEATH DEACONESS HOSPITAL
PRIMARV CAUSE OF DEATH GIVEN WAS ACiTI'E VOLUhtE DEPLET'ION
THORACAL ABDOMINAL AOFTIC RUPTURE
CARDIORESPIRATORY ARREST
PH'fSIpAN CR COFONER gRUCE BRI NK, JR. , M. D. FUTOPSY ���
PL4CE OF BURIAL OR REMOVAL OAK GROVE CII�tE'fERY �NER NATURAL DI SEASE
FUNERALHOME STODGHILL FUNERAL HOME, FT.BRANCH.IN DATEOFBURIAI OI�2E�2OOH
CERTIFICATE NUMBER
OR VOLUME AND PAGE DATE ISSUED
00000143 O1/31/2008
NOT VAIID UNLESS SIGNED 8 SEALED
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