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Death Certificate - Schmitt, James A_11/9/2001o�"�`�"O`� b° �' � ` , . . .i.. . , , , . . . , -;.: .. ..:: - ��,::, .: , , . . : .. . ' SOCIAL SECURITY ADMINISTRATIOr ; ;. _ .. ` ' 8 N. SPRING STREET � ; , ;�, , _ NS.VILLE IN �g77+� .+3��:'.'•.. '. VANDERBURGH COUNTY HEALTH.: DEPARTMENT O 13 9 3 9 Room 127 Adminislrafion Building - Civic Center Complex - One Northwest:Mariin Luther King Jc Blvd. 'Evansv/lle, Indlana 47708-182B _ CERTIFICATE OF DEATH ��jig �e�tifie�; . == ;� . THAT,ACCORDINO,Tp THE RECORDS OF THE�HEAl.TH DEPPRiMEN7 ,�y �,ry �' . �' �i, . , - ' .�L j � I . . � . . ' 'n • . � . � • i . NAME � � r �.� � ; JAMES A. $CHMITT J °i ,.:;.it '. �, n � ,� DIEDIN VANDERBURGH�� COUNTY INDIANAON ' �� ' � N � � � ...'� { , . . . � AUGUST Z3 '/EAR .•)OO� . .r...6 C "� j�'� ,. 07:30 P.M. 5�% AOF RACF,� 4 � � TIMEOFDEA7H �MARITALSTATUS ' � �� y + MARRIF,D ' MALE 48 �''�' `r °' ' sorinisECUam � ITE � � � \� ; , inre nF;aiarN ' N ar a�', . , 10/26/1952 i ; az : ��i, ; :. �: . F PLACEOFDEATH � � ' . . � 1 � s �� a�� r�.: .,.:.� ST. MARY! S MEDICAL CENTER T �,�,+ ', ' PRIMARY CAUSE OF DEATH GIVEN WAS \ ' � ` r �{ � �' � „ ' ' 4 2' -j 7� • �� , ' RUPTURED`APPENDIX,wITH,',SEPSIS. . � ,,,;•, o y.�j . , . � ,i . . . . .. . , . . ' ' O `.y.��,�..,E�.-. .iJ•.,tl. � �. 1 •�� PHYSICIAN OR CORONER � � � �� ' � � ' a -U' � 1- '+�1 t .�. . � JAMES C. ;HAMBIDGE,, M.D. .�u7oPSV ' F- ,p -i � _ NO PL4CE OF BURIAL OR REMOVAL - � � ' � �° -`� � � ' � . FtEMORZAL PARK GREMATORY MANNFR NATURAL DISEASE ��;' � FUNERALHOME-' ' , �. . � ' � � . . ' ALEXANDER W;ST CHAPEL .. , onTE oF auRin� 08/2Z/2001 CEqTIFICATE NUMBER C � � � ' � . . , , ' �. ' ' � OR.VOLUMEANDPAGE � '�•.+ ' . � �� OU001644 � onre issuEo ' ' , 08/27/2001' , � � � , ' ' NOTVALIDONIES$SIGNEDBSEALED '. � ' � ' \ !/ � D /!-�"'c�'�%�// /.: ,'! //�O ' �/ , � . ' .� , � • ' . �' . . � ERBUROH WUNTY TIi OFFICEfl . .. '. ",.., � � � � � .... .... .�� . ��,� � � • • . . .� . • : . � . . . .. . . ._. .... .. .. _ . � .� . + , ,.. i.. ': . . __... . .. . . . . .• . .. . .. . ... .. . ., . 1 . . . . . ... .., . . .. . .. . •... . . . . . . ...... , : . . . . . ,,., ._ , , : .. . . , .. , . � . .. � . . .. . � ... ..: , . . ,. . - . . . , .... . �. . , . . . , . . .: . � . .. . . . . . .. . . . . . , y . . .: . .. . � :... �