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Death Certificate - Smith, Moreland H_9/25/2001
J a 9 Grh.:P�:F�N:I� COUN':L"1'' LO�..1�:1) 07:� 7-1.:1'iA:1=,':C:1-f I3URliAU OF l']:7'AL S9'A'f:1:5'1'ICS CP�:R':L =L ]�'=C CA�C7�' OF I�:I ;11T:I;1: 'PII1S Cir:lt'Pfl�lli3, 'I'hc offici.:i.l. records oC I:hi.s depurCmenl: show Che fo.l..low.ing Namc M021sL:1ND 11. SP11TI1 Agc 66 1'R Sex ?I Murried a Single Wi.dowed Divorced Plucc of Denth GRI�GNE COU\�1'1', 1NDIANd Ual:c of Drulli N01'PM1Sfilt 19, 1992 Causc oC DenCh Alt'PERIOSCI;EHO'CIC CARDIOI'r1SCUL,IR DISF:ASI? Signed by GENG P.,OURGASSI;R. Di.D. lluCc ol' f3uriul \�OFliMIIBR 23. 1992 IPhr�ici:�n, Coronr.r, Ilenllh UCI'icCrl Funeral. Ilomc I,A�t[S-11ASIli\AI �IE��IOIZ1.11, Address 0�\fiI,:1\p GITI', I!1ll1:\\A Nnme of Cemetery ASIif31' CIa�IL:TGRI' Addre_s OARLAND G1'I'1'. 1NDI:1�A Issucd p13CEM6GR 2:5, 193'L I�il.ed DI�CIipII3G;R 'L:f,_1392 Recorded I3oolc No. 5 Pnfic 252 SI?AL � ( • � %��.� Signcd • �� . � CnunT��. Ind ❑e;ilth Officcr . • .-