Death Certificate - Stone, Don Henry_6/17/2004LOCAL CERTIFIED CITY-COUNTY DEPARTMENT OF HEALTH
RECORD OF DEATH City of Evansville Vanderburgh County EEE -i$(7�.00
Evansrillq Indiana N� _ 4 1 J i
Don Henry Stone _ ______ ___ died
Thi; i> to Certify, that our recnrds sho«-_____________________________________
-- D��'---- ----16---- ---197� --- at - � _'lOP.lI. - ---------St. Nary's Hosp.
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monN day year hour of death atree4 hoaD�� or tural
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Age ac death __55__ Sex --�----- Color ---�---------------------------- rrled----
yeu�s write aheiher married or sinY�e
Metastatic carcinoma liver, ?rimary carcinona of rectc
Primary cause of death given n'as ------------------------------------------------------------
----------------------------si moid - �
g---------- ------------------------------
W. A. Hein ric� ---------- City--------------------
Siened by --------------------------------------
yhyeiciav o7pp(qp�( address
Walnut Hill Ft. branc�, In3.
Place of burial or removal ____________________________________ _
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aame of eemetezs address
Date of burial 12-19-�0 _ L3ib Ft. Branch Ind.
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��� Flinernj �'mtor address '
Signed ----------------------!Y- /✓_ZI�ZCT�y�!!�C�,-/-'{ev --------Sec'y. � �-. " �
_:
Evansville, Indiana �'2-23-7� ' _ [SEAL] —
__"""_" date _______ ,. , .' .
\'OTE: Recorded locally in Book No. ---------35--- Page \o. ---------��-• • �1•
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