Death Certificate - Wallace, Mildred_6/5/2009.��
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VANDERBURGH COUNTY HEALTH DEPARTMENT � g532
Evansville, Indiana
CERTIFICATE OF DEATH
�his �e rt i f ies, TF{�T ACCOf9DING TO THG H[CORDS OP THE HEALThI DEPAHTMGNT
NAME MIt-�iu;� c. wn[,t,nce �
DI[DIN VANDERBURGH COUNTY INDIANAON
TIME OF DEATH 09 � 45 n• �"�. MARITAL STATUS �« I I%D
socin�secuRin 314-14-6502
PLACEOFDEATH DEACONESS HOSPiTAL
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JUI,Y 03
SEX PGMALF. qGE H%
DATEOF6IRTH 04�12�19�1
PRIMARV CAUSE- OF DEATH GIVEN WAS CL'RLI}ELLAR }'ICMORIiI'U1G�
PHVSICIAN OR CORONGR ANDRGW 7'ROFI'KIN, D.
AUTOPSY NO
VeAR ZOOH
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PLACE OF �URIAI 0� 17GMOVAL SC. JAMGS CL'MCI'GRY
MANN[R NATUI2AL UISL'ASE
FUNERAL HOME STODG1iILL FUNERAL HpME, }ipUDSTADT, IN � DA7E OF BURIAL O%�OC>�ZOOH
CERTIFICATE NUMO[R
OR VOLUME AND PAGE OOOO I 3] z DATG ISSU[D
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NOT VALID UNLESS SIGN[D 8 SEAL D
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VAN ROURGM COUNTV MEALTH OFFICER M,�.
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