Death Certificate - Sensmeier, Mildred E_4/25/2013 ISIS AN UFRCIAL1COP.t0E.RECORD OF DEATH:ORIGINAL 60PYi0N FILE:AT+THIS COUNTYY S HEALTH-OEPAHTMENTI 019 9 3 5
•ATTENTION ESTATE:The Social Sear«tT 0 is
being requested bli this state agency in d ro
,iplucae es`slatutory rasp:metAWy. Dsdosure 6 INDIANA STATE DEPARTMENT OF HEALTH
CYOtitaryand t. be no penally penattypt refusal.
?-t'"=�".=Ard CERTIFICATE OF DEATH State No.
1 vocal No..
r'i•'- " THE RECORDS N THIS SERIES ME CONFIDENTIAL PER IC 1547.1-10
- I DECEASED-NAME Qat WAY.LAM T SC. 35 T►E OF DEATH It DATE OF DEATH aw 0 ni
I O CI o-I; Mildr d F Senerutoier Female 6-30 A■A February 21 7004
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Fort Branch IN
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SDH06-004 State Form 10110(85/1-99)
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