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•s' VANDERBURGH COUNTY HEALTH DEPARTMENT 01153 i-
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$� Evansville, Indiana Ni
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�g THAT ACCORDING TO THE RECORDS OF THE HEALTH DEPARTMENT 14
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Ex NAME GRACE E. BALLARD i:?
f!. DIED IN VANDERBURGH COUNTY INDIANA ON SEPTEMBER 27 YEAR 2003 3
Es 0 TIME OF DEATH 08.00 A.M. MARITAL STATUS MARRIED SEX FEMALE AGE 65 RACE WHITE [sa
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T PLACE OF DEATH DEACONESS HOSPITAL
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0 RENAL FAILURE M
••• PRIMARY CAUSE OF DEATH GIVEN WAS E2,
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5E PHYSICIAN OR CORONER ANDREW PIERING, M.D. AUTOPSY NO ai
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T PLAC`,OFBURIALORREMOVAL NORTHVIEW, ELBERFELD,IN MANNER NATURAL DISEASE ;,
Es FUNERAL HOME STODGHILL FUNERAL HOME, FT. BRANCH,IN DATE OF BURIAL 09/30/2003 �?
to FUNERAL (a
tt -CERTIFICATE NUMBER
0, OR VOLUME AND PAGE 00002091 DATE ISSUED 10/01/2003 N
.40 NOT VALID UNLESS SIGNED&SEALED N iii
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