Death Certificate - Maikranz, Von D_12/18/2013 . . � 136901
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ATTENTION ESTATE:The Social Secuty k is
6amg reque9,Dtl Op re 6'`'e algyr. oroe2lD INDIANA STATE DEPARTMENT OF HEALTH
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4-^--"J THE RECORDS IN THIS SERIES PRE COATIDEMLIE PER IC 16-37-140
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Von Delano Maikranz Male 06:15 AMM I.luly 8,2007
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i.a m HIT R R NI Box 112 Oakland City Gibson
Cr) --O. • 10 MARITAL STATUS II 9URYNt.(SPoVSE IL DECEDENTS USUAL OCCUPATION(Canted(P.-v Ir RMJ C eU$MEssckckSTRY
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>o Q Married Marietta Dyson Factory Worker Manfacturing
H fl IL RESCO•CE-STATE IID COUNTY Sc I CRY.TOWN.OALOCATICN Ib STREET AND NUMBER
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O O m 16N Gibson Oakland City R R F I Box 142
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�m� le FATHERS NAAE Um I16
o Joy John Alaikranz Lucy Hyslop
RI C>- NT is MFORAANTS NAME Ir,s.m 20o M%.M1M.ACOFESS Sit or And N.ktw.ay Tr r:.¢&a ZO Cod.) ?Cc P. ,fl
5 2 C; Marietta Maikranz R R#1 Box 142,Oakland City, IN 47660 \Vife
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C y.IOY m EMIaALMERS NA.E 220 EMBALHERS LICENSE NO :a WAS DEATH REPORTED TO CODONEW
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m >3 \ �rU--_ 1/)010052 71 323 N. Main St.,Oakland City, IN 47660-
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1, x YI NAME AND CORMS OF FERSCN W'10 COWSETED CAUSE 01 DEATH OTEM MI I'mean,
°C Dr. Magbool Ahmed 421 Chestnut St.. Evansville. IN 47713
>C 31 KALTHOFNCEPS SIGNATURE n 22 DATE FILED(Mame brY
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m 33 MANNER OF DEATH 34s DATE OF VAMP! 240 TOE OF ' TN HARPY AT WORN, 344 CESCRAF tON INJURY OCSMED '
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.. 501106-004 State Form 10110(R5/1-99)
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