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Death Certificate - McFetridge, Clara K_11/24/2015< diTnt` , --.�� IIVUWfVHJIHI_CUCI'67[IIYICIVI VC.nCHLIn! � ; - ,`I � , � ' . ` � � ` CERTIFICATEpF DEATH z , ; ` `, � �; �Local No 00�0973 'a � •�`�EOR No 000000445990' . ' < '�state No'022085 � i.DeceEem'=LeqalNama�IFVa;MbCeLasU. _ ta MaioanName(1ltsnale) 2.Se ,- - 3,TmeOlDesti. ' 4.OateOlDeath(MaNWry/Year) . ; . CL'ARA K MCFETRIDGE• E �"� ` � - r DIXON : �`. � `� t ` �FEMALE ` 04:00 PM _ �.�� . 04/25/2015� - i$otiL Smnry MmEa 6a :Ay! Yrs ; W UMe 1 Vear � Bc. UMa 1 MmT 60. U�tler. t Ory fie_, I/nCe� 1 Hav - l Date W&M �MaWJOaylYear) 8_ 9vitplace (Gry aM Shte a Faregn Can'ry) . . . . . . ` Mosptal ' � � ' ( ❑HoapreFafbry� ❑DacNen[sHana ❑NUrsiyHOmertnp;er.nCaraFetl4ry, � ❑ Yes' �` No ❑ u��o«�, p�i�'em O E�+w.+em+�ro�«vo�rar�m O�oeacooa,;a p om>iso.�m � . 11..farAry Name pf Nn InzcY.m. Grve Street arq Numce� . . � � � ST MARI^S MEDICAL CENTER OF EVANSVILLE INC '�• - �� 12. Gry Or TvwR Stas. Am Lp CaCe ' . " '� 13. Camry Oi DeaVi EVANSVILLE. IN. 47750 � - - ' � VANDERBURGH . ' 15. SrvmgSpouse'zNart< � . . t5a. QtKt'e�GneMaEenlastName. .18.�DeQaenYs � � . . . � , : � � .. COOK te. Hewerce�.5iae . . , - , tea: CaauY . , � � 18e. CMOrTO.m-; �. , _ INDIANA. ` - - �� .� GIBSON � - � �� FRANGSCO , � 1BC.5trcetAnONimEer., : ' . . . .. ' ' 18 203 NORTH.DIVISION STREET � � ' � � _ - � 19. DeceCen[s EO�ra'.a� � A. OxeEaV OI HisP� OnGn .21. OecNenCf Race . HIGH SCHOOL GRADUATE OR.GED � . . . � - . COMPLETED � � � - NOT HISPANIC . -- '`. White. ' ' Y2. Fa;tcls Name (FVZ� MitlGe, Lmp -. '� � IJ. Moltc(6 Name (FVSt, MWNe, lesp � GEORGE DIXON � MYRTLE DIXON'. ' 2a.lrtbmmCS Wme , . 2aa. Rda isn0 To Oereae�u' 2d0. MaEnp Aaaess (SUee� nn0 NunOa, Gry ❑ AlameC Q MameC. &rt $ePara:ttl ❑ Gvwr.M I A Q Nbawca ❑ NeverMarn V ❑ Unba.vn �j t. Ira�ae Gry Lmtsi 0 Yes Q No �&i�a� � CrenmT � Dma�ael � En'nnErtmN . . ',. ., . I ❑ Renwm v(vn, s�r . . - .. � ❑ omer �soearyc ' ' IOOF CEMETERY � FRANGSCO, IN I . ffi. Was Camlr CdCaCMi . 2J. Name Pn0 Complete ACCress Of F�ncal Fatltry ' � . . ' � 2]a. Fweral Hane liceme NumDet. ❑ res p r+o . DOYLE FUNERAL HOME. 520�5 MAIN �ST. PRINCETON, IN 47670 _ �� FHt10400010 xro. s�veoiu,a�F�,aws���: �n�. uw,YNU,�ca���t I BARRETT W. DOYLE BY ELECTRONIC SIGNATURE � ' - �� FD29500009 . , Cause Ot Death (See Instrvctlom And Examples�.. .� � qpprpximate 28. Pan L Erper The Chan q Evm�s �- Diseases, Lqunes, Or Canplira;iortt - That DveNy WuseC The DeaiR Do No� Ercer.Tmn'vul Even:s Interval: Onset $urh As Car�ac Artest Respiatay Pnest, Or Vertlnalar FibnlWlion WtJVn Stvxvg TM Etidopy. Do Not ACtrevu;a Erte� O�iy One Gaiae On To DeaN A Lvre. FbC ACGlvial Lnes If Necessary. � • 's :' �� � � 6rvnetlu:e Caase (FCaI Disease Or Corditbn Rewlivg In Deat�) A ACIJiE ON LMRONIC OISSECTION THORAGIC AORTIC�MlEURYSM � 3-4 DAYS � . � - . . Wu1P4�fd�qne0't , t SequerxiaAyLisiConaitions. Ilfvry,leaC6fgTOTTaGatiseListedOn . B. HYPERiENSION �ti�pN ���� I � UNKNOWN Lv�e A Ercer TTe Uritlertyrp Caiae (Diseasa Or Iryvy Thai Irvtiacetl '. -.: ' .. - The Evmb Revl3vg In �eaftQ last , � �. CIRCULATORY SHOCK ' � " - � I . 3-0 OAYS o.n�uu.tn+w�o'[ I ' D. ATHEROSCLERO515 ' � UNNNOWN �Pat tl..FSxr Ovw�cv'ra�� ('an'�w+s Carndt.mo m Dea:n Bw Nm Revi:ng In TM UnCNyieg Ca�se Giwi In Part I 29. Was M Aicopry PMameai � Yes � No AOVANCEO AGE ' •. ,,.�. ��^ A�opry Fvtivp RvaiaDle io Cmpere itie Ca�sa OI OraN1 ❑ Yes 0 Na � ]1. DiCTaCamUUCmndf.eioOe�'^.i. : .32. IfFemale: - ' . : � :: . �. M��p��: I{ . �Q Yes ❑ PioEady 0 No Q Unk i ❑�Pnpu��'i°v..r ❑ Apr�un�wao.a ❑�nmwKdAn!!��mnao-ri Q Naaaal � MortutlGe ❑ AmdeM ❑ Per�� Imesiga:an � ❑!ea.o�.�.s.a�.v�-�edr.u��e.u.o.a ❑o+,....wm��,�•r......: ❑�s.meOcavaNaeeoe:erNree 3a. Da:e Ot iM�Y IAIor.:eVDa�'/Yeeh ,: ' � J5. Tune 01 WwY . ]8. Rre Of 4yi�Y (EG.. Deceeem's Mome. Canssurt�on S:e. Resuuant V.UOECtl Ama) .I 3]. I`MY A� NVki " ❑ Yes ❑ No . 39. Lora' OI�T�Y-=WS JBa. Ci70�TO.m - 380. SIreelBNUn�e� . ' , �BC. AP�NO.� �BE. ZiPCaOe �9.DesmOeMwrinP%OmmeE . � . . . aO.I(Trmspartaom�Tn'.SOeufy. . ' � ❑u�0�s Q�s,w QMNn Qfv�arli'M'1 �� 41. Sg�aae. OI Pmson CerthW Cause OI OeetM1 .. ' � � . 62. Certifix (CPttk Q^h' Qie) � KELLY KLING-TIPTON , BY ELECTRONIC SIGNATURE . � ' 0 cemMremrv�� ❑ c«d+g .I ❑ He�no�« �3. Name. PAtress Ma ZiP CoOe O� Persm CNJyvg Cause OI Daa1R . ,, . M. Ixmsa NunOet ' <5. Dale CeNfieO 1 KECLY KLING-TIPTON , 3700 WASHWGTON AVENUE. EVANSVILLE: IN 47750 � � - 07066455A � I OS/Ot/2015 as. AaaamsFUneral5eviwPfv.ieer. . . . . .. a;. �ntas: . � . i'. ,. :� .. Y • . "� ♦ , � - . � a9. ForRegizevrOnty'-OamFi�eU lMmNVDalrvear): . � .' �B.�SiW�cemLOtalMee1T015ac.: ' , .. . � . . � . . : ROBERT KENNETH SPEAR. VIA ELECTRONIC SIGNATURE = i � � � :MAY 07 2015� � � s � AMEN�MENTTOCERIIFlCATEOFOEATH�ENTRYORORIGINAL) - 'I% - .. ,� f :.,,� �f , �i /%v. _ W..-i �f . . _ t �� �� F $ta e Fan 53395 q7TErITION ESTATE: The $ocAal`SeaitLLy Y is Deing repuesteE Ey Ws stxte;agercy�in ortle� �o pasue responsibliry Disdosure is nluMary antl ��ere wID be ro p¢na�ry tor refusat ;�' � ��:_�WARNI_NG� Oq�'�L�UNENTHASAMULi1COLOFEDBACKGROUNDONSPECIALWF1fiESECUfl17YPAPERANDTHEGflEATSEALOFTHESTAfEOFINDWNAON0r1CKTHAi _ NRNS FflOM ORANGE TO YELLOW WHEN FiUBBE� OflIGINPL DOCUMEM HAS MIDDEN VO�D ON FRONT THAT AP�EAFS NMEN PHOTJ COPIED. � . . . _ . .... . .. . i