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Death Certificate - Mathew, Patricia_12/1/2015 (2)_ �- -, �_. .� .�-. r- � �� • � 4� ���. ..a� r�' �-. �'�..¢-'�, .�_ .r. � ' %' �� �- r + INDIANA STATE DEP TMENT OE HEALTH '", " " "�' � ' , (' i� ; � ` , > � ; CERTIFICATE'OF,�DEATH � , z � ; s : ; ` ' ��i 1 .� r . ' _, � Ih : .��:iF� �i � n�:: % �{ e �,.� : : t . :�� s � t E\��� -LocafNo,OO2`232�`: _ �-EORNo.000000476446 <�� �:staceNo051160`,�� ;> � 1 OececeRslc9alName (frit-MEme tasJ�: .... � . r„'' a,�MakmName (l fe?lale)'.' ' 2 Sex.:: ,.�;:ThneOlDeah•.+• �...; .- . � _ .r ) : . " , .. „ 'y .$ , " ; y a. Da2 Of Oe N �MorcJVDaifYear�^; � 'i � � . (� .' ;� PATRICIAANN'MATHEW '��` / �: i HOUCHIN`- ` ` _ -�� FEMALE °`09'.24AMz :-� A'"7 02 912 01 5 , "`.� j� 5 SmalSttwryN�anar Bar Apa Yn� 6D U`Me 1 Year 6c. Um 1 Mortln Ea U{ber 1':Day Ba.'NMer 1 Hou ).Date W Bum (MOn:NDayMear) : B.6fJpace (Gy v�a 5: a Fareig�COinYy) y . t I . } ` al �: • ..`.. . ...../ � �.., �Y f.c�i .,- .�. .c:.� f"`ti\ `S`�. QFhspreFarBR'. �'DecsCeirt'sHane, �ONiasv+OManMU9trnnCxrefaofY4 �`.. ' O v� � No p�u�w�a:n ❑�IT�� O Eme9�YDroaartmertOuYa�w O oeao�amm 'p'om«csv�m �.I.. re 5t FxityNar.rc (IfNatrw:amqGrveSbeetaMNVnEer1`. F " c : ' ' ; ` 1 �� DEACONESS HOSPICE�CARE CENTER = ` � ? � i 12.,GY Or Tavrtt'Sta�. MO LG CoOe i: - . , ' ��'�13 Cauib OI �ean^ �: . t�: Maritg Sta n At Tu�e Of DeaY�• `- �\.. � •, � � � :`• 4 . �•. �� �ManiMOMV�nM.Bu15e9mn:M ❑.OirdceE • -. . . .. .• • '. 'N... ;. ... ' Q Vb�oa�.W _. Q I.�ever MartieO t:0 UnFnwn ., : EVANSVILLE.IN 47747. . � - ; VANDERBURGH� . t5. $irviwg5pweesName . . 15a llt4Ntew eMaEenlns�Nane •:16 pece0en[sUValOa�a`'.»n t] : i 01BUSVCSSIIkus•ry.'. � . i .. � i > �. `: � , . ., .; � ' ' � OWNER �. � _ � � ' z �CER.4MIC BUSINESS z �tB�`Rezieence.5ia's � . .. , 10a. Camq .. '�„r" °<180_ CbOtiwm� � ,,. •. . , . • .' t ' ...i" �. j{ � IND�ANA : ' � GIBSON , �. HAUBSTADT,i �'" - � ��Y . . t8c. SbttllvbNivn�tt . - . . . -,2 . 3 - iBE. APtNO. tBe. ZipCoCe t81 I sq G1ylvMS�. 105SOUTHVO"!PJA�LANE,, . 3 � � ' u�.ves�p+o 47639 .� :9�DeceEen[sEC�r]on : . :...� � p.�pgqgqp�HisparvcOnpn ' � � 21�'OeceCenlsRace � , ' HIGH �SCHOOL GRADUATE OR GED - � �- � ` ` .�'' � �s � ' - � COMPLETED �� � . NOT HISPANIC ; �> VJhite � - � `: I` �,�'� - 22 FY1c�5 Name (FVSt ltiE6a Las4 . �, , . �# � L � 13. MGels N (F � N.iOae La �� 2]a_ MoTCS Maitlen Lasl Name �' - � . I ARVIL HOUCHIN ' - FIORENCE�HOUCHIN : � ; HARTLEYi ' Z<. N.'ortnarifs Nar.e •,, •.•.. . . 2<a. RelaDanslv0 To OeceCeN `' 3ap. Ma£'�B NCOress (S:reet Mtl NurOer Crty:StYe. ZP CaOe) ` � . : y ' �...•' •. V . : TAMARA MATHEW � � DAUGHTER .� �', r�r " 703 WEST CHURCH STREET,�HAUBSTADT, IN 47639 �- ' - � � � -. � i : is. a�a a a. x�; - . 4 '_ � - ,{� . -, -_ � ' 25a. Me7aa q Gsposrvan : 25e. Raa Of psposipon (Name Of Cenetery Gema�y Ot.xr Ra 1�� ZY. Lora m C�ry. Twm MO Sws • �. � e .a� O aemrdon O �oonamn 0 �E`e«nemem . � � : ; � : : < � q ( ` • � � - . t + ❑ R��FrwnSme � .. � ' � `. _' ' : i, _.. �"' ....N : . � : t ':, � ❑�o�;.is�y>: , :'" BLYTHE CHAPEL CEMETERY:� - . OWENSVILLE� W . - � 28; WaslamxCaYa[�e0i � - il NameAMCOmpleteAECressOlF�nttalFatlYry ��'" - ' ` ` - - � `� S � . ", ' Da' (ln IHanelxeneN m0ef' �❑ ves � rvo ��" ,. HOLDERS FUNERAL HOME OF GIBSON COUNTY, INC- :319�SOUTH MAIN STREET, '' �{� -� � OWENSVILLE'rIN 47665 �- F ` ' ' i% FH89000021 2�e S�aYe Of IMw Fu�vel5ervice L'[ensee: � , � . . . • • ) • : \ 2)c'.licrose N�nDtt (Of licemeel:' . J RANDALGK DIKE , BY ELECTRONICfSIGNATURE��� % .' ; �'`'; � � �: FD07010177 � ' . f��� ��� - 1 ` - - • • . . - �' Cause Ot OwRrl� NStrucUOns And Ecamplesl.' ••. � . .. Approevnz:e, ,' ;" 2d Pan I: En er Tt�e Cham OI Evenis - Diseases Npmes, Or Canpfca,ioin � TAat Dieay CauseO The Deatli Do Not E�er Teemvial Events '� I�lervat Oinet � Sucti Ivt Cardac"Artest Rrspira ay Airest; OrVerrtrnAar FibnOation NM.tiout Sfiovmg The Etidogy � Do Na Mbevia e. Encer.OrJp O�re Caiaa,On �� To Dea:n � i A Lv�e. FGE ACEt�al Lv�es If Necessary. : . . t � .. ,. i , • i i � i ` MmeCU:eCause(FinalDiseaSeOt�CmO�..ionResWting�InDeath) A' PANCREATCCANGERADENOCARCINOMA � 1YEAR� - : .. ; _ a.aN�a,:: ,r . . _ , . , .� �t . . .SequertiaP/LWCaiCUimz.IfArry.LeaCigTOTheGause�rstedOn � B� :�.np,u��.w,vy� . ,\` 'L'r�e a Ener iha Urtlay'rg Cause (Disease Or Iryuy That IrJtia:eE� ... f � : : f'"� . The Evrnts Resutivg In Oeath) Last � . . . • C • . > . :' ':.� "�� , � ' � • .. . ' . , . . , -w.��ow m, 'A . ` . , D: ;� \ , . . Pan 11. Enter OP�c $iprt!�wit Contl 4ans CmYiW.tw ta Oe3.1� But Nol RuWCnq In Tt�e UNerlyi�p Cause Gi�in I P'M.1� \ 29. Was An ANCpsY ��� . ! ' 1 �.. . �twC � �.... ,.. .. ❑Yes ['�Nu_ ��,.� ,,._. J• .• � f 30.iKEre A�nopsY FiMVq A aia0le Ta Compkle TM Cause Of DeaN? ' NONE. � � . ♦ : �.._ . O Yed.� No�. 31. Otl ToEarm tlse Cm�nW'e To DeaID9 .32 .If . i L`k�1 _ �: : ° ? ; Y j L . i �. �•. . "� li. Mama Of DeaT: - > :' .e � . . ': .❑ w"w v ❑ n.owur.:aa ❑ ruv�p�:,i .�wwm.zw,.aw.0 .� Naaual � HomrAe ❑ nmcent O Pmevg invotipatmn o r� ❑ �w o Na o u�F;o..;, , ., � ":�._ .,a . � . ; : > . � r �❑ w:eu>��oW+uo�n*=�rwsv.am �u.ee.i�mvwvmmtwv��ru. - �❑S�w'iEe�CaJENdBeOelemveiM 3C. Dag OI Iryny (MmlVOaylYear) �, 35: T' Of Iryiny f. �`�e Of Yy�vy �`.G. DereEe � s Hmne Cansieunian S e R<sa�rinl � Area) -� �3J Injury A� KMk? �. ' . ::'� .,� - a�; , ?i � .� i '_... `� s�; -� _ t, :�� oYe� :oNO•. 3B, LxXa'nOl4NY'9aY y=�� 38a. G�YUTamY � 'v�1. $' 380. SYeetdN�n�er ' . � 3BC AO�NO', •39C liDCOGe . il . T �.�.. . 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