Loading...
Death Certificate - Esarey, Mary M_3/29/2016 ; - '• :^I'ltc "Wr■712-- irrr-rid!)13-d:ttl I r-'171tti INDIANA! : ••'• PA" rz..„0,1",c •-1/4--=-Nit-3=40.._.-4Qt-k-,..,..▪--cEFifiElOATOtirSIATFI Sie 147%Villia" Ii11.:(21111 da.I /thr:7--.7t1 t .77;' It177;31 cf-WIPTC7-17-":7 „la: „el; '); 000184' 1.:M.A.:uu'MR448irEPP:1;711.c-tr'eCIC.:1) 7":"Si IL112-.;.71:527s3Pk.1.3,471211E2-1 -.5--415:1Ir5reri:I.915-1(ct‘'tP-;m:;.:7.4.1.C.1?"1:71j,ci;c:Ipsthiiit-Hir2ctINDaY:$011c;I:4:5'..Er`ttl'it::z.1 . :77. 2 ,RATOKA,IN' -; •=4.ktiss_•., Z-,. 9:Eytirp&AnadFases7, 70.tiDec Scone n A Hose --4; e ,;A r0 "70 trona oared sorattere Othe He A Hosee, : n "7" 0 jitielfent; , '13 Paving ticeertecriani Case FioTrn 713; 'lei 0 No USelostn hati;n7 0 51;trlimeikeFalFwa°514176;n! D•Ft;n7Frivai to Oar ) >-.1• 11:Forty Name Of Not insituk ,Gal Street tre Nurnterh 7 ; " • 7. S • ; ; • • ts I • RIVEROAKS HEALTH CAMPUS -3 : ; = sir City Or Tom%Sues.And as Cod! • ; T. 7. .;f ;13;Gana Otpesal r: .7 is;Masa Stria Ai Tee Of Dere - ; 7:7 3 PRINCETON1N;s47876 . GIBSON ---"Iss„ „.- 15.Seriarg SPAyles--- -- -- --- - - t 7" .dr 15‘1-01555(99415111°An 1-1-115415S 1." ' 18-%.°15•6r. 25racer 1?[11ST,71q EsIlhirts5.17.0, INDIANA DEPT ESP 1.-a•;•' ; ; .• ; s , . ; . STOCK ROOM CLERK I TRANSPORTATION . 93,211-y -s 1:4Yorftwn : C., • . . - , . . INDIANA • GIBSON -• PRINCETON • :1 ,;(-; Fs,'" I % • •-ss s s's I ; ; -; Oyes 0;46 12.44 VAIL STREET: I % S. , : 47670 s •"I , s- '; S5 s s s .\;;;..; 5 : • ; . ; S . s• ELDON MARVELL" s 5 : % NORA MARVELL •.• . SPEIGHT % !; O NANCY CARDWELL • '• " DAUGHTER P.6:-BOX 267, N 11.1A 52315 - 25e Method Of Oisposlec • 7 25b.Race Of Dissesitas Mine Cl GemeSry,Creicatery.Otter Rat*) 25o.lochs, Crty,Town.And Sate " . - .7.77 - &ea critissaton'O 8onatua Estectsmein • , •-• s' =.• • ' s • • " I s _ CC 0 spe414: - ST JOHNS'CEMETERV.I BUCKSKIN,IN • O ' ••'.. CORN:COLVIN FUNERAOHOMEIsINC:,323 N)MAIN- p y SMAIN-SE-PO BOX:278,OAKLAND CITY,IN ' . es ., 7 .. • % 47660-02781 I is s •": ; I -... - - FH19400002 ..) LLI 271292ns:ea Of Sans Funeral Sense Lassen; r 7 3,.: e- - - - - t f : y. 27n License Number(Of Licensee"; • MARK R WALTER, BY ELECTRONIC SIGNATURE ,S ; I : FD01013010 • .- ,c Cast.Of Death (See lnsthsctian And Ennwf es) , Apwcm1ate . .28 Part I Enter The Qtr EIE32212 -Diseases;Injuries,Or Compreations-That Directly Cased The Death.Do Not Enter Tenneatl Even. • , 7 " • Interval Onset U- Such As cards&Aire*RespiratoryAna*Or?edemas Feetatiori Wiese Shoeing The Etiologyt Do Not Abbreviate;Enter Or One Cause On A Line. Add Ad6aireal Watt Nessay S , ;7.- 4 d 2' " ' • - kurnedjate Cause Disease Or&intake Resisting In Deihj 11; DIASTOLIC CONGESTIVE HEART FAIIURE " ;' UNKNOWN 7: :Line a. Ester The Underlying Cause(Disease Orli*That Inigabad ts. , • ; d f ; -.7 - - • ; '04 , . , Pat IL Ens Oreraant2ilmotcs!mtl.s :3 Re His Rrine12 The 115:71”.A3 C5ra eicr !al I 29-.;?. 51(It1"1."'ran T 7 0 Yea 0 No r ACUTE AND CH/116NiC Falb:IRE:PARKINSON ANEStai.GASTROESO.RHAGEAL REFLUX SO-Wee/Scow Rang Amozok To Complete The Case Of Deara? ; DISEASE CARDIOMEGALY.HYPERTENSION.HYPERLIPIDEMIA . .7.." ; -, - • , . :u Yes:0 No sto . - 7 •0 its; alas Seca a&neir - sea does Nsisid 0 Hoaxes 0 Adasit 0 lAersarii sw.eiagesn 'S TS 0 Pioliably 0 No rig Ohioan ; I ; 3-7 • ; z ;• 7 0*41..i•04 4,C07. _, *a ...; StidOe case Norge Ocerraneo 3. ; r.q a I 34 DO Of[nary' CesnanseTear17 -''• 35.Tans Of triarY .- 1. ?5- 107 - • cA1H7A0,011 sAA:Reca1n1115b3led Alia) -,37:15Ard v`br : /e. 41.Sqiatse.QfPenaiCeittysigCfleOfOeatt •• 42.Cater(Check Only One), T QUENTIN BRENT-EMERSON;BY ELECTRONIC SIGNATOGEBSON.COUNTY AUDITOR ',031 cartivirePtiyitan :0 Carflef • El HeeSGOcer 7'' 43 num&mans Ma Zip Coda Of Final Collybc Pose a NC -- 7 ' 44 Lien.minter : 45.Das Cestiled ; 4r; QUENTIN BRENT EMERSON--;7861 S. PROFESSIONALDRIVE,'PORT:BlkANCH:IN 47648 : : 01027038A 10/14/2015 • •S:; 43-s4M47.1.0II-0044samoszer.;.„. : . s ,• .-s; s's 04013155eea):7„ CRUCE3FINK ELECTRONIC EldtRtRE i ; ss • ‘'s. : I=.0OTT16 015 ' • t s ;•; s, ; ;• SALIENOMENT TO CERTIFICATE DEA111(ENTRY.OR OPJGINAL) S :7 T 7.7 1, 7 7:' 1' • 7.1 .t• V ; 1.7:7": ?" r -6 F(/ - - t• • R o -o: t::: , (-Y-= AllthprON ESTIT-E-rATiiicS1-34 40-.10 litickc,a_..,,,n971A;11• 4.4!**:541e4Seicl.. °r6111,c,,,,gfit°,71&;`,14?;:Ldp-i!Lictrd, 3:77.7.3: 11VR:hIn NI kg a.....0 ±3OCITC4ERT:HAS 5415-11C17110PIA6 PrAcK1S51:091014.7d:41-SHISPAe LTATEOE ON BACK IRA_ ,F;t' haa7-771 MI1 I% irlifFiNSERCat OFIANGE.T07iEung WHI.NROBEEIXORIGIStae,000Jat mkT.APPEARS WHUI PHOTO COP -/4.N273;‘217s1"---ard;t7^1