Death Certificate - Stewart, Steven M_4/14/2016 j.y^<J.^.lt:aY Lai. J .t-:1Y V:.. Jl.\\•.-1N Hr'/ V=u/ Vv�J nl .�Y - 'yP Wf. J/\t JA�.Y�sJ/�t<-'�.Y..IG.`...1!•:>t' .],S J.\v-zsv..Ys'-:Jiv V
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STEVEN,MARKSTEWART it%t - ` ' ��,a�K�S'h ..i.-Ts. �-`C` :,c2- S.MALE 06:30:PM,, �_�J 02%242016,
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62 Maces �rs � ew >' M�+k*A�,' +:n�� ti0 R9/,1 53i NSV LE IN(I t 'i` ���
• 9 .Ever hU.S Armed FOrces74 9 TIO.tf Deero�ed In A>NO5P1S , '6 F n rim I Yrilu ma.Ilr Dim saunas Some�.+,ere Dm Tnal9 H9oa�.,,.!1 /Ilt . ;7.-I sir/ /�III�/ li� II'
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'❑Yes-®No ❑.Unknown) ❑.Iro n❑.EmaOati*DSParelem 07?Oern ❑Deaoon AMv� ®;OVic(SCa"M) :%•i;"\- .' $ .I,nOTHER
1 11 Fe r Name.(If Not Marton Give Street and Num9r)- • 1 \ ` < ` - - 'c If 5 C
2010_EAST BROADWAY STREET r t 1 - • +st-&-,i
12 Cdr Cr Toan-sa,o Ana bp Case x I 13/ems, 0(Br n J 14 MamSStat M31 O1DC th ZtI!'c .•d.4k c b .1::::...4:.,,r, \ , ). ®Mamoa❑Maned.an swaa:ed v❑Divarce\
3 PRINCETON INr 47670 . r r .e l'c GIBSON ..r r � ' PWd d ❑Nenriar.ea>0_unimo n,y
•J. 15. Sariwq SP,use s Name-- 15e N V. )Give Maiden Last Name / le DecadaR\Utal OCCcsor / 17 Knd a Bimnaandusay/.I� i•
{Gam,.: _ > • 1 l _ 3y�'1`-,'' ).
s GAILSTEWART- HENSLEY ; a - : TRUCKING - - TRUCKING ✓
• 18 Res.derce,Stab , 183 Para, . 188 OtyOrTwm -t x ♦ :-:---,-.7-1,-:'1%.!:. "Jt 'l '
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• INDIANA`*' .. - . GIBSON a - PRINCETON w .- ., . c tI�1.1�1'(./' S
18c:S-,71'. nd Nwnber. .+°' 1 'S' !190 Apt No. . 10e Zip Cade 1et ., ...9Ay Lm1as <
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L %v i' . i. � _ ❑Yes ®No !i
• 1573 SOUTH250 WEST ' , - . t• _ - 47670`,. <-&::..kr j•
9 D,, c' sEducation,r r 20 De9da,tOt.,h-a ,' 21 'Dece�eitsRea 11 '/ tv I yc J•
- BACHELOR'S DEGREE(B- ;- BS)-'-`.. NOT HISPANIC - \� White. . < ` - ''Im-e/..��1 T
'22 Name(First MidCe Lasq 'S ;Mothers Name(FaLMidda Last) 23a Mothers.'i;; den Last Name /' - ,
,•ALVA•STEWART . - : '. MARGUERITE STEWART - ..■ r. : ' YARBOR _ >'.-�.Lr
•4. 24 It cant Name"...it. > .. 24a:Retations:op To Decedent 24b`Maen9 Address AM Naroec.C%Stab.Zip Coda)- [\J."'"l C
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GAIL"'STEWART-- .- WIFE - - 1573'SOUTH 250 WEST PRINCETON, IN 47670 - 3 I .4:. iI
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-• 25a Method Of asp`ssm✓; - j 250.Place Of Disposton(Name Of Cemetery.Cremabry:OUar Race) 25c.Loca:on-City�Toen Ar▪e Stare;• `+
®B A ❑Cremes.„ ❑ceatcn 0 Erdane EE
❑Real From SOne.t [ � ;\ - /i
• ❑o t h er(Sp/-y)':✓- C, COLUMBIA WHITE CHURCH CEMETERY,.,'' - PRINCETON,:IN.:' - - _ . te• r.
\ 2fi.Was Cuce,er ComaaeC] 2] Name Ana Conwiette Address OI Fuier Featy <� >`• Feral Hang Bane`amber: ;
®vPa Duo-r : COLVIN FUNERAL HOME INC 425N-MAIN ST PRINCETON IN 47670-. I - • 1 . FH83005671 - r. -
•t 273.;Synetxe Ofteiaa Fu sal Service Licensee o-\t t >-'\ rtx x - �,` 27t License Nanba(Of Licensee).., --41<
•; MARK R.WALTER, BY:ELECTRONIC SIGNATURE.% rr7 >• -11:ti. . .-._. :./ :e F001013010 > ai ✓ 'I
- - : t - 'f-.': ."4�' - Causes Dead, l5eeatruNana And E`amPles). ,t Approaadate! c
•:- �dc s 4
I Sudi A L Erdia The Aires‘Respiratory Eterit -Diseases It r, Ib Can niraliais That Dimply Cainetl Tire of Ab oe Not E r 0*,O• Evadse O Trteival Ornat .
A tid 0.s dd Add al Li cessarest Or Ventricular•cr '-Ftbnllation VRJiaa Stwxaq 72ie Etiologic at -t AEtreviata Enter. <el Ny S5 Cat On To DeaRt,r i
l Acne Atld Atld<•i .-c H Necessary. f`•' SE - • aCESSLass rt R HZ,OSC 'v..+•
�F r ° .SEVERE THREE VESSEL CORONARYARTERY ATHEROSCLEROSIS 90-99 PERCEM _, . 1 i•
immediate a Cause(Final Disease Or C_ond tion Resulting In Death) • A :000LUSION7:R.Y/_ !;' [R:Y'/.R:.a -YEARS -
P.
Sequel-ally Ltst Condaions H Any.Leading To The Cat Listed On, i'B MILD CARDIOMEGALY.WITH DIALATION .. \ YEARS\ -
' line A Enter The Undaym9 cause(Disease Or,lryuy That Inha ed - `' I!, 'till!?
• The Events ResNtag In Desin)Last j ;-`y,- - '� 'C MODERATE CONpGESTION AND EDEMA-�� ?.. `> / - -MONTHS•
Pat IL Enter Other - - Death '' Na Read iq In The UndMy1,9 CaU5 Givin In Pahl '.??21;47:M Aitspsy Patarma r? ®Yes '❑No - - -i T i•s- / ✓ /
-\ "Crec 'cos. 3o_'\NMe AUYgsy Ftravp AVeea"TO Canp4b Tlr Cause aDea"R `®_Yes,❑NO'ti
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11 Did Treamo UseCut:Mrte To Det'i] 32. II Female - -'/ ' • -- 73 MaarrWDe>;K ,. .0 \%
is '1 '❑In P,.a. i e.a ..❑rte!\ 1e ep. ennw;;∎:•-C o.,ao:e, 0 Natnl❑Havnaae ❑Aindert ❑`Pe,tfn9 Imestipaaai
❑Yes- ❑PioOabIy❑NO ®.Un4c4.n tit
y �. (The n.a.tu piggies amsr ry a..o ❑aie.nePrivet At.-r:v.a ❑SUOae❑Cold Not Be Dbmunea -
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34 Date Ot Iryay(MavvDaylYear) _ 35. Tone Of Irvtny - , "'ay(E s Hme CanstOCtion Site Resreaall Nboded Ana)::. 3] Irgiay AI Wb t?
i•• ` r ❑Yes -h❑No
` 39 tacxm Otlijay-Srere >ea.City Or Totm J '• 4t ' <L�l Lance i .4 3& AM No: 38.1'ZiP COOe
- APR. 14 2U1 o9M ..o yay 5 eoy: ❑ y
39 r oezuLeHaa Injury 0mmed
J 41.2Sigrearrel OI Person Catena Cause Of Death 'r . - 1: '.. L5-'2:: ::-'-'4 L!/ J���''�,^', [ - 42. Certba(Chad'Or*y One) i
. BARRETT,W.'DOYLE BY ELECTRONIC SIGNATURE .i `��1PAtG r .- `� ❑cew,wPMaman ` .®Corona <',❑Hexn05c r- d .
•T 43.Name Ad ass And Zip Code Of Parson Candying Cause Ol DeaVt rrjiSDN rCOU NT" st'_ 11 I- ; -. 44.licaw Number 45.-DeN Cen.3edR T
i BARRETT W:DOYLE '520 SOUTH MAIN ST PRINCETON IN'476'0t J'4" C i, • - - '03/182016.
45/AAWitrmalFUnneralSevenPtu /, t -iJ C4 Jit- y ( 4] AFas' V
)i'`'48 Sp,mae Of tom)Haxim 0159r .r• .✓ - r.; :-J-- .r..„4 :::-.I t ...-">T �s, ;2= , 49 : ---. tre ...2 DN Fried (Monti•299 Yeak/Ox 1\*"ri4
1P,BRUCE:BRINKUR VIA ELECTRONIC SIGNATUREta . 1 1 J 1i' --.rIII.F•t Ili i is rI ; �: r>t ''>%MAR182616 t..::::::: I rail '.
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