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Death Certificate - Schmitt, Martha E_4/20/2016
a Ir n c"-{-:,11'ff-?;-111. .2firpj,,c,.!!IIV::::,firv---,VINDIANA5„,TALEME141,RThIJE,,N:FL.,0T,IHEfAL-THfr/t. --o,m,:,,,,,, ,,,,:i, .,,,,c--,,,„,v,-, •,-,,,.?...,.,,!, 4,,,,...., ,,,- ,,,,,,- ;‹,i, ......,_,,. As.:-.,Ac.... "4"-r4c`FSCERTIFICATE:LbEitEATH.... - ' "ki:-.,..., 'kz., >1 "c`z.:1 ....::•Ki• 1 -s- Kl' -ciFlOW; Ilir.'llIft:c: II :aiiiirc.--ArrreciflipiMIErvinr_di rst, '•., :!-- .;:ip Eff 7-:54„ .. .-qu. :IF i .-1 r , -s- f1 '. i .,...0.•Deseitsleglit eiv.i.:(Ri-5-3,tddw:Lav).:1-Thwuri ,xt--e.,-,:::;i--2-.11 ,b,-4,;iniarm7e,:.of f.??#v 1 ii:rs.-P i I/reff,.il!;4e;z!. .-1-_,:.-0,D.,,h'q?,:ft]ti.9!pradrimpira4, :r 5,.kii0E---.a, ./trci!!rfltuj tfl--"" --,^c•iiit.:-.:<-. Olt„ecolc.:,.,:tiii y4liii ‘.1.,,it '.•,: MARTHA ELIZABETRSCHMIT;P ;S :i;:>..?2,:::::• - . HERTEL:'•••••••:‘,23',..s . 2:3-:.f.:-14K-1-s:...SFEMALES SS‘;10:10 AM.:.--"4::•!....:,. ."."4•01/31/2016::,.,••;_ ;•,`, ' . .! 10.11.9ean Cot:nab A Hospeal:- . •,-.„:",' 1:c.?(Nit!42 o :Wale Deep...Occurred Sorriewhere Oayer Than A Hose"!r, P ir(-";,;i r..f.;Ili r%., , ''Ect..: ■'1?.., L.P". ==. /4-''',7.-`t-.....:::-.t. ,,-,-.x ....-,“<.„ .7S.:::7;- : ;,,, d+0, kF!..;06C":(8:i 6.0-6>iai art ...0 Nemec HorterLetitem,Dare Fealhi• .-zcz-Z:"<.--r7:7-$4 N 0 Yes 0 No El uidoloia; 0 in*ii,iii Efieggr.cyDeivnelitOuqatia!O Dead on Alivel tiot,4cay-i ,..-,...r --...,,,, --, - -.,,. -, , ,:.. .;.-->s,,,,,..:.>„ •,-. 11:Faotty Name(t Not Inatracc.Give Street end Number) ' • :.., -. ?, • .;, ,. ::".-. . k .a a : . ', . • ,. , :: . ;.. ... 1376 EAST 950 SOUTH 71 ' ; 4 ' , .4 ;:•i I ''. 2'. I- .i'4 1 ; -2; . , 4 .' C-.. 2: ; . 3 : i'.3 -.>:#324 .... •-: .: 2‹. .12'CeyOr Team State.Aa ro Cod - ! F 13:9Ut3 O Death , • 14 Me &eta At Time Of Deem I.s=, ,:: i 0 Married 0 Maned.Bet Departs!. 0.0ivOrted 1 N' 1 HAUASTADT,'IN,47639. . ' . , •:. '• :ex". ., er•-•;?... 3.te3._ . ,-; GIBSON -.7 -:.333,., •,:•:‘31. ;:•('':..l. .0Ywhit'S....:P rirscm,37.ctss,;;Pps093#rfri 7.- 15.Donate;Sptsese's Nara.: , •' , ' '' .''... 15a:Of(AUNDive Maiden Last Name ,: -:-yr ,.- 16..Decceart,14valOacoosaish 1 ..; ;17!KFIcipf,BusizessAnz4ustry 1-C ;:, ri ‘ Z'; S • .S.)...` .';'‘ ' ''. ` 7 --, :- - :,.N-Th',''''..■., -{ ;:, :, •:. .; : .' :. •, 7 2 ' ' - ' 4.• . 22. . ' 2.2.2 '4 '-'; -- - . , '; -'Zkf, • >4. -' ,-.1; JEROME SCHMITT. • , • .. .', , •;- t . : % r i. -.3.:,_ 1.•, HOUSEWIFE i NA . - 5 . 3,..;:---- ▪ INDIANA• :-'1- . 33 *, GIBSON ,, -•-• z'""'••:- •••'-' ",, HAUBSTADT,..."•'-... :231).-- .,•'• ‘ , c„,•,., „,r:,... •."',„,:_•11k.c.3,:Z4:, -:...• 18c.Street And Number =; ▪ 4 ' -: : 7 S ''.:. t..:::.: % ' '; 1 ''''''• 1 376 EhST..960,SOLITE( ' I. (. z ' Z ; , z. 1: Z '. . ; . ? 0 Yes LI No ---,.. i , ' 2' a z -.! z •"; a i :: -' !5 'Z. ! = 'S C . r Z 47639: --.: !••., •.•.„1•':,-..7,,S=,, $ ` ; HIGFSCHOGL-GRADUATE OR GED ‘•• , ',,,,..,•' "‘„,-,...' `-‘,.„„...:•• I--c•-?,*.C4I-4 (cz,•„":"',3. -•t. ,,,,,f‘.•'•-,I.,i. , •,,, ,„ •-- :,...‘,,?•,1-..:, ' 7: 22.Frilars Name(First Madde.Last), • 23a Mother's Maiden Last Name',.---.2.-•'.T.-•'.. 1 , , GEORGE HERTEL ''. -...; 24 Inftanants Name ' : ; ' 1 - - : : '.• : ;1 .., : ' THECKLA HERTEL :: :. .,._!.;r . - METZGER : : :-. -3•-• i e 24a:RelaNanstip To Decedent =(,./,' 24b Mang Adaresa,(Dart AIN(tatter.CV.State 220 Doses' '' ' ".. • ''''>:,.AD;.5..,7,4.±. • ,1.: -. zw.,;•,..,, '.-yrritis.,„..• .:-,•-,_•-- cf• ,, .S.:.,"?..-r:..- • -• • - ! 4<-3-„,,,,,,',•,5',, • ?i. ..IEROMESCHMITT " " • ' ' • HUSBAND 3.'-3: -r•••••••''• 137EEAST 950 SoUTH(HAUBSTADT .2t 3 3---.. r. -e ?; "; •:.---:-.:•4-,...:_: 2', e . , -e• f-rs- :::-.‘..'s-, ....,i„ :-..- ..:•i?.1=3•Lleitit3s4Coralin-I:e.:7•1••.-"E"..,---;.--:••..- :•.3nc,c.:-.."-';., : ' ''' - ,, ,...,--;•,,,32:7s,,,,z,;„,,,:.... i., 25a Method Of Casposzcon !' =, r 1 , 25b Place 01 DisposiosnIName Of cemetery.Crernetsy:Operplace) 25c Lecebon-City.Tot. AM State. . ( : .- , ' i ..-;:( i,:ts. !•. 9 Bine'El Cremason,0 Dcoabant1 Eracentrnint .! , , „ ;.- 7 ii -.";13. .12-3. . '..--• ...3 0 . 1 '3.2. 4. 1.52 'I ; #4. 41;$ .3 . .„, it. .1 0 0 Removal From SNte , " - , STS PETER'ANDPAULCATHOLIC.... '21' -. I- -,,, „,1:2.3 . • '..."c ' •Art( 2 trim ... . .. .., -- 0 0.ser. ispecim:.,,: , , - i CEMETERY-,.•••.-• 3i...,.; ,., .hr"" ,?•--,„,3' . HAUBSTADT;IN ..• .., -. - .,• .. ':„ • , !• fir.:•:?-,_ -..t-:, 26 Was Coroner Coe-aactac? 77. Name AM Complete Address Of Fsn Feokty / -, '. > ... C ' '-t -t" 0'efts 0 No - ,' eftist--% 3 -4: ,:r= .-...,: ,..,. 4 -..,,.-....-. - : .. .. . . STODGHILL FUNERAL HOME INC E PARK ST HWY 168,,FORT BRANCH,IN 47% •••! .,. ' )•II I I 14r\-0.4 .; ......;-' h...: :: 273•SOnstre Of Inetana Tunera!Set**Licenses:' Ta -....- ' ' ..=. -..-; >S..'" T". r. -p.;'.5(.0- :',. : --„,-, =•,. ,, (.. -,-, z 3 27c'„ IgNeeD3tUN I,,Y A. 9.1.;■.,-”‘;',.-- •,ANDREA LYNN VINCENT, BY ELECTRONIC SIGNATURE -3. :IL ".•.--;-,.::• •;:;.:11.•;'' ,2 .---4 2,;; .7 ''':3. FD21400 ',3" t t. , .,.3 ."-- .f ;, (4.3 : l : 213.Part I Enter The Chain Of Events .Diseases.triunes or CompricationS‘That Otectlytaused The(kat!.Do'Not Enteiyerminal Events..".::• " • - i•fraenTar.Oriset I.:', • . ,Such As Cardiac Arrest,Respiratory Most Or Ventricular FiNillatich Without tievting The Etiology''Do Not'Abtraviatti Enter Orty One CaOn ' -: !To oiittVt:-:-. .- '.?"Line. Add Addanal Libel If Necessity s % ,' :: ,.:' '‘, -...z.: e.: •a. -,-,. ‘0 :,- 5. k- -'::'•... S.C.-.%z4.: ' !!•- ... . . . , :,- : ;•.-f -:, . Immediate Cause(Final Oitease Or Condition Rev:Niel)In Death) . A 'ALZHEIMERS DISEASE -; -- E %"..! -.-;--.1 ,c.. ?, .. = : : . ,-..- --..i; ,,,boopt...Accceepn.0.1" : r - -• " -- I •. --,, „_1_,,,_ , / .-..,_.L.. ,.,:‘ E" "‘•, " ;„. ;'""?>-:;;;,,--:,":-:; "">, " :"." (- /- ', . . ': i. 1-" ■: :Sequentially List Lonaapon.,, If Any,Leading To The Crerse Listed%el,: - ''-- 7:-- • - .:': '. -.:' -es:a-,;;::, "- -0, , •• -,Line A:Enter The Uri:ferrying Cause(Disease Or Injury That Initiated s - tt , ' 1: t- 'z 'zr f% .,( . ' -c " .'', -"---% ;-cr,,"c(I 5/ ..S.: ;Triii,Evehti Risiia In Death)last, ' , r ' 7 ''' C.t: ': .- . .,-"i :"-..-t‘". ".. .11 r".. ■.1.•..`-...‘-" ..-`:."-: Z"-::. -, '"\-,-■ ' ..- '--- --:".<,■-`2...-:...:--t-1 -: ' . ; i- -.-- .",I =-. : ;::Cr"(C".•ca.••••^:•°0- " . [ • . ,.." '.3'3' ; '. % -i.. % t: %--; : 1: 7:C. . -Z : . . :. . . . , • Pal'''Enar°I'C'S •t1-.1F42°IP°I."I But N°1 Restdt^0 Pflderra 2•11?"PlYt0th Pert! ;.'" ' 29.:'wr 41Sr'AL590sTfefc(mtdr1 ' L.!0 Ye; ,'::CEItia:':;" if,;29Ri.:*-2. C.- 33 iwOf Death -. .• '' '2 ■ s' 4 "k - .''''' ,,:, ''.":.i' .-- 2' ?P'.-"vtZ"Qc,ey finlr9&?-21"To Complete The Cause Death? 'Aj'Ygt:th 31. DC1 Tob,:co Use Gotta°Toperir .:.; P,v:es,D.P;?bab-iY .t;1°.:El 1?,nkna#41 •:' -1:1,L7F;cp.;9.-nwg 0 owi*:i y■;1; ;-1=';.,.-.izzOt--',...1.2;;.;:?-.4."-;:e;Ti.,-;<:;-`3.-/=_ • -z o-•sp:::ij,;o'6,-tielkot Be' 6,,C, -i '.--`=:--2-11: :..".•‘- .-; • .34 DW2 Of Injury(MOrdilDaytrear) . 35 Time Of Iniunf ' ' '"' t1-'% 36.;Place CO Unary(E G;Decalarts Horne,DOrtititi■I Ste Reraurant Ntcdea Areal'. 37"trauT Al!Nada Vt....i' ` 1 " '` -• = . , sec Apt.No.( 380 Lp Tole(r''%,s•• '=c.c. ..:. ; : , ' • ..--c-j;fta:-..9•;) eC.'z>. -...3-Z,%'' ■.1 , -..'-% ' '., : ' . , : ' . , , --, 4 n•Describe How Ulu!),Occurred . '.e-csi:"orr e”::(< :!=t71 -6Ci L.. ,!'" --7 .: a "Tran•-----04-yr -0 .-- ,--, ---.:. . • (..., 4e t","7-1-tik.",‘"--;:>' '.-% "aC'':"..: , C.."°"nre oft''''w Pr c"" a-?("kn.'"). "..ifi:frinc,//,-I Yr:;■!.2.-..7.[Tt- .....-1, -/SU,* ---' --,. -, '---. ,- C,41:Signature Of Person cerchang Came Of Deati: . , ; .. •:-it zrir•kt-,;:y2..lx.;Brzia:-.:1;icr;;;Advita,;t.:. .,, ••• 42.Ce(Ltei.(Cntok DYT One) , - ,.' ' :; 'l I. 7::. 1„. :.;... STEPHEW•jOSEPH KOEWLER BY ELECTRONIC SIGNATUKEWV.41k--$:-144-"mc:-•..-Z--- :,0 Cal-Lying Physician-.9's 0 Coroner, - 0 Heath Othcer;',;-.02' .:-....! ! C. Name.Address And Zip cox of Person certtying cause q oetql. - .s:,->-;t:r: rr-4.:1717,-;;;Prri.-- ,•*),-1 -, -, ; ",„ ' 44 limes,Minter : 45-Cara creteicr,:z :•;,,,,,:. :t -,7- : -; .;;.!..=, ,, • ..lia.:11.E37:ET.,..i :.":41J-,:_%- ;;7,3.-!..9.tr(-;f: 5 C ..' " < - STEPHEN-JOSEPH KdEWLER 3801 BELLEMEAOE AVErSTE3200C,•,EVANSVILLiEriN 47714- ,' ' 0103e949A-' • •, N . ''..02/01/1016;:',":S :--• •oaeJ . taap5-iI R -:4 kcil",„, :„...z... .,,-;,.. -:-"' -',.-•''-‘ -.2.:",± ty%. :--.-:.--:::.'ilic44.‘-',‘“*.b...4 '''‘'‘'s.:/(7.".-Q-<-;' -:.'"■:!-A.3:-..'"::- . ' --1-;... 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