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Death Certificate - Simms, Clarena M_4/25/2016
. .24F7Y4-. ....3"---.2.14 ....1--.2., -.4 ...-1-74.• .4.-4-53) ..C.21-9 te7.-, •=:s.111.2.1 A • • A - ".v., 4L---x.., 1/4-;-7-14.4:_---::., =2-0-stsr e, -ii.J.1.15"€.-)2=:12,-:' - ":04=5... .-. !•=1,--=).:02=0:==nil,II=I:4->:.,..,:.19::-.".-tf.1.;INDIANASTATEMEP 1• , ENT DEMEALTHO-:;7;;Ir-t!'-"Vtit;?..1ll:::::,'.:;15,fr:".=,:ili V r""'-'-'-- ,..".-t,,•-•:•\-...qp..--,,,,-,15...-..c.:0;--$.,-iy., -1.--c•Aut-‘.c :s----.....,1,-.-c-,t, _,' ---- •-.-s4....-‘ t--. .1'''s-i1?-•"%---.'";:tur%•fe„*.tr1":1";Ct'..t:-/„.S41.t.0.-'..*.1:-/ '1* :::tot.%V;"-;;;9.1;,--...::3 t-2 '; ;.:2-44,-(22:2-z.::*"ri ,2:-.2.2,z,: CERTIFICATkurtra 1 rirvt-n-J°::::-.,;-'23. -r`-.Sit...:1,, i-r.stzal,.21-=•••t..-c-4,Ak--,,t8,, ..,:yi 's ••?!rie-:•••To.c.!. 4.-iiitit,-...---T- le;; •,.."::h:Ilit-f.:c.f:t.,-,ce.1-.;.-:,:iit!,•:.-;t; itt--.:•;•••-la,F;.....,-tirt-7.::11,:trf-1;‘,:..4:45:1r-isti;,-;,---Bcf;,;;;;;illie...,:i4thi?;.17,:r.-1-,...:-;ill kg:.-2 fli..t..2-"•!',2,.:- "- %-f;'.(421I1t,--F.P.:.-- - - seatitAt4.4%; ".•:::, ;;S:."::: 1 •-:--1".. i ; 2-4--,-,-;.,t4;1,23.,.:42. :43:1:- 2-c--221.4:144-.4;-.1: 11;2;4 , ;47.3.3-%2r- 4:(,41:11ft46131ilUU.9347:::•71:sr4"2::::32.4;.12.3-EDfrNe.i. 0 00000450887,-,s';--4,,Y, :state-146--026001g:-<--..-.;.-.e> , - .=II..'1, =C,--2.kI=ArRc,)E=.;N=1A1=sl-i1e74:-=l=k==,7iAk.-E.STS,,II,W===-..AS:(==:.=,==t=",-.C..=:=:1.=..:Irt;Cc.:f=0:-.1.=C:::=•.=•51=-:-)1.ii-;5r,...-“-< -;,T•, 0-,:=14......s.o=(=p..i-.*-:-"t i-=SrS== i , 1::7 -./2 ‘ :1;= ) PAYON " . :::•:"',.-:.).-.-.-..;, 9=.11=9==t.-,tr.-.-I..:V::!r===t L-4-'-1';Di,:..;=:2-=.-:-°.,j•.I•:•r-r.2-,C2i=.,:Ili--2•;FC-.,S./e)trr: s-:' - - ,..:9' 9-.EyttNOS.Artoez;:*Fenots; JCL SpeaStOcoseld la ARcesetrt -.„, ;./: t, ...: „; ,'10a It DetattOcones Sotnesseen Dyer TionA Hosattr• ; ,;:.:2'1 I%-t,: :",;.;.. : ;:t.ta..-. ,;-...i., ; ...i., ,.• - .......-S%---..-S2:2-...:,. -.......,;%.-St-...,' ....,:,-,-s ...t.. . ,-.•A, se"::-;, .t.1.2-1-." 0 No:Iplai partite 0 osatostesticior-ati9ircHoi.s .F.Fatits-- ; .5.-TFT.„•st""F"-Ye ' '- CFINP-1314-Sosest El.flarcen.t0.BroalaPecasaatqamar! 0 Dukanhaa 'Ercliarft;ar) -7 :... - --:- r.%, ::tz• --:4 • -' -.2 1 43 11:Forattosne antonnsruial.c.t..sztestenvasoberys z. t: 3 -z; re ..-.1 .t , 't ■ '- t< ri GIBSON:GENERAL HOSPITAL-,..: ;•i: 3 3" -: 1 , , z 4, .1 % :: :--,- 32 :: 1, ; % .,1 :, % % 1;. 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',- i, L a ", 2 :: 2 - ---t '. -, - i z 2 4 :••,7 1.• % 23.1: 11 f 1606 BRENWOOD DRIVE< ; -i - 1 ii.y.„• a;24,, " 4-'• - 4j670v-. 1 It Decesents Etbsgen- 1-• :::: O- RGr E -.-• -21-DasalsotOoftspeleOnonTr-r-.92•"-cr 7--212 oeoesees Rettrr-1--"T"'"Tr-t'-'!"-''"7-7"'L7T1--`TS-r-'ce--"=-= 7--s------' -- - ' - .... : COMPLETED ‘,....%12-:-.3.f.:".7.-..-;'',.1-Y....it NOT:HISPANIC.r.'7.'imf . %,:. z''''.:-.. Militle-.,:' ‘--...... ii'''''''''`%..-:"' '''`.:-.. ' r>-%- t:.%..:‘;:,....'z''''., tr'n-...-.. I 22,AP,Man?Fralaka IF301.•f':.l': ---.c:,' i: ". -.. ..' "ra t- i i a ' a Weal Mane(Fitt Itstde.l.asty: i :3, 3,. t.,,i'.. e.1■101131flliedellastramet ../...- 44,3 1 •?.t i - '2,42.?...'2 1E-, : : C. '. • '-,. '3- .1 ':,.'' : .2 ' 2. : C"; '', 1 iz., •:-.;.E -.ii --.- ROBSELL PAYTON: -1-: . I ." it_ ; ,I % :2 =. i ; ' 2..% -]2 FLORAUADINE PAYTON ': ;' i i- --, • BATES' ATES .....- . c riii•'._; i-1- ; ; ?. JOEY;SIMMS ' ", zr-212 4;i2-.'''k. 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BOONEFUNERAL HOMES;INC,5330.WASHINGTON AVE;EVANSVILLE;IN 47715-, -s --_ ,:- FH88900004 ,. 4:t.-.-. - -, 2Th.swage or Irdans FtntnlIStalakinrosaz s-1 _I.' : s ' ::„: It- %; 2 2 % *; ] - " 1; 1,, ';' :-.I 27t Leen=Peres*011 Lio”sek,,t• , STEVEN LEEAUST1N--,-BY ELECTRONIC SIGNATLIRE;-i i-i -,---// 1. ' ,' -. ;- -. it. FD08601381 .•----- =;':.'•- -.". y?: : --)-/A..= 28.Pat C-Enter The g&dtaitiaetait Diseases'eisees.Or Carnp6Setia-o s That Discay Ceased The Death.Da Not EnteiTermeal ESente - %'' "". :. I .';7; 't.'..---' ,‘...:' wean I 'Steh As CarciaSArrest:ttepiseoty Attest Or Ventre:Aar IRtnialtan Mtn/Shoires2 The Eairey.Do Na Abbreetate..H;:Enter Oity CIO,Cane On % :: : ;_, i r. r,...•.■t To Death A Lilia.04d fOltitail.11?SniCICEISSM3Y. t :.-: i .c -S: : 3 t.": t; • • -: ‘; C 13 .."- 'J. , Is..adtate Cane(Fred Oiesests`01 Ca .Restitseb19,,a,) . A. RESPIRATORY FARURE WITH PROGRESSION OF PNEUMONIA -- . , t • . t '_i"SEVERAL%WENS t; L A.Entee The Under*g Came(Cheese-Or Iritry lbat trakzead ,_. '.- 1: .?;" :-;:`- f. :42 :.- ••: e .,. t, . • ..., .‘, : i C.. : . C --APHA.134, '" ''-. ---• ""." .--• -s:tt.:2 :Fr 1' '' 94 ; %"'" i 3' :1",21motufts 'I,% :2- 2.-2 J1'2'. • - ''' 12 '12 1'. • . t ?44 1 I ; -1' ; ; 7 : : 43 ;2 zz --.741".4•4144***°""■••••• .4 % % 'i-z ; 1 .43 42- ;2,- •-, 3.. i - , Pan A Erser;Ottsr2trEmb BLANSF19301F9F1TISLI'reITECCWSSC:4"In Pell ..ft 29"waft:1'14e'rer'F'Flikti ''' •7- it tt;2. it t 2 I ';''•,' 31.De Topeco Use Cceselate To Death? .: i, 32.OF-at Tr '! : IO i'' : . 't'S 7 ::. 7; c 11-':t... 3 ar'Sartier,°113gli:Cf: ': ttl::::xt: • zi V: -'-':`, .; ''.: -1: .1, b c.i...Nr-i,......c.ic.i.... gi tense 0 tiorecide 70 eathey:t 0 i,,,taircalsfaaa : Djr ,P:rizt.S4 q. NyLP u:tr : ; '0.;:e.:4...-..:.:,......i.. ,;-..a..i...; 0 L.;,....;:i.......ta.......,, , d 1 ;.._ 3B.t.ccuticn oftFiwy sate 1. i'L r ? .Ciyp Tc■ron t."ee 1 .m .API ,! f3 ‘ 's : 1. • i 44 - '' T - .;f- '-3 1 .4-k Is s ; .4' i •-•,-ti''.' ' . 3;, : 13 km; 1 , - 3, z z 4 1' i 2 i ". t .: . i-, 13 1., -,; r 2,?°2°°;r147427. ,,°°_;47.14° 411- 2-3-.41- 1 :"3 'L,...-' : 2,,, „s2-. :, -,-.3 cirs,..3 .0..,...,_ J z,. BRUCE:CARLTON'BRINK JR,,BY-ELECTRORIC SIGNATURE: --..:--.--, -1_3 •;- .."=. la c•rtionaponician:-; Ei catmer3:-310148th after,r .s.-.'t .._ 43.; ttraretAactess And Spec*Of Perms Cateyba Cane CsOseitx 3 -'':1':':'' ' t;%,2 ;-...■,-A'I-- .-1. -'.1'" II i,%- ::t"...-?,-4:2 s 'N:. I : ; '.: -I l.;:. 3:. - ts%. ■■4.0D0a32 ns.'."N-tr--e;s.sr;• .3..1 t k% i:t 45.-;p ato Ci sNe23 s 4 i BRUCCRLTONBRINK JR ;410 NORTWMAIN STREET PRINCETON N 47670 - -, 020619A‘"- .,' = :45-'04 /1FttnalStrfiaPt''-^'-rt'' •>'. , ''""''''S ' 'L-t"- .W71-C, ..C..,:D-r •,:--'13---. ' -..."' 41?“7.12tz.: .; -: ' '' . -'''':';/, "-.-7.6.0.< JOHNSONANDVALIGRN.FUNEkACHOME INC:e' :-",-. .Z " -,‘,. . ..,.. %...: :t ..-... .-.',"*%;t,..:. te'....`,.z..,... ,. z". ..., % -.4.....,-.:2>... !..- . ',. •.-... a wan et Lccel Falb aka% st -:"..‘ ':-3”.,1/ •:i "i-. • .'•: ,, 1 2. *, --, "I s• - >1 1 : ,•"-- tgr•For,CriFtrarOnz0226 RS,clica,,caffneYN ': ? " ;-.4Z-, BRUCE BRINK JRNIAELECTRONICSIGNATURE -- ').- 3... -. t 1-; .;e ..r. -''' : .. ,CJ-''-.: ':),.....-,, ,JU 1 15,, ..-. 4.4.-_-.. -.3- - •..„ ,.. ,,t ft:,:fi_i,r;:c.".-ii.i'-","::,';',-..-is:, -.1..;--i'..e -; ; AI1ENDMENT 113 CERIIIRCATE OPDEATH(EiNTRY OR ORICAtiAL).-S;-:',:t vt,,-;.;--.:.,...ttnt;'.---3.--St:-'.3-*: "1 '2-t",,t'T'.2 :-.:';::::'•'' i .; '..-.EC:1.: -ii(''....SZt. .1.9".*::; tvti"r*-1.:" ' - -;.' ' rt ''sget ..2' ..'=';'..11.5ii==.*•fr:R.:.--='..'fi..-..2.1====sif:=4===......1.!:=_51.=.1.=:.= - -41,1-,---=-,===....;,- _ 1. : "'''' ; •gI;s-A: Ct‘-.° -.•- 1-----" c.'-‘-as!'-. 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Ri.gibI.,....IAL 4E==RE°...nrrrrnyn...n.t..s.j.a.u..-' scus:BED;oRimputtvillicumen- sPEcrAi- HTEEHAs HoossEcurd*PAPERIiRoNiAmanc-darippgthsr sakw‘..inNaroaf THE 4tATE. - -..5.--MIA....514-if..:.w}:-?: _ .