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Death Certificate - Young, Carolyn_5/16/2016 • � = �i;)I� ti 1'r:'lll • f` INDCERTIFICA OF[)EATtI RESO MAffI 1 Ali `. 'yi a . cif tt*, ;; "� oiA 0'G%I�i•II / �r n . , -- t ti' tl,� r ,• L, ! total'1 149r>� .Ik-cE' --.'' 000000503109 �l ;A ri.state t+o 014662f.�i/� ✓a. i• "� r:,‘,....-..11810013. : ..•!-'s LSea- -�} ,3 Tp.IX Deett a s'De�orDUtlK,,rvlp�i'F,a /,•'r-DarsdsMt Legal Nacm,(FrM:Mme:r-O„Li;i1Vatrfl•/ {I it ✓1 l Neor�,,1/<fd�I: . h▪ 11•iyr. -.`: Y t ;l'I s III✓ f1�� 'I r7 ''r `k" `��t0�"`� '� C;\y.^ 7' GROSSa '<� ` <. FEMALE '0327 .7 PM ,1 0• 3/24/2016 r-.I? _. ti 791,n>. ▪1`* , to,. no�amnwsa,..�+...o:1.Tw1ANOw�-- _ 1 Jr.'1. Ever n V S Armed Fr\�'ti 10.11 Mani In pe..Q.t/' 4 I )v Can Forty y�• `''x: n . ❑HOSpin\erAty 0 0ec9a.aa Home' ®Nwsnp Ha,aLmo-m �•: loj �•sUr r DaeE9"...: l I]'Y k se tit ll7.1111t ,pot.,,mnp.E".Vc. • :- ,,,,.cC le ❑ ❑oe�:ISP.�r) - , T - - �LHI Berm:fti 4JA Gill ft11M ! / 11'%OD NaMA I AN:H Give STmt ANmaNE' BI r I - v•• GOOD SAMARITAN HOME'AND,REHABILITATION CENTER 13 co,nyl fD. -_ i / 1e maw Stems At Time OfOO*t' 12 CayaT9...snb Aln zm wa( y:,ttg_ ; p Ma,n.a p Mamas s.o.r_.a pawa.a OAKL /1iw YIIf 7 '• : \ - GIBBON ®Nadawa '❑Nev,Yaniea� ❑u,eanwn OAKLANDICIT'Y,IN 47660 - 15. Ul vs!GH•M.iaen 152 Name le D.c.dencs usual 1L,) aam,.ssnnaumr 1s sunfwfttaS 3111>N.�1. ?;;7::: . a - o TI .! Ilf .�.1�. %e -• LABORER i FACTORY X18 RasCeKe Sbb • 19a Ca.¢y _ / :180 cdya Tovm { 1 _ -C IN IG: INDIANA�a�\ - GIBBON ' OAKLAND.' : - 100 Apt NO 19. 21p COM 181 Inside C,ry Linn]-..r• tf✓V' ti4 3 ®Yes1p NO , 1.■ 231N JACKSON:ST s - ) ; i : ? - + .. - - 47660. . .5 1 A19 iO.cWenfs Ed,rum i - - '20 Deced dOthis +c Ofl 1 _ _ 21 0ec.d HIGH,SCHOOLGRADUATE;ORGED .:-- _ Y;. 5 COMPLETED - - ^ > NOT HISPANIC _ r 1: W 1fe _ - .22.!F C,efa Noma(Fast Mina.Lu(1 c i 23 Mutes Name(Fasi.MCd.Lass)- 23a.Moa.fs Madan last Nmna ADDI , YETTAMARIEGROSS LIVERMORE - y - ADDIS NATHANIEL Gross " , - IIrmmwCS NOma -- 21a.RMCmstep TO O.oebn -, 2a0.Maiinp Aatr.as(?n,Ma NUrC.City SM.e LD Code) ` tc. : . PHIL.YOUNG - SON e. 12124.E. HICKORY-LANE%OAKLAND C I'}�■TTy'�■pp 4 0 ■¢TT■¢ '',,• �i <. - :25-Rafe IXDtap#laal \ L . 1 3.J 258.Manna of Disposeco : 25a Place Of Disposition(Han.Of Cen.bry Crenstry_Oter Race) ZSC l 10i City Town.AM Stla .• t 51 Buy p Cle iatm p Owuaon pEmcanames L✓ ❑RemwalFmmSSb ' MAY 1'6 2016 Qoa«''(s,--.rill) -; I y WILLIAMSCEMETERY ' flit 4. OAKLAND CITY IN • . 29 Was Cam,CamC.a2 \ 27.Nmro Ana Complete Add!".OQF,n.YFec 1•r' �-<C ssl 1s 27. antral Hare license Nur:Eer 11a2 ti��1 IAMBBASHAM MEMORIHL>CHAPEL,INC 226:E WASHINGTON STREET OAKLANDbba TY ":;A - - CipYes ®NO/ I att' , / / vt("%d . . v- rl .- {: if , 312 � Wit! II IN'47660J11 �i .1 ✓ut/�lI1C/..•1:IIC!,avl�i..,t,l, la • . I�-..., p� i- >21�: ,. " a 27Al sia,areIXlater.FUrslSemnLio.ns.. rf\Sir v:\c> r7cr ,\. ?� 1r,`'' \�71t• FD0106ypaaq�ttUI , • JERRY LEE BASHAM,,BY:ELECTRONICSIGNATURE+ 1< I: , .......9!!::----III.,:-.:-..11!: f1 SBA° ��UNTY AUDITOR L'<\-i \\:; �� \ T.�v\i\ •:f�.GVa O`MeN ( .elrswctlom/WE?`?Wes).+v - `:r -Apprmsnate 28�,..C,.- �.ae,\1�'ti]..•; 1.�.> S.\. freers* Onset 1 i Stns IardiacAg Ch ainaFVente t.Dsa rV, ciar i Cahn,Whou ThatDeeay Cauagy DooIA DO Not EM,TeiyO Events`.. 4ALn .Cardiac ArtesL Rs H Necn Melt,Or VeM1al1,Fbd. -.VAtwut Siwrulp Ttie Elbbgy DO Not P:-travbte Eieai O_rly.Ohe Ce,lsa On :TO Dea- E'ALine AM Additital Le.s It Neceesery.L > \ rc 5 . t1 ti:;t :Ge 'r. na-1 vim_ . . _ > :' i < ,. S �j Immedbte Corse IFrnl Dnease Or CondNm ResWnlp• DeM) -A LUNG LANCE- �' D 1'. M t - - 6 MONTHS fl; � \y�i7: :�istC > '� `..B CHRONIC TOBACCO ABUSE\--- \ • - '.� 50 YEARS ��•T :Seanmalyr TheUaeyat. 9Any Mins"(',1 C¢ilaLnted On wwro,•�.�ar � , .ISn/CI ntS R The Ug h Oea )LaSt(DLCmse a 1!NY TTe1 aMnbtl , r 't r �?CTTo EV,es R.., : .,--Death)lest •,C f i h^ , J}+T!/l Y - ( p.wN Dery a6 3 1 I"Pat II.Err Oa.r ..,,nh Den D4 Not ReM/aep In The Wa!tyvc Cause&rinln Pant .t. . 9_:WasMA1eopsy Podmned? 0 Yee• ®NO !•: w • j r!rit:zt� , t. 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