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Death Certificate - Robinson, Dorothy C_7/8/2016 _ _ _ J.---411`7.'n'act).;111:34 -li" ,, 1-11 --- tf-C--4 FINDIANA!STATEWEP• ',Mr `. ;• .r• • , • :r -im!t .:.::: : :.-virs--..-Air. ? • I -y -. •L-:-...tr•i,--•••t-s.--..“ f ...":?■‘(.4 --, - • 1.,..N. 4:b .4%.. - .1/4<--- VntEittIFICATEOPTIEATH "K- s. 1 '''‘.. <-4.i,`'" • '''''" a ,. ..-. Ir.„,.. -, , ir,_,) 9: , 1 .4 I E:..,„, . ;A ;11,2% I k.......11 e'-':•ii 41.' -f'--e•I -----C4i-' %,•:1 -,.1 r % N; A W, 1 " --''1%; ii ,cli c.-5.- .„-, ...,_-;`, . ..tc.a1CNo:.000095--,.:c , ,..!&.:Ebrc1-00000054.0540,t,,,,a.Acs<state-No02,2044id .x.... r; :„..-c. I0,Decedents Legal,Name..(Fret;'Male.lastEtIlyPiCenyky,'Inrct:_r-i;:* ,11 `r.:°iMatfil:95710"°74!)-CA■Ws 1111,-;-:- i'..e...% ': ..-?.."3:11Th-P1 -,Derl'll :521°,9:9-15itathati"PD'ax‘ giarstuJW•kitIV444Mtr.115;_.4.1ip,- Ir. ..c....±.1 '' III.-atKrajs35": ' - 44p,", Jik.-:,-;:iiii7.5 4, <Jig - -,-,p:v;itio--iiiiwiii ek- DOROTHYs.,C;ROBINSON.*. ..•:;:- -4,-.......• ?.:W,C<","`"1.4.fr.N.,.'"-:„CAREY;S:4 .- .*:;',....„ ..,`.."--:‘,11,4.St,::FEMALE■`......b.,09:40;PMSU c.:::: 465104/2016--"...r... 4c , 71" •‘0.If Dean,Occurred In A Holt:Can 7--..„,‘ -;;;;;! 1t,./...%;• ;c„--1,ks!, -10a:If Der OFEurred Scm,errtiere OlherTlitertA Hosprl;21:'I-r-.:15,i:.; =I i Y'C.';I,.:, (:!,' ,I i"?i- °- "'..-- ...::::..----YS,----">- cAt ....-S- Alk.,-‘-:;:;%,:c.. .fc• ,4-..- .,,sx:-.--.': :.;:c-%; --c.:-44,:thriQicaatc:0:0%Sckenr-slilirri,,7131 teasing Homekong-inhari FeaTkilS..,-e‘"s.4c4.7:".2.:rt 0 Yes 0 No-1:1 Urdcnorm 0 wear-era 0 Emer2 cePart#ent?Saran''0 peel.aitiniVV ;Ott&(Sped& ''''.• • . :1"•••'' .. ••''' ).1.7... 'f'. .l• .2..•• 1' -' ••••:" t......"?.'t.t•••:.°••• '' 1 U-Fealty Name.uf Nct InStalt011,Give Seem srcl Number)r" 3 • •-•=-. .-r• . ". • -: . ' Z. 7.r.,/ % C `t ''.. :ILt -; 5 '.- " :-• • ' 5 GOOD SAMARITAN HOMEANDREHABILITATION CENTER I ( 1-`,-.".1 4...4.r,'7.;... ?I ? 7% 7, , ',:44. .4":--.-7,T.',4%%'.:4.4 7.5 7 12.CL1404'TONT,Sues,AFC np code:. -..•' 7 / t, '; ? " ' : t. $ •:.: ,17.'•CanY 0Dat131 4- I' I T ;", ' 14'M454,1 Si4r;15 E‘5 1-Ine°IDerr'' 1;4%; , '' ' ' 5.:444"45• • .% %'• ' .. . 5‘. ez ;,• -. --4,- --.- .1,,,....- .E i . ..."' • --'-•-", '•-'---'•'• ' • `• --.2;- • •-"--.- •---: •4( I .,..:"S.,1"."''-'2.....r -1 :".;..;„„P' :•,, 'C ‘`.1. - `• „ ,,.'-' •.., `". ''-r 8'.:•:::>-32 '''rrs • ''''..4 r• i t• - -•• '°'baled°Marne&art Snrad•'D Dwmed Sr.• OAKLAND CITY;t:IN 47660;-`el. r.-'-'•.., r .2! .;. ,-%-%t:,', %tC.;.":. . '.-. GIBSON. ". 3,f.-... 2:11...' e.;31.,-C- P'Arida;l45 'D 1,Yr?i!..-4111;33"PPi%)9:&;5 ° Z.I. .15:Striving Spouee Name,. rd. z.t.t". "; 4 ... ...;- -r ....'".' 'Ise•Of YIIII0coar Marlon 1•141 Nam, 7-;I:s•F. •?'•..,.:05,Decedents ustalocconta?,90 '- --; Z,17."rx041sca4a....endursr;1"-:-.4. e. :.> e;:•-• It-, te i • ; . , "k.. "V".;- et--",..-..- ."-e--1,7"'":-.5-..- .`• -".:i i; " '1-,-e: e "` 'se N. ; ` t""e-f.: ----,,`->•-; l'..•Q"SS11::•'t..-", : ,-, ' : : z. • : •• ; ', ; i : i . ''• .., ‘ - .- -• r.- •? '-t. , ; ". . - 3:- t t. ri.z.:-. :I :: -Z ; .--. i-•:":- •, . ..... ".z , .. 1. ; .' :.• ' - 1 I. • ! ... (:- I :-.1,- ' r t . . OFFICE WORKER: ;I : HEALTHCARE iir:-..i. • t:-' - 1 1 INDIANA "...cf• ..--.. -.'" "t. -.... t: •;"-." GIBSON . "..•, e-:;,... 4,$}1Fi.s...; PRINCETON ,..e."L'-,.; .:1,!)-..... ,>--;,.... -.0., ..,,,,...:,■.=I'.., ... atte...r..t. ... t r•r", '.Ir-,' ">- I "..P./ .P...t.„ ;-,. 150 Apt No --.; • lee.Zip Code pis. 1al•ItiskleCny Lires?„ $4,' ' - ; S II".I 'rr• E '''•-"- z-. •• ' . • ••• ..; I•• . 'I..% 'ISI2rei I•''': i .‘, 1071S6UirrilieR01.1/4DVIEW,CIRCLE 1 t, ■ i z, .:-.. -`- - .-• :: 1 •••:-- Z.' :••', i ...- 1 e:'' -; •.' ,.... . r• : - ‘•• ! •:-.47670'. 19.•Docerfmr , s Educate, r.-"I" Ct7 I1tt..V.- .: :- 20. Dealenton*spanicon :, ;,;,......- , : ... .• -. 21:.Decedente Race,,•-er.:'12.:(.3 •rt „• :- •:.... - r:-.: .,;-;-1,_,,, ,t.:.•c.:.: R.:,-.:.,: HIGH,SC1:10-01FGR.ADUATE.bli GED '. ,.'• .t. t......,.:0'. NOT.HISPANIC ' > ' 1tIt raeiA- -4.:1&:::-l.....s.4,;"'",-4...,... . --e* e"\-......s; :".""•,-.4-; . 1..,4.-4.' ‘-'-..-.:.1.,1 rc;;;-;;,:... - f-- White...,-"F'-',-; e't"-'‘,. IS: ••`,.. i `,. • •-•;•••••)--. .".::::.S•..... ,,,,./1 -111;:•-.Z-$' ,.-5• 22.Fathees Name(First Middle.last) • 1.. 1. ...-- - ( ' s 'Cr, :t 1 1 : ',- 1 t 23.Mothers Name(First Middles Lest) - ' "....t.ict-,.. •• - 23a'Mother's Maiden last Name r,t-c-•It; ` • - - `I'I . P.. r I`PfIktt.:Ic: %....(.(I;Iclf .II. 4 r- tACI" "', "I ' ' ' r'r rr i I",'It ''.-":1•Z'-it cr,fif-.4" t-:":•-4.; • i '''r'-'9-3•-(1,'",.----t: •.-' -‘. T. •• ' ' 7• . • --. i'r'"" ,.. :: a, t•'Sze, StIt•N-C t't :; 1r. }$... 'It :; .r.•.:-...--...-p. 1: •; !;...z.?....;:s„ •-....z.::"...tt„:,"•, I W,PAUL CAREY ").- t".: ..: . .:, 5" k• I.5 i: ..;•.: ; ..-... HAZLE CAREY ; ,"..f. ; :-. :1,1" - ; ;te; BINKLEY , •....: ilirt:71,:rut- iii t t 24.btu...sass Name•" .-'t,. (• •---•••• -.... c ' '24a Refarbonstipio Nadel .54 4,2"' 24D.Malmo Address(Stzet And Number.Qty;state.ZIP Ctide)‘4,: tr•'7 T. 5 54%,(F,?; p 2 '421.4.:' 5 47_77‘.44, Z44 .7'7442'244 '''',?4.4'. .,'' . - t77 C.242.4:4rS.44,4,4,44 ::'74%W'S.:4•7:%14%rirt'-:`...-,',:±-: Si' r-`.. : '':?.,- I.., „, ;,.S,- ;',.. CHRISTOP-HER A ROBINSON".'., ' ' • ...i SON• '” -; :'''''z: " •'-, 2161SOUTKHART.STREEEPRINbETON:•IN 47670 ..;^..-:.;•;.' : ("le:, R-ft. . "AS. •-,".'-‘1.-C.:12.:-.., :t.....;.c..-4.-4-,:;;•-.2.:• -.„... .1. ;,- . ?.....z-,..-/-r-cc.r,i.--.,:r., ierelacli oiCiae—oe-';•4%;%-;-:"!"-aSe.2.4%'...?"%cit.-"";;;-f.••:: ' ::" .5; S'7.-;'; ..;%""="-1:%:-S'.:'r=tik‘3:■.v.:1:7?<" :,... 25a_Method Of Disposinon'I tf - 5 1 ' , t ( 294.place Of Clippcceban(Name Of Cemetery.Creme:cry.Other Place) ?5c tones-City.Town,AM State.t• ;••I; '`>:•._:„-..' --•-• -1,";- - til."-;',.-pr.;S' 621-ig Efdir 0 aliimovalFron?tat;'`.7 ; :. • „, -I"; . `. $ \... ,...I.,' .: . .. ''..r" :)...:... .:t.&"..>,:7:-. Ii.t...:„„... 1.:::::• -.....ft,: - ..! I. :".:r ; tt ".I r ::ri- ..ti.,ja.:t,--;...; r'. El Other(Scre2ly):i'.if/ ' , , t's.,;;;.." - COLUMBIA WHITE CHURCH CEMETERY? .- PRINCETON,IN.:...I" , ''..: .r.. .'.._1..r. :-..tr...:. K-::--;;.1......f....'.I -1 26 Was Coroner Co4lacted:7.1 ;" 27. Name And Compere Address Of Fait!FaoFty t..'V tt:',-...,;.-..-•-•tme.t.t,.r...t.tr'tt, N.•II•-',N r --ct ', t 14, ' ..1t- 27a. Funeral Home License ttrnber.' 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