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Death Certificate - Leister, Gene A_12/8/2016
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Wy/.h.ite.1 tire$c:•!i:tr"::r.:1/44:`.b(.....,- 1,S...., ", - - ..• ...?,.22.Parents Ige(Fast.Mbte.Tail L 3 -''.--. 7,.. -C: .:c•'-' "..,;' 24!ft1 ts Nante rt.-yYle".:AF:)7:. 4 ' I....El.' 1 ..' 73a•F"Ter:11j17,!"r.."r...>-•arriV. .1il :. GEORGE A .:',":„>.--,:_.1----.--"; '(1.> "': ' ,. ; .- ; • -:::. 31- '....`,-; ,- .. '-::::;‘, s:-. _:-:.:.fz,"-`);•ii -, =-C'E ' :'-- 5. -"CC ..'":': -•""--- E.Ift.<,,,:kk_,,,k-c,.. Zi.,`'? I .LEISTER .•:::•• r .. :...-:I %.-j;:- EOITN LEISTEB.-.2.$,Ik;;;;i:L.1,16:-; . f'.: i : SMITH 5 • -.',..":? .) 24 laramaras Name..'",'',..,'",..., :...., ', ," % 24a apace:Lipla Denaciant.ki i',re 24b!Maang Aaraess-(Street And ahrarzer.City:State,LP C..") e '7?!!" •:C A•t<,f.!j,cr...."(...-ri r•:, - - • " i" --.."as--=,..-7:::....--::::$4, .issit., .::::: :: ‘... .-:-..--•:. : „:::::...2€-..z......, .';:. SHARON LEISTER : ".'". .. .;'' WIFE-'"--,:. .'.---!:., K.--.1h: 3490 WEST,950,SOUTHrFORTiBRANCH,,IN 47678 1 ::::,-..::.:-.--i::, :-4 J. .7.2;,-...s.,1.-t-itts,st:A.-Ts.-c..-'4,.':-.::.:: ::-'-: c: • :: --:,:::::s. szt - s26"1=1/4,:;;E,c6f isgr:::,csl,V4 ?-„:..zI1:0?:?.. i.:ed.*:',...lirk.V41.4.<ii-;it.-3.. f•.'..-ij '7;5'7.‹....t 5 55 55'.11:::::;5:25•Vr55C.(442r.;:,7554,55 i I 2"Je..let'lcd ofPisF,r?";;;""/ r '' ' : - 25b Place cl!eisP5541"1 Tairle clCenr"PrYt-9."Treff""`",!? 245S'!-c,-..:5"..-CirtY'Ta.'”<^i°site ' ; '.. ::.? - --5. ■'? N .1.,421Aal:iteCtrthaban.,0 D603'7011 b!Entecnoineya . '... : ,--, ' 7 :::.:, ", :: :--.:7. -;72-:" r..--i...". ..7:.. ' i j, • '., i; ' : • : :: • : . :,'..K.;.:<' ''.,, . S . ::,.=..). ., •-,.% :::- . .ris.. .- :t . .; ?• : • .:.;-*:.: 5 d-CiipUi:).:3'; . ,...,, ",...,,' ... 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F1189000021 ..".";2(03?-.-_:. e,.. 27b:Samoa Cl Wind afar-al Sent.Licensee:N. ;:-.o...- '.<-..a........'-.Z4-4,2"at•, d' , ,." ;.1-...i'..... .-3y7Rt 1.-t:'• 2: : . :.:,.. :-•:•-<„<., -c-..' 27c.license Marta fOlL4n40 . .•••;.2 ,•- RANDALUKDIKE tBYELECTRONItSIGNATURE.J . ::-• ..- ; ss•.-3,v,:_::::,•-:. g te FD01 01 7,117:•::: r ;:.7 '1•;:::::::,77->9.:::ifri7o ..1. 1:;;;.:csiz....'s_p•ozw::::::,/,-.*:,•••,7'..tt"-.2 • , ,.,, '-:,,... •z..:i,z,,,44.C.auara Of Death'pee Instruction,And Eix,ant.. t;.skiii. .'., i,: t-... . :.,, h ,,,‘,..:"Aic;%:zitifilj,c, 1.1 } ,..21: Part I.Enter The Chad,Of Events .13iseeses,lil;ries,Or eciarpliaaticds'..Thaf OirictlyeaUaard Ica Oral IiidNgt Enter Terminal Elentat??T... ' -i j 1)- .-. ;,/ i .„-F :Irairvitc,Ondet.SS, 'I: 2 Sta Ad:Cardiac:karst;Respiratory Ariest,Or Ventricular Fibrillation woletn&wiring The EtIoloW:Db.N61 Abbreviattil fiter.Onif One Cauca On.,,,- • ' I-, .. - .<:-...i.T6Dearthatt!Ill ts ,A Line[Add Additional Lines tt Rimesari -. 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