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Death Certificate - Morrison, Harry_1/31/2017
1.7.:P:,./ lire....1).*i.:ji . .cr2;!!li --..:1 i.c."-----; -INDIANAiStATE DEPA-TMENTf0FdHEALT,HJI rii. ---.::: 1 .•-,9‘ ...fr,--,7-91,1,--.. i.,-----”,..;,_ '' ..••• `CERTIFICATEOFDEATW ..: .-- • " . ' " I -.--."- ' c*,. .,i-",-sru- - -S) .,--,.. . , - • . • 4: i : %.,. %- p, ..,...k...„ ..„. ‘.. .•.i "... >1111"::a7r•I'1. LA:CaillriNIC11010?;r01 itill TtEDIIRgill"0-. 0010111r0101"5515"61511 .1,. 11::::.--,111. ;11;11-tat)e:Noli:djb2' g1111"..111---'1"41:4' 1.---:. - • ,,,Decedent's Legal Narne.(FirsL Midd.e,LK,57;t i2::....,...7.- I(ila:-/.1aJoen,Negram0, P[2.119 "aft-..;...2z,St...,:ci:un ...2.uris.,,,,,,010.1.....om :,,,,-:..Elf€31°.2"0435.43faW(C:TIII ••,-&.iii.E...:(12. .....c. 11.„1 :6,,....14,ra..5!kgit .,..s‘kii,--1 1: -"... 41 ...c.s.:41r-n f .'";" ,-"" E ,<,,Alt...alkip, .41/11e: L',4,&.4..".1.11r.,-;1/441.;"1/44.41:k.4..,‘, 4 FIARRYaGTAORRISON :.'.%Til,:::-...-.-.:c. r,4-14":?,; -t.... ..-. `': -irk. ...-,RI, ...; :::::MALEa"; ,... 11:00IAM.::::2' Iki.--1.:1-$8r.01117/2017.::: /...ci.1.1K.4-..ti:72.i‹ pi..7,.J:•,....x...--,r ,z',,?% ,;./., ..11 7:7 "rti."......... _. .---> n...?-5 ..1$_ J. -•-.74;.‘SCI'''::.,,Z,.,HSZ.:1•,,1..,...:S ...-...ft(SH --"IS'',...* 0 Holpicri riollyq,,-, 0:-Dai-ill-11-14cie."<",..`0'Nilding Homeitincj-terin Care F aCi!ti....k,...--,..-,<.;,,,,,.. .. ,....: ,. -; F. ?-3f 6 a 1.1i .7r-c. ID irrp.a,ti ID int-igeric'y 5rtinertircxes.atitre 0 Dean on'Airival t ;;;Cae"4):":42141-P?%1i^: {.,.'' ,,-,--; "e';'', F. 10 ;,12.Qty Or Town,SatAnfl Tie Code-2 .:-. c, 1 , -. , ..; - ' •.i.:' L. .r.... .13 Carly Of De!th. . 7 ,,±.-- f -;. • 14.mantalStalus At Time,Of0e.a!! med,act Separa,ed 0 Octoroon . 3 EVANS'VILLEit IN 47712'''', ' ---. ''''. :- .•-""tc- 5"".''--- .:;'' ':--:. . VANDERBURGH'i:- -„:".• --. ::,- , 4 05;Surviving cFn'Ys Name k'', • ''' • \ • „5- 1 sa,Last Name13e.ece Fest Mainage-... :•;,. -.16..Decedents.Usual Occupabo,n. , ... 17.;Kind Of Businessrtn&zaY , ; .... "... r; f. . i .,.;:c .::, ?.... , ,.:..:. ...^ MILORED.MORRISON : -. ' : , .. SCHROEDER • I.: 1 : .i..:-. SURVEYORS. ': • I COUNTY GOVERNMENT . S.-Reseite-State" i;c: 15--I ,' ,--;:,-Io.::, :-- : ..4- .," '....,:".' "" '' :A.(' 7" '''''''. . .H4t.: '';:9; ...•• .:•-••INDIANAt:I.: -.... .. : .. ' . GIBSON . tt r '''' PRINCETON: .,..e tc :::-- -, ir ' , . : ' . ." -:, .... .... - , .g . , • v---,1 . , --- 7, . , -. : : ,- : 1 ..., , : , :ft.f-. .:: :7..- . . •, : :, ; : .,, -.., Dyes .,,,,,,, .......;f' ;A-,, :••:?";:...; .,,•:",,,.r• ; •:• :',. .,;•::;.;>: •;:.:::::-.,:z...- 5:•.• .-.-,..: 'f: -.::: :: : . ' • .•4767), ".• -• ••:',•:• .:: :-. ,' .,6. lg.-Decedents Eacatonwf.".:::::F; ' - L2oionf5rtoniepr.99r,;::-."-„,Iii;?.:4:::..-,. I 21:Decede5s RaCe0;i 1 :::, ''',"''. I ' , ....z ' --• ''' ' :. ' ':1 I ' fr )çvc ' ASSOCIATEDEGREEI(AA:AS). ''t---; r IJOTI HISPANIC:si: -...”.e1.1.: ..-:':::" VVhite::-...t,".r... ,;:f-r-te...: :,‘`' . -.. '.. 'L ? -1: V:......,c'',.-? 'i„,'" ,. '-.),- 1 22.Raenrs Marne(Firs,L Middle,Last)...L t. - ,. -L. ;.<4. ;, ,..• . -.. 1.. i.. ..s; r;:.t,.. 23.Ravin,Name(First;Middle,last),:::-. C " -. : 3a..rarents Last Name Before Rest Marriage' . S?;-(6.:>..:4 ' ' --; L .:- % - i , .:. :-..Y • ; :.. ' '.•sf:.....:‘`..."-z-----C1:-,i,.tX.:::.-.',,'. "..: 1-:. :',.- 4 .‘ \ ' ,- ...:: .,- ;'.›..-: l'... ..f., ' ... : . -, .% .1.- :=` •,-.':',;?: -.I. S.H...-.1.',“--1,.C.2-1.”:..k...-.:.) .. : , -:.... , ‘-- ." HARRWCY MORRISON :6".. : ,.6 i ' .i.: '. t'....-.... H.. ADA'''..1ANEMORRISON?4.IIIIIIII 20::: r "2. MAXAM: --.. , • : : - - - .24 tPec?";F:tif:::$: '7,r,-; , ,2.2' ,..--: :... ' ::(:::' ":"'r''' ""V-f ''.' :•' : r'.-:"rCli" '-'1;"".4 ‘ "•2 :' •••>•••••'''' ‘"::'"''ke''' " .• '•• ', ' .,'•• :":- ! MILDREb.MORFOSON I..,' - '', : II,. WIFE:.'' - -:..., : ,I.:'.'it:t.,-II; 1248't.i\S'E280sdliTn;PRINCETuRtIN 416TO d-'I.. .,-r. ":: - ',..-.' . s:;:.-,,;.......;-. , :.:,.r- •-:..`H-- g'.-.I:I'. .,,I: .::. \....".:.-4"2 -17.::::' :::,Q•FoiiiI.S.--S:,. , :-.:$:;?. :-..-1.- ::::- -.),t"5:::-...C. • •":: ...>: .'...::•• i ',.. "..s.- 3,-. i''. " , 25a:me.Tica Of Oispr,tco; -',": ...; -..; 25b Place Of Disposition(Name 01 Cemetery.Gretna:cry Other Flace)". 25c.Locator+-9ty,Tor;Ann State i •-..- '.' . i- i' • : :., -- '; 1. ' ' e th Ei0&Alatrog.0 cWilbon El E;•tomornem ::: z 3 :-. i. . ; 7.'-:,`..r. '[.,. : -; r,=,' :..1 L.7 c. .1. ,,.7,.: .,.;, ; ,3 ::, %, , . , , .. ,., „„,.,, , ,,, . „ •. o Ober(SPeoify)::!1■::'. "r.7, ' '-',../:'," . COLUMBIA WHITE CHURCH CEMETERY-..ar ., PRINCETON IN -..,:....e . . ,t -, , ...... ,' •-..., ... 25.Was Coroner,Centactect7 . ,..... .27.Name AnaComplete Address Of Ftneral Facihry-''-....;;;;; .-7'lc .:.'. N..s.... N..,,,: ....;-,-..\•f. ',:r' r.t. ... , 27a. Rmerai Halle License Number . _ ',. ?....:: '... COLVIN FUNERAL-HOME INCl:425'N'MAIN ST:, PRINCETON, IN A7670 ": -. .:i . s, ' , ' FH83005671 27o:Signabire Of Indiana Foneral Service Licensee:..::.:'t 1,-:.1.3.r ,.-y....-1 / f-c.., .7. ,;:' :•.• ','--%!.F.:::,Ns.,,-7..If-, -.•- 27c. license Number(CA Licensee): ?; .,,,. .-, , - -, .' II MARK RI WALTER-1 BY.ELECTRONIC SIGNATURE " Ir. • :' '/ l ." /..- ' 4.':', it. --- :1 F001013010'; ‘ ' -- . ''',., ' .!.. .": :. - ' „ .. .,":::::".'...,:-•:::-.: "4-^:',.."-.".c':• causeofDeath'(See tristrgctiona And Examples)::.-4(:.'•:"•,.‘, `:',' . -•;„ ", Aripraaatar 11;rit.2sult.sietrititrzre e tafnliEL7._e2;sn"-'-'sKr-riDsteit InTorill,Foitrii‘ancpp bco.Aaitsit 11311, ...bie,g l6E4,tai.,ThDo7udiatrine;bro:nalictteEEtiptiri..otina.onaCEveciut EI, ,,,„..-.`,;. ''; 7, ' 'I / .7. .:.TInzawypetIti: Onset ... ‘Showsng • : - A Lifie.":Abc1 AdcktiEgial Lin-S. If Nebeiiary: 1.-:',', ■ '‘. ::::: :'- ' z :S.:Z.- '...■:-.;;;.:. ,,. ,,....3.-z. .z...:52-.6.:•'-'46-1:.!: , ..;f.-:7"-,... t.' : ...; 1.c.. '', .,..!;-.: i....., ?a " :.. ..- 1- .."...E.'.i.:7r.... , ■;.:....; •?,.c. ,. i 1. i.,.." : ., I: cm'', - I I,'":" -- - .: • 2"Immediate Cause(Final Disease Or Conthtion ResOlting In Deattf) ' .., A-':-ADVANCED DEMENTIA,. ... ..."....: . ...,... ... - , 0_,.... :. , .1 ,... ,. , . .- . ,... , I :CHRONIC , . . . rtr ...rt,',4PC ,-;f:;,.:.E.if 'i;4-z".,‘C"4-jf . ', ..-.- ..' ‘L-••cl;.:11 '.` i .,. .rcr<,..17::S. .:*Itec,Z7-.7: ,i.a'.4..j‹...: 2"•L :C.•?-,..t.'>i:-''.. .:-; .-9,, ',Z.; . It 1.99:9r,i111- 2!$.,7.-4.,:.4-:T..'": .„s,/ ‘." '•pi.'- .., -,:r.17%-',t;,,,,%.-:`.. ,z-...;;;Tr;i::."?.- I-.:.:.... ;:)''f;,'"::'"4-?;;').”; ;.' .-','3:::-.:" LI -t... ,',..Y- ...,-er. '■;.....•. I LineWl Enteillie UnbeilyingCause(thieas e Orug Thatlhitiated! .., ;..c.. .! -.5.4f- ci.,',z^...,...-,'r.;.Ciekki ::".' ..,..N u,- .y....:-..<,,J:..::::?:11,,.:,.3:. :: .:4 ...-1 ,; I:4 :: ?-,.. ,,, :„ ''.;--- ..--.: ,, e-„ ,:7,-::: . -Tr-,• :::,' .-:,2, : ..-_-47*.5w..,.. - ..:-: .\-,..siir:::: ,..,._--;., , .,:: li, „), -. ..:,: c. -: ,..,,,:( I •,,,._ „r .. , :: .. , 2 : . , ,- ; , ,-. •..„-ri: „-: ; ,.....,. ir.,.......iwr..-:.- i c '; , ::. i ; i ',"•;:.:- : • : .:-,.• : . -:- . rce,"...ysKc...s, .;• •4 ",c i c 4 , .,..,. •'. .." •-• Pan )En*r°ther51916Cant C°Cd6°n5 C°nInbUtnCt to Death But N°t Rest"-jn I"Unc""n9 C2!!'"•9)%i'Pirir,r).c..r,:7-.. 29 -`57Mr:-.1-tinTittrk.C..,,,.1b:Car:.. '.e,34;;,..iii 4: ? lar:::-. W.”).. 1 i 1,v?"..'.i'.... ...t.,W;.1"\-4.- :-..;,..;.,4:5‘•=4.t...,-s,,,-&-,...C..,...„..)j..,""P:4K.at...., .4...-...4‘.`30.1.1/4.re Ateopsy Finding Available To Complete The Cause Of Death7c-c":-'''-r `.--'''''-/•:',.%Y i GFNERfia,DEBILITATIONtn&- ...1.,7.S--, - - .6+... _rt,... -or- ...v.."...... --.....r.........„......en...."...av7s."......... .. --z.. ...........-1--::..-----..y...n--,:.0.Yel,,.0;No.-..- A.. 31,Did Tobacco Use Centnotte To Dean?.r...7. ;322.1f Fenale:; (>1.c......:;fl 1 i-,,,..-....?..1F 1--,,....,..-ill i,k...:,. 1 f iity..g.lisiv...:-4,11r,,L.pilwiltr,p ,3.33,Manner,01..0en.r.S.,I f 1 1 rs...,;11lj nt.,....4. 1111MII! e-2:;,s 4 ,,,,,„w,.-..1,,,,,,il, .:-.W:=4•:erp...ty..,111:Pjr, -Inro.tho.ntliCILN047wkeuP4-ouri‘i■nosoatc.•0-:,_ a a-acjai 0:izicifficioe,0 Accident;O.Penciaig Iriliestigabonttl ';,,t.t.. lives tall FloDaDrY'VJ:NozEllUnicnorai3. ..--,--,- eNc.-....--x7r..Z.Z..., 'N.N.I.,..MS,--.Z.,,,,I....-C_-•- •-:...tie:Stc.V.r.."44),",...; •r.,/,Z....."--,,-,--",-,---..a,---....: >.t...zrztt...z...3.$‘'r,:•.`,...^. .,,-C,t.. ro.....t.....;;;11.,..1„..-...,1;3.V.-_ca(•;..":,..r.,:b., ....r. l u1/4.oTt.e...P.,.9-..1■30•7•7.1 r•■s.Y:”9•#a.,:.`7LIIT9!-Y.,•.g^or!..w/n,Th.Pal-Vs°. ..•?.•:It. Diode LI Could Not Be Determined,0.:-.Y-,./...•t>...-... c.?CV- t.... 'e Woate Of Injury(1.1couvl3ayfeearr..2.-...,t;Ilk"?L3.5Tine Of on),,-:!-:-,'-,;;;;o:•,t r 30:Tace011njury(EG Decedents.Home.CalkLI.C.1,154te.Restatrant yolled•Area). •1.- :37...Inx}ry Al'Nat'l --'5 .:-.V4-.1 "c'‘`'s...%''' ..."':`‘'}>„1"-Ci`....6"44 r."--C '''''.$.>*::11.:e'S.N`:::-V:.7.Z7i.t.e."-.'%:ifis'S',.:.C.' •-•'''""-(....":•1•- `1., `0 Y' 0 N ,,‘"' I 4 .i.N.Y...‹,ti.'..0i.'....-'t -r-ii-:.• .....},;..11%.;.'..4 ::-..-_.7„; :-.9.1->:(tic>77.-.:ii.-:-rr.--.,>::::::::::)::',,;us,,,,,r;:e.,.:,..-.:27,>,,-.>>-..,-,ct:,... yr,..-:-., .:,..k..-.7 . ..- .332 location Of Injwy-State : : :.......R..:,k:<,.:: :.341.CC.4.70.f.T?","...:..,"',■.?:;...4‘.4,1"Cz'?: i.?8,.....b4ct-rint,.V.I.C?J‘C",..i.* [:::.:-...4,.;E'i.1.1:;•?13.4.:r....,..z.4 : C..:.-: 1.3A,01-N.?.:..:.: ;3!1:cf..41.2 C.,?.2!; ..:.?;... 4' " 1'i gi. fr-.......,g, Li?..f .t7.. -.11if6,..:;11i ?.;; :Cf.,:;•;,1,I:1',4.;.....itlits„ .,;,....,/.:: ..; ..,..:, ;.. .-1 -...: 7;;■ f ft--:=, . i:=1,:-.. ir.P:...;3!,::::a.-- r,:tairn-;:..,1 ;I:./..-.1 tit! ..-2..:;:::;:ce.-.::rir; :<-: r:..(..: , "..-: :, .t • ,, .4. ,,,,...39.1._°escnte".....°HutrY c'T ed . :it'C .1.1:65'. :4,-.1-.5:ce.: ":%:*:..14 4::.--- :,...:./7:,,,-,&,..%!;%E.-. %;.1?(- ::1Z.C.,\S:4:4f;s:C•srl:z.. ..11cc-, 1 .46%',Y,z,striPat,T,:aw-s- E44i-:st - .-6-.:t .,-f: "i, k Fr:'-r-- 7)-1..-- \It-, .."1-_, c,--,124•Sz>.:.:.--z--:-;.:(4:-.,.;---.9:,-:1/4----:',%'?..14-;*,>...Sc.•;.•;-:?-• ;,'-‘b,r-,• ^:•.%-?:"-•..,y,-...--,r4-j.N. ‘. .-,..--.-••te..--.1.-13.„-;. .w.....•-v -,-....'„...,.---,,„".• -,-;•.- . ?.. .. r ....c..<7.“.4:16-C--.:1,:fl, ..4.,,..•,4",:111......trf:1,, ......--11,:' ..../•1,!........:14.s.........:.. YL.....-1.,1:7.--.ft:.'-,.. . 4.-; :41signate.,,01 Person Ce..-.;fygg Cause Of Damn:jr...„5:5C10-_---c%I k.:. Y.I.V.i:-.-.'.Q.J'.It.-;*,t.:%:-;sc..t.c:::::,.....;,,i7,:-. .,:j<c..c../..i.11.pf .1211beitLii',(Chick'CriliOneil? ...&4.1.1.Cr..*:.:;a1S..:„.1;: :-.6z - ;AZIZULEAKMEHRZAYt-BYt'ELECTRONIC'SIGNATURE.:>1%-:.....\-r:::-..."2:4".:”"*.:•:S) 7:•::---> tr.EFI'Clegying Rhisiaiiri. -:aCoroner.):■-■:.".0 He=l0racer.-.,,,> 1..........3-Mann?19-dressAnd ?;cc,5,,St Picer"cnLS,Wt_c",°LtV11;r„,-,11 il,E.,';:, 5: :' :";..:; :Ir: ' --.:1: i';'?:?..,-16r.-i-, ! ic.::: :et___,:ur-ev,”erti_, gi=:::,!!t. ::55, P,-",...cer,"65,.i 1 t ../.a....4.-4......:),. .a,..-;94.. ....24.-. .-:1- 44,:a■.., c......‹,...)"i.-.f..1.,,A.;;;;cz.tz.ji.4....,<4.)1 ,j.",,'.ZS._ rc........41Pa izitr.< 9.,..Zik.,.‘•.:7:9:6:4;::,(... ..,t 7•■••■. ',...;-::S'li.erk.."■•• li: AZIZULLAH.MEHaZAD0`,44448-'4181;AVE2,-.EVANSVILLE;IIN'471.10:;;;;I:c:>>.0 -Y:::;4::>,.%1 :1:439T4IICS 01057692A ",-;1:1‘:; > 01/10/2017.2,,,,:: :',If t, :45:(Ada.5onal Funeral Service4roraerffilip•?-411ps..?1,,,13 .4st-e'itim;..2-41m ;;;".4,r---,,w;v,-,,..th■rm.kpir7,1WC-.0:._111 V., ,j;ill ..;;47..1Akas:.41I!:. ! 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V.,* t,?;•1"ir„.. - .,..Ir 4il Vill #:/ r111. :510) ._.,.. ...„ _ .:.... - qttra4Agg'-'43))/51;ttr60.1 .-SiglIrrt'gra47-st'. ' ' ' - # i .-"'W SS!'4 >7 t...,i. .?-,.. ..,.:. .w, ..-:. - '-'..1-fr.:- 3----_71. .. _ i.it:..._ 1,,,-:, T.•>'., :,.,.?,:-1 fit ---,:ttr ..:".:ii-,•..--1 --:-01, ,!'-iii" -'-arr -,%-' - --%7%.":,-::, I- -e•frr--%. ' ,-----' -:::::: ‘*. p.., ,S1,:teForreS3395.. .-ATTENTION'ESTATE:.(TheSoall 1 ' Seurgy it 9 be,na c9997re_ .5..id..(99:41.__q.aliftr,egrrYorletdvoreorsi3, iTresPpi24,tti___k_r*rtioure_,. y.c4(p.tp7C12:1„,e1;itS=„liciPswof r.e...k.iy_LJ Pc-I._..„-MI - , pc-----,-ir - '-'• ,--1-svoRMINIAtitiottsiEdNA.§74 muatcoLoRED,BAcKennunu ON 75C.'ECtAi:AY1-12 SECV5FTY,RAPE, aliND,THE GREAT SEAI:0F,..THE S I Al t GE INDIANA'ON BACK THAT-‘, .;.: --,-WARNING:r _.ITURNS FROM.ORAZ4GE tOYELLOiVNYHENTRUBSED)6RIGINAQ'frOCUMErell HIDDEN,461610titRanY.THAT,ARREARS-WHEN PHOTtiOOPIED,WII:W721fn.r.e.c.1.: id ' ' . . ,Ayr ... /f . OfTr 1-C -r . re . 2.. •• .,. is. . osr •... 74