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Death Certificate - McReynolds, Patricia_7/13/2017
Lu. — — vr,r-- ..ez, -1..e..r.ca...,tact(,-,-,,,,,c,,.,) cer---..., - • • • . 'L.-, ...s.se,---:....c,-...,7). rar,!...Cl.. -W r,--.,Ca.._.-, (F7.-.7 trA-7:,, 7. ‘,.-..■,-, i a g,, ;, ,.: si"-kS.:1 t,,,--dW)-440 tto#,, re-EntipfeAtEL6H5EATHrer 1\ rc\ li _or-- \\%\s,p),k,„,e4n ' "itraS1}#}4 00.1306::N•, C ..,..-211,C%%%.,EDR;No 0000005844' 411 "%-ifi,, State:Noz0314124;t:‘,N, ',.. . 4 -.,it:Decedent's Legal Name Wm.,Meddle?Lasty.% j 7 „ALM 1 cfr-Ill II 1e,Maiden Narne,(11fernalep \\-C,C.,•,,'-'' t 2rSecli II I ip',LTirne 01 Deatht.51 ,4.I Date Of Death'Wont/I/Day/Yea re R eAllkereol.,111\111r 11 ljall ilir,,1\11)111, II r \ l r;,.,M1‘11r.al Itclri-rin11 .,i\119 -j E: PATRICIA'MCRLYNOLDSL,1 '' 1,I11,...-accra MCREYNOLDS .FEMALE. -4-107-10 PM', ..:.S.LIL.,-_,-06/20/201.7 .1 -,1 - allika1r;viccHAIr &Tv, -- ., ' - - -.... .„. ,..,- --------;„%t‘.......- ,,,, ---,% -k., ca,c5;••Eacilry.1:01Decedents HcrteiSs,.0:Nursing Hcme/Long.termpareFacilty,n ^..k.kk ,....„„ V,I...., ..',....! El'Yes a No El Cinkr.iff- CrinaaGentnElfiergencY D;rIlment CX4'asn't-PIDead°n Affiv° D'Cith.;11%-S>ectiiThiliNRINWIlW7iVa ft A..">''..f>11›.....1 ., - r - • ., • '-..- r.--' wil.-t--9-...-.-,11..tlr,-22-...-f.,-111111,w-Irt L.,—.,...•,.. ...0 n„ BRAUN'S NURSIN&HOME,e-1.----/ZS.-"j', ,..‹ , . '11:Fciname(""Inst"°n:GivesYeet-andNumbelli I real\5Tff,a1 Ill'allranthraraltkIVc-1111111'01111Y/._ t't!ti"') , .....„ GI ''. 2 City Cc Ton,Slam'And Zip Code ', -N-.\-, -Z. k...."..",..„-S.,..C..3, SS"..?.."...7`, ,•137;County Of Death %-.; --C.,._,.., -N..t.,:k.,...1 4,,Marital Status Atcnrne Of Dean u k:,-....\-,:t.o. ., ,, I--; -.. - .,- --:--- crr `.. ,■-----.;,1 ‘ r`-.7--klikz,,H.S.-■,...7N.-...er3502(1 fi...,.:"..- tr-1.",";<S,..},AN 4 ----,;"1„-Pfl-*----"s`i&Orc--N-W9.-2ft, !.:-,"“ ■ " , , , •• ,-.-.-.,,,.., ',.... ,,,■-•.,' ,%. ..:35. ,`,.be.„„ ;,/ raw..... ,-45-‘,,,,,,..7 Wi, n ..,,,..54, ..f,u_i.M.niedlaMamed,But Separated, 1_,Cevo9g; ,k, EVANSVILLE.111.47710:4-4'... tvr.,-,...-o,l A c!----,_ I i1a.4.116\11.4 k VANDERBURGH? Iltle5-51i1 ,I: .=„P_L",,,i'ff1.-?...414.e.: 1.054P Unkine, ,\. 4, 15;Surviving Spouse's Name CS.J.J i‘Itc-f v-t,...3.1 115a last Name Before East Mamage^.- 11 k15:.c.KEIZZezdent's UsuatkOcattknonWit'll:::17eKinct Of Basin. sfInchrstryt Cr,C<`.::. 1" . ''' 4 . ', 4 '. :t 4...:Y i.,'Z'....-.... ,‘.1 -..C.",slik%-...‘kS.■'...t .44.1..' "It:' MINIST Et kterP M u S loSA N D.z'v -.CjIi*,n 1 ‘r ---":'>'- 2W4y-Ye -- --• .Ali ': - -- >- I-1 --- ,--'''''-s-- c :: -: -- • • • • -- • - ,---. 1 :: :- ...?- - • EDUCATIONs ..,4 th"..-.,-,-"....--3 CHUROltlaili›- s ,-' :8 Re•eefice- Is'e ' -"-CC., t ':e;"/;'. 13 riakW, li 1:9 1 Mrilcmnarc,..1PqM'IN-lir 1 till\c1?;,Zc:4kil 1 i'• ' INDIANA .- -..-- C.: ;-.',.-;-,:.. ..-, ----I:N. G113-8-0-N-:513,.. ....;‘, .!-' .NN",.._ OWENSVILI c ,.. --,r5.,,,...tm•ictv,b,•].„.. , ,..si.--„...4.11 - :„..2..j,t,1 (‘-‘,...,5-„miiitr.- Ith-wwww,zrai:.„,,,,,„„„alti..c\iii,ii;,1 .,.i.p•:,2,,n„,.,..„,,,,,..„. :rn ...72. et.,&....,...c • ., 1.• . :• rt .2-,-.,-,1,4\ e" 1 I 'ayes El No , C 104.NORTH SECOND STREET` ai--'5"..a _AIN al\_...A.O.11 --,2.: IM.4.-44147665*-111 6-.: ;Pr Dect4e•rnduccnon.,.-27:._ . ,„:".-N■C'-:-,. ...,. ',?,°*':1;iec...tier-g):IlisP"-SprtX4---i kl:-,..,,,:;,111.-k.F.Z...%>,..-"MS." 'bur-r i..VIN: , ....S'''••■■%C."::;:r:1-.4 te% MASTER'S:QEGREE(MAni, MSL:MENG?-4, ...o lifil ."", „„.., 141 \1[iN‘ r„,.211i, , IC ' MED1MSW MBA)19t-C-4`,10"-!....“1!11111;:. NOI'HISPANIC4411 z...**5), 11111, ....-21 cVlliiiirel\c\W.it .---)kat,'-':',.'izi)%;tflte.-}Vkil ..-2:10111-1-6,--011;clit 1 c, 22 Parents Name(Fast,MrkintstIqk C.,' ' 54 11%,..(c ..-111 j) -:,•4411t11-0' I 2-3:•Parents Name(First,Middle;Lastn/ 't ,..IrkeerW•)ltli :23e,parents Last.Name,Belore First Marriage WARRENWADE.MCREYNOLDS .... C.:1,„ ,-,%- .--5.--",-,'mi ri-- --..c--.21tIla ..,--,ilEVEN?JANEIMCREfil0L'DS%nLrii BARRET:till. il ....,::;.7-.. J 1 1Relaccsirp,To Decedent 11\\15.!,:24n!MaEng Address'(Street And NurnDer;Sri;StateZrp Ctoroe).- 11111111rir 1, v. .t....77 • ' 2 t'!')",r,'”Nre ;/:,.1)19 riNC"P 4 3-;a--- 111,1-- Bi all9117:a... )it. le,:-.,...oulk-..,,,bli n ..:: r_.,2.tur,mc ,..v A\1 1.!V • .., ..e.- -4 ,<IA... 1 , 1 7.,.. MARY.AHLF-= ..-=,...-----s, I ,..v...tr NC•••••:"...:,. SISTERSEI , 691:1 OLD STATE:ROAD;,EVANSVIbliEcil‘8473210 . 4, ,:r.k.Svic<c-s• - :',..21.7c-- ...- z l."-Nc'...-99, . W`2...-r ,"11;St--. -511-7,:-.:W2-5;13ta27:0161sizaithin:s7S-v-)511,its.. ..afrfirS.C"■-Ma0N1-...Zst.N.art '...) • .., 25:3 Me1710,1 Of Disposmon',.-...,- :ill\i,a c. _kkkk„Aar 2.spplaCallisrigpirarryOther Peace) k,j...5c Lclarn&Heca--Citylri,k-Ao;:_t State Vs.lif„, qr.....2,-\\ir...„ 1\k‘11; 1 .0,:st3, ci ciery,,,,pf,',Oodiaitnp tp,,tnei \\a ,,,..,, , .........„ , ..,....4,t ,,,,: -.„,,,,, ,,,t , , ..,„-- 41, 0 Removal Frea;Statel.1.1.2:_,..."•,‘„ -1/4.,.. 1 ..,...a-a...' -t....,.‘- • ..: 0 Oui.e.isi.<20t"),-......."‘:-.“... .:,211%.. -....:WARNUIRHILL:CEMETERK§..■ ....2 , -on- .kORT:BRANCH;-IN .N... 1.0A ........%.,01 ...0,`SIN`.... ......1.n • 26..Was Ccr°n!e.?.°,recir 1.r■V.r..,-, Wi'.7""5-0-„m".: cafrItal.F-,3,.._".11l1IrIrtlificier%;211.1717r,,,%-;11ittlfff. hriritirfe----mw ionsHca-2Licectinii,-,-• , --- . ••;,...5-..; HOLDERS:EUNERALH_OMUE.GIBSON;COUNT,YINCI1■319;SOUTH MAIN;STREET.,..,-4 , il ...{,.-:- (;,.. .4-.., • L.: 9Yes..`-."°-.....!, '-<:-. . OWENSVICI1E;;IN!47665S.-1.111a.:411Vt':s:Jt....411W<Ckk-4; WICC...—%...... EH89000021%*:,...v i,Gtc , 21:"Signature Of Nor Fuleral Service Licena _see ,":..-...,`.?5,- .L.k.....v„....2n wk.,-n...„--..yn--,a.„-%■-::2414cene Nurff(01Uotnne):l i'•;`.s.,,I..., ,7,1y.fc't„.., ---• n>,--",-;,..., GEOFFREYIR HODGSONGiBYELECTRONICISIGNATURE,WIR11,- &4L-dPr...-91111M/: FD21200002,11,1- -51111trnzer47..?„=. 1,1\':$ -. 1 - • : -,,,•••>.,.■i t"yte4.7'`...:„Atim\ --fau\)5Ar....a51151W9irs?peausivp,p5ficw .9■Thircc ‘e'r,VII tir. 11 C.2- 'Apprp?iTatejlii‘ al ['MI I EntaiThe ehain Of Eioents Diseasesolniuries;Or Complications-That DireCiliCaused,The De0-00 Not Enter,Terrninal Bents II r?-4',..„ c.,_4,1kk,../ ...„4.) Interval:-Onset,\1 • . Sven As Cardiac A.West.RespiratofrArTeit,z0F,yentraai FiktdllaQc41 VsIttictiShoFinicrEtiola DO-Not Aolarfiate■EnIttgriii-.0neceukskst On, ,rk.,tk: ,..0:..?Nlk k To Oath .:-.;,..-:ki • A Line Add Adstaiwcal Lines IfkIMinikt i.), -- NT,,.-, rif.rkkkkkA 4 \,--„,,,,k,. c;-,,„ ,„ 5 .,1 ,..t . Immediate Cause(Final Disease Or Condi tioci liesulaiig In C4ath)r?,.. kk., A el STAGE 4 COLON CANCER1,-9.--,9 IV! .911 I t1.1/P.: ■it a It-r%-.9 'ft,!...-97-91 it I)Ikk CHRONIC 11:....<4',. ' : ' 4 4.1 ":4-r)\7--; ‘1'[..k441V;,.---A raralit, ,,,V4°.t&car<N7,17.VKAlik‘452.- u.13‘or&S,■,Cltrac IN ,;- ... . iSireicietitrerList Crons, lIcAntja ysklieDatisgseTooThr iseiritsfittganti iki.„. ;....,:4til ck.rw........r.„....,o-1-w.i„kk,, ._,2„..(9,,,, kkkkkk. .op:2,...>„;(ki.2,0 w i...c,:,- tut:-.,!...5-2;522..fA ,•;,..,1 2...- ‘-‘,•!;,,,,..- -,,2 1 The Events Resulting In Death)Last %, -1.-=' . '.,"1..9";:.‘,...<21:.tIfi\,... -C.;:k, qlthicet;".......r...5("Ikntrr(S.... kikal\\\c‘... .....-AniC.Az., -,-- il kl it, `,<,&11; A IA, --!--- ' .51. -u-...9;1; ..---9....d .i,16,[‘c,..cii,,,.../..- untie.- c--Du i,tOe/..•taannac.,°en('try,„..-el!1• -..r-..,l1 ‘V‘V-,<",-,.„,,ei, ,.1 •.,:,..,...,,,-<,II • .:•1 r's......: ' ' \1-. ' .1 -- ,-...•.- -Cs< -..- 1.1.0.-...;.k 1 I\\ .....,,,•,(•.. ii c,. ...-,-,;,,,,ri,I {...1., ,....4.C...‘,:-..% ' ,, : 'I" •,.-.-:,,„'.-_-:-..:-. 'OA- D...- .,'-' 3*"..` - '"' --— e Pals:Enter SaC61211"innt450). c .46EMitir Rek„.....--3U":nirk,,...1)--neletnng„,,,, Cause Given in Pan irl ileIVN"!%riiti:MkgenaZ -.4g1../5.f.hVerex;tetilV. M;59ltt:fek.: -' :I_H-21' .•ki.."--,...-.,1 Iti. ./- 44, •V 'Wan\-alinc„,, . 30r Viler.ALg Find Avadable To Complete The Cause CM Death?--6- -II It" :--;,-",. 'i DIABETES MELLITUS TYPE 2 OBESITY;GENERAL,DEBILFTATIONrW.- a 1 ., *•W •E 4 il- ...c.,-,...9?,,,,vngrz, ..,,v-,..t.,.-......Er IL tv-^>-..-...-:-..‘i t,%., D.Yes 0 No,-:e' ..4 ' 31. Did Totucco Use Cal:nada To Deamr, 1,32.1,If Fer„nale:‘,... .‘„..... -... Ikk.%.,‘,.\--N,....;..Z.- .... ...;- 3.5_,...s...-k,-?sk,....„-r‘UI;.334,....e.Ter_Of_Re.„kt.&.,, Ur‘,.c..\--.'''. '",e.,..„,,,,..„,.,_k!S-.,,k r-"i, '311,,,:FinC,:va,....p......5.0....awtnn,..-";al...,Ok-tatc.,..,...eaFt.okkktmt Verve 410.”PD.., a Nahual,p.Florne"...CLAcodezt,,D•Pee!diC leno:uleiat9n. :k.) 0 yes CI Probably 0 No E1 Unknown --,---, ,,,,,,.,..-,i,eyti 11 11,-N-r.......s.s-11117,./...."-.211 II I i R..,./..1.,.0 At 10.„.;:kk....214 .ati,s,fg-deti,bildNai-8.;:bligiiiii . .ice,4.. t,t I, .., 1,4 -,-,-.--■ lup.,?q,,,.....r!79.0-430./..,°,,wenaD...ili II 1..b.......", I. g 34 Date O f Injury(p.lanth/Day(5f p a n 4 ,t-5 .?: 1,35!irime Of Injury II5.-'all Rito,.,))•!.r..01141s(EG.;Decedents Horp:3:Ccostruaon Sae:restaurant.1,:ko_Oe0 Areapl , 37.;try Al42,,,,.131111, '',..1 ‘N • ' . - 't c- N-‘L' L-i -r--•81,,4cW'-- ,., ',, ,),C f. 15'Locate.,Of Injury-.State ' r • :38a,City OrToven5,: r, ;,k---- n .'3150:•Sireet 1 tin u rc,-- 1,,,,,,,r4.,-..p,, r •;„ 7 ...,,,,qpt..."---k....: .ki3scrs Dade t.,y-,., ,362-..., -,-;',----1 4, ' 2' , ,lk,----5-13,,Aic----P.J; ,1., ,,`„ c.c. '. 1,4,,:..*, 1 - . 1 12"'.1 't IV \I\\V'al\\1\ \\\\ . 0Stlit `t-. L 5 ' ' C ' sc.: t !,k•-&;,::vittl-,.., : ,,A)A . c,...t1,■ .../4:.. _. ■1 .e5K ;A.h.4 ,--...rr:-,;.-! h, '-' -......:-.... .40,11 Tra0SpOrtabOn InPrerTk:'-'%:-.›.. -••••)-"": • .--) 1 33 DeSCnbe kicw iniunrCX?".71 ''.:“:':;- ,..\‘'‘,C-7 _,./,.. ,,, ,c9- %() -ne "-Iil 7. 'r" ''N'5•■, •,„,,..-ILik 1061“, .5;ct00.6*-5•9.; Pt, EIP.sr(SP•a0•';;• ! ', ." '•,- Pr ' " ' . 1•5"4-' .5:‘ li.1/2 2;--.7--;?2,,ThUli,-.Cr-ei"..e ft ft Cse ,...72ft ft ct n025)0111'P-',_ ":4.t..tifli'[..%.7.1?_.' '11-9'6::-Ati',11 c7-/-4-if,1Thret---72.''111- --. r"-•■ .ti‘;, A, A, • , ,- .. ,_. ..... . 7- 41. Signature. Of Person Caroling Cause Of Ce111F-2I)II I117-6.C,..o isnIrreavr.. .Awl , ,...f..... ,,,kl I iracc,,erialie.:6417d(ohn/di; ST-- a4,111‘11y2ktt ■j..,,c...,;..;:z `,1 " J AZIZULLAH MEHRZADBV.ELECTRONICiSIGNAT,URECW11 r-,..2€47.:1I.. .-,. /..0 `,GEYCiltaidn2Plisri,■-al 0:Coconectg 01'a Heakh Mar C . 42 Name,AdOre's Ancgt CocitOcifekkruncierufing.C1c1:2ett -W. (\fl.>:-..s--7-5,. -..,......,:.in,i....kbyckgeAurnber .3 .-ctrk\r■DaCert.51eldt;„er•--an AZIZULLAH MEHRZA11,(4498.1ST?AVE,EVANSNALLEr.IN,-.4717/1011cr--#111IIIllaffc:01A(1 .1..' 010576-92-AINM \U.06122/261%.-----e---,1 '1, It. 48 Amon a1 Funeral Seneke Przreider.:"Ck,„74,`'.:rkkt...M-lAye7 "L zz,113-11alkSk)it c.. .1 --e itt•.A ... 111 e," qz 0 C..;. ie. &gnaw,.o.Local HealtI0Mcark.. S. ( / 4For Regit(c,1 Crr...2I k rt „: ;? 4: ROBERT KENNETH kwr \\r1J*-1\s :\5 5 1 k:JUN26(2017A tr• ). • 1,- ,I,c-....- . t■ -,-.1 • 1 -. t ,. :„..c.k-wiiimcrkw,rt.tanEwom ENT]TO CERTIFICATE OF DEATH(ENTRYLOR ORIGINAL)t12.9 L 3/416,a,k);1 I t al It 110-,,,,,Z.0.:.,1,' •; ( ' )!t e.). e• rc‘-- .5ts.'C',. 1 5-5.',..),C1-•.;:- 1 . .7,'‘ •\,..Z ' ,...,\,, ,Ir,oV-7:1 ;'''..'*''' 5 '-'.-7•S\r,,, 11 • re ', 4 •5 • ./'-'1,‘ 'k•"--,,`,..4.:' * '/I . il '...- : , n7-. .-..'en'l 'ref-Oe,n-"g, 'sr," <:;1441/1, rAll,..-N,‘„a\ -_,■,k1,tv;r7:--2-;-* •,$,-,.. ---..--_-- upi.;‘)\j.id- •klyek-i ;,.1 0' :676) 7( 1 -ri4.?iRb4ZO's, ,-fkuP(-7.?t<4.Z1,4 .---1=?.lek.W.--„, ‘kc&-‘ "-, ..---A% •,-C ,H 1,... ;-; rs--ti res-pon—Siddity.;DiicldiUre is voliintary—in:f theiiiAll ognipirialii tot iefilial-er.C:it L;.-St3IPTC4TP S'}3?5 Arrk, E,.1.411°N ESTATE-Stilir-E,"The Saaialsu il St-etr15,-->r*..-,Itlit.ilitgx-4,./_-°Z154....Sfttiiitilti.t,itelf,deolifYk.ii ei-d..tit,-'T.-1,e%.i-mnIlli-'7.-0-.-sit ii it Ir...-..,..,:t cpifi ../.....u u uli',....!--1.-.ki Int 1,.. .,.' .-11 '-'1 1.- ' - .. ---•".-01RIGINAI:DOCUMENT HAS A MULTICOLORED BACKGROUND ON SPECIALWHITE SECURITY FAPER'AND,THE,GREAT SEAL OF,THE STATEOF:INDIANA ON BACK THAT' 11 -,-; i-, _WARNING: =TURNS FROM ORMiGE;TO.YELI.OW,WHEN'RUBBED7ORIGINALOCCUMENTHAS'A HIDDEN VOID ON FRONT-THAT.APPEARS WHEN PHOTOCOPIED.CtronbIL 7'.--:...-' " 11'.. art...r..Waussze....thataam.,tanatnita--same, - .4..one...arn.VO-ominuameal... ..c...invatio.”.Ao...e.w-Aiarovi.