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Death Certificate - Birch, Mark S_11/27/2017 eiv.;,„....,,,,,,,,,,, c,,,..:,...:,..:-5,,,,,,,,.11:.-"Pin-vflii,.41:2Kinn“.P-711%-.11. ' • • - 11P,.41.C.-9,11Prallf.ALCnr...C.,:ty'...1.41. .j -Kr.C.121=4U.Alm-c.1c.Kennlinnannira.-V ,IIIP,i 33:1 k o,"..... H- . ii,v-Ii---------•;.:;.7..-...* -.7..-..1....-..1- .:::;:::::::_ ..---.2.7-11".:3-7"..t._"2-71t.",7,7::-;------,------;:-- .......:4 ,,.„...,;..:,_74-- - --•-_j . ONDIANASTATERE t •RTMENTIOF;HEALTH' H III , .Iffr:-.: i -. '•-• I .:= '%*•.•-`-;- •_. •■••■.%:••; % 2 .......„,,.... ..,_,„....,,,,-,,...„.......,...,,, :1 ....-• , ,.....14; . .., s-.. .. ZERSliftigATEgoFj3Ektlf. . ... -. '•••■•••;,: % .....„.. „1-...t.r> - -- - )1;.•.± ...”-c.---.I i rc..--• r. ON, rt --, ..."t -:-.;,...., , -1:- ‘. •LLJ. : ..- .,e-....c,c,.--- , .d .-- 1 1- • - ro 4, :c.-. ?•-3. r.>:,•7:-,:-;' . LocMle l'O., a....State.a.- :.: ‘ '.---""1 WDec..FseirsuNamanr:(r iltialcuTNI-2 "HI 111, MT3Clti ' It;23a.ttMalderc/ta .:I Bei , 4-,9 "T-1,%11 ri,Sexig :,??7-Tin?.01,0"..infr.; 4.-RaP,cdoe•-p.:0:4Fr- yo:"..54Y-0 --ft- Orc4tVattU ‘..t• 4114 ." "(-7.,...... 1 ...‘•-•.... '......---4`.. I r<4411 tiCt •, ,, • ; ..:. MARK!SiBIRCH ...:..2 r).-.' iri. .Ni.:,.. ....."." .....::..,-1... , ,....rhil it.,:... z..:::::::::::::?.f1MoicALE:::19.101.m.4.28;P,Mr;.ffifil la_rilacm'ily1/68/2018. /III. : ■,,i,,- - rI ,84 -"......1 r.Pl'gu-ti..IWT.1 ;Isci -Cr.s.14. ..1.5n...es-... . ... ,.. 3A.571i,"-.., . .x.03/1.7/.19524::?",tb: IEVANSVILLE, IN %L."‘9. Ever,n U Sf ed FOTWS?k10- ‘1,0.,11,Dea Occined In"ArHospitar.ea " 117 :;10,tillifliZay240ccuzeVaneveteivONer,:chianAtbsp_ital ' '2; -',/ - :i., S. ,... '' .„%. ,W4.c4C , '`'` WY% ,,P2)!Yes,--0*No.,0,Un knOwnhi i a tnpatenttr Einergency DeparunentOaDeaa on Arnvat IrTI" .g.1 ,,3•24jOiT14"4-T1 4. ---543'1,.>„•-,;„4""3 r ` t"" , n,111110m,t11:e....---HilltS-1:111 k,4,1t1111•2594311234111:kX4311711•23-411:111111-T-T.413•11143%2•1 ..„.f.:Titicr../.:.%1:iscE---;nr.:2; : . -. kt. .4 .i.ispapiffty.Name;(11Not InSt.titiostPlve Street and Numb_ ......_err W-14.&as. -Nip,..Z4. .- .,.-"•;..tt t.t ,.<-..--,. ".'SKI.K--:.;,:s ,•::t ••• ... . DEAcoiciEssIGATEwAert;Th.tIri:in..ratintatii-M -A7kii--;.!? '. ... . . Ws,- ).-,;....• 112,gin,Or ToverK State:Md Do Code „JNic.‹.:•_;ni rts... li, ,- .1 i I At c•-• It•-•..... f. 13iConnty,Of Deat11.21fli<47-' - r% r •; 14.MantalStatus At Tote Of Death /?' '‘"41'NC ...4'.M ' WV.....i.1- A'.re 'Vk S. -1/4:fr ^ .:'C'$1.1:1', '. Mauled 0 siAa • e Se Tit t4 NEWBURGFIMN 47630t-,alikil !r*.: .., 111..... iiii --rnia ..--.11 ,-..:WARRICKiiih..-5,N!----.. nt'.<-.-.. ' ""ws° Neve'"tame° unkna'n stL:4..,, 4.15:Suivitg Spouses Narne3Sarsc...-.1/4,74,, ..I.S.,.7.E --N.:. ,-, : M 1„1„SzzlasIN‘e„F,t,?,.tarriage P-.......,;;;Thasi7„i 15Dece&ents Usual OccurSon• ' 17. Kind Of BusinessAndustry rimti- -;?-. .--, . --- - ... .; _...., J.."'1: „al: trscrAri....:..--irr=5;....I p irdri, 'W.Ali--1..eiV,...::-Sitr?f,,..5.1•=ei:1..'i =. -'. '. • r,.,I R fct".. CAROLISDEIBIRCH.tf*Zt4I1 ... lr 1-i .,4'.. _..WAGNERr r Irlalk...-"..-:,<itire.%. POSTAL WORKER . GOVERNMENT E:1-.':‘,811ResiO,HdencelelOstateliMWA -‘ IN IYINI11161:7-z, ----- crafitiattr-1.T.;.•i'A'::- .: • i PRINtETONC,<"Zilic":2: -:**... 01- TsCritVintgflifi4r&ql`r," 1,r,---: -,..• Nr l•ii --.;. ,. -----,nr ,,,,,, , i,,,Fzigere...„-,_,-,-• '?led;^Petit% ' lee.LP COle _ IrprS,'5 1St Inside City Limits? P.;g: I 1:4!Nilik:44111PYMIligji ,,../. iv-A' ‘..'"a e- -5 I '1 !. b,.....";. . '" ..."'!.; -,"" , P.7,:itir>':::i I .::. • i3- : ' '1&":::: 32841WEST.50!SOLITH •-:"-....,..`•.. a 1.,:z..„. . . ' ' 4.,._ -.4"......ts‘-,.: lc_, t ':-. 0 Yes 0 N3 - -'' .......,:na ..a...,.,...-,,,,,,..• An, ti- , . 44e, -4 ..., ... ,. .n..... ...t...--letn... K..4:7c.:-.._ . . •z. \--.. 47670 .-fa,-. '=.1?:1.,.P1Sernt'sEducat'xiirellIIIPOVIV-ililtr.iNt 129:•Dn,,,VOlrann Prigp..19 r i i...•2}.1..”Decedent's Racelip:-.0 : ,P,..., •• - ', • ' SOME:CSDECEGE:CREDITABD,TJNORA. _ ' -,,,_ .±. .•":4 ‘,„'K..„ 'N. 1 E.s.......nr-erta-lv si.,:„...,::.,;. . 4 9 ' DEOREE,S3Ilaii;ic...-- Iiir NOTeHISRANIC.f..:41r 5tlt .., 22:Parents Name(Fht.11oVege% il I" ' C,20",,IMI;-41;tH ,42,1t, ;.44- lit .-- t. 23:Parents Name(First.Middle Tast)- •3 3:-- ' k. - 23a.Parents Last Name Before First Maniage ..... ,....%S. U'. ,ca.,.., •e.c... q.. .:3-;:.&It • 'ISIN--"*"Z•%;,,IY,,,ZJI,Z"..-,,..,1 Jittalf",,::A „ rit ;,--:-------7-ff-- --4'..t-c--4-...Arn-.. • Ko .2 . CHARLES BIRCH . .,::!, ....IM .4.--i;I!: Al:IIP14 : _i_4` ...IW ...:11GENEVAIBIRCHaile-Tiliii .:27--ii.; .. .... . HALE )).;- t24:Informant's NamaS,. .-e.,..,■.1.494N: -.C... .„4„ :4:24a!Relatons,p To Deter ;24b.nalfingAddress (Street And Mintier.GIN;State:Zip Code) - ' . 74"7'/3 ;;C-•>Thr4/- 1 if$l).-11`11.),Y4-nj-4% -W./II "r4'll;73-"" .."4 ,4 ..yd./1114.e.:41 .1"›•.11'',..b. .1, 7"•37Tit›VAI, •••.. • o A CAROLIBIRCH .431H&I,IIiii. ....--liliz....r.4 WIEDIISIIIII ..../4i? ,....e,Iii■E 3284MESTi.50]SOUTHPRiNCETON:-IN747670' ill zag,".... 1./...%.: atiC.-.1::-:..%.<5.‘fac:aars'SS.:Wd:15Yg.t;Tecoregsrpallon''IRI.7.S.".1.4i.. ...W.:;S:::i.t.6.:.■' ■ ' cir 13 2Sa.nletnyd Df Dinyanereal 1 ii.r,,_;;_.Inc...c..,:iiirc 950:PlaceCif psposition;Name OfGemeterve, i:Nyder ef.P1ace) .,25c!LocationnCinn.Town:And State-, , ; • , • 41 CI:ek:,0,44je....xThon.:0 Do.:44_4.„,4...icano-c70•Etc>"%iiti"'!I I - ! rr 1 • 3: z :.,,„ i w•ti optkir-20! ?ill .: -. .., „...--r....,w_,,,,, .... -• • .....r .-. rp ••••:: .<4%-:::-. cc , .• 0-645.-grwip.....--init.ciaiihr.%-.1„,) --I ..., CREMATION:CENTER,OF:!EVANSVILLE al ...e. EVANSVILliEttIN,.:g4a.: . . • O ..1. •26:Was Coroner Contactecla .27K Name And Corripien.Anness Of Funeral FainIrpsW P- ,..,, .... )$„*.z.s....WSKz-KIe • 4,44 - ' 27a:Funerat Home License Number n :2,..7f?.31P;..1,.,..., e,-1, .--_, .."..„ii.i.'i.. te.-iiist-Wr?-&-rair:Viiii.:;,;,..t% A.N.,....." •1 "tf..S.---,t>"--:;':".' r - 4 : Yeir...0-at'li ' '..ra ille:41LP.f.e.-1Iel-re.:.gitiv,...4*Ilif. ---...':i „el.'. .../.4-111,447.43, Ar.-NI ....,-;114,•.:-.-3,:t, .5'3,1 12::::••• : ' . li'l ; :,...:sti.s-.7:,zal °L.-!...C.t. % ....*: BROWNING.FUNERALHOME.J738bIAMONDAVENUE;EVANSVILLE'l-AN 477111 .-.." -• - FH10800012 alga- -...j.., :2712.4„SigHltuve Of I,ndana Funeral Service Lkensee: ,,•-•44?n, -,, ,- ,-7..,. ..,1.,.;;,..)..2.,,,,.: i,..„,•-,.sz;.s., >;', •,; ;;„•..:-_,.I 27c>LIcensa Numatier!Of License0 KYLEsIsFiouErzifiBYIECECTRONic siGNATuRE.....2:iffilarr.o,w..-em:v_a'Hilliinr"cfcilikt::: FD21500004 .:351(4•7.7".„3,3c%••■•••.3Ktar.,••.. ... ...\41;(4,„,a-raause,010eatn (See InstructIcAn And Examples):III-T.4.:1731 -41/41,-..r. 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'1,`,...1-147.•,‘:4-1,P,. n ,1Tct"--,73- .,-'• s, CI ,.1 '1".. .T1•1::nr1".>>13;.-1:I•:-a----5rPs...,-.1:+1.--,znTiT`-•>"-;1•1•,-",. r r• 1,.... ?..'•Th... 2... r.... ,th,.--..... ......-r.R...--,--k.c.?„. _....nr.4 . .I% Me Cause(Final Disease Or Condition Resulting-in Death)▪ , At:(ACUTE CARDIOP LNIONARY,ARRESTiN ttrAii II,-:-. : t, -4 'C MINUTES ty..4/40.-Te.m1,11::.:14,4r4Z411/4.314:14•3.---AEU-3.?.4.1 ....,-.2411r3 1 a...4-eutze-,-- -t --tit-39,19,At*ot44-taH 04. t, • > •,..., .' y :■••• ••, K`..Z.,S,41t,,l`,..`T,33.56n... .,‘,,•-`--W=a , . -..T.N...i,r("StE4,,Z3-14a.S. ,, ,..e.--;*‹. :1--'",W4.•-• ,•"4.,:-.(''''. • ..3-,:.;ii,...-:„...srel•-verjuarkchtTcon,„•,-itior4wejicice-as„,99 Tpi-,3,4s„!tb-usos.„3,8110,<CORD,NARY.ARTERY..DISEA, ,S5.4-..., ,t,../.34.0.%.AS":„..4.13-.."",03-4:„.„-T":„341.,••• - .. YEARS - Line AynEnterThe Underlying Cause(Dtsease Or Injury That Initiated-4', 1Srtire„.41& .:*;.tv..-..,..3..1g„-..-3,1 ' .... . 'k 'The Erin(iliathr ISDatti)CaTht,.„.t -.,, ., ::„.... ...- ....k ',‘‘-iTA--. ''. . ,;,-C‘C.:\--)T4-- 'U. "■ = a _.t. 4SS■SN.,-,".r:',<C,..l. .... - "..,-}fat*".16.S...., .C;‘,.: ?Z... 13,-",n1/4- --- . -% - . ,•,-_ FI:Partju Enter Other Siontkant Conctdons C.on7itnnno 10 Dean But Not Resuying In;11,...UpaerItng Caum9Jven In Ran1Q9.....-A I r:29,V!as M An.tcary:Perfred?z i 0 iis 0 No {.P.LtiMliZZWIM4IIKSrt4t1W-Alitt ;;. < !....,Aiz .4 ,;,... Tzi .t;Ir _Hi1-11 rio>=;a"lei<jp=pekif: A, ; Complete Ca TYPE 2 DIABETES MEILITUS3PERIPHERAEVASCULAR DIS S.", a -".:., • 5:3 i ;....,--....---3•1•,"3.4 c.---z.,.__..Autopsy.-.32r2.9....Q z_IT.T.!-Farn.ne LT". Be t Of Den'? 0 Yes-01w- ,f .,{1 31PDici Tobacco Use Conmoute.2o Deattrytz 02.We1-40; lic..iiii f.,;-, 47'5 110-i:1 1;•.Tificr4 I lit,5,....;:,iiir-...4.--5T.il krE,-,,.H t •33,Manner Of Beam: 1 . i,„, z-• i4::IglitrebilMirrettntr, tI.Tri.•';',.;,40, _,...,;,..,, ,.....sx,,,, .t...v.L.,..ziczt.e..PH.r.i."-,4420.3‘i),9,a j'.ED NaWral U HOrrtycle 0 Madan 0 Perocrag InveStigathrt '1:-.”--,.."Cytten:-..4k3Nr.r..aar.41,..-•-.4134'1,"--4,m.. rtr,.:-3"0 1440't•m“.sml"HatH a eat I°1,••'6“..."••, 0:1,...-^xf^g"."1/4?-,,Tho'nr,!..,F4-_- ,, CI Svicide 0 Could Not Be Determined . "34 Date 011 mom:ma ..-- ••,744-,..,” t 4 35•T 011 " •3-•" • ;Place Of Minty(E.G.,-Decedents Home.Constudion Site:Restaurant.Wooded Area) 37.Wiry As Work? Ct :. IP" neY! ' YiYeTittir";"4“;`••tir• niviY10 V-211120 78. r.% • W.,__ ,-""- ' ...4,-,.. .,,,,.,,• ."• ,,.9. . s„..„9?,.... NA` ..z.., >cf--S-cctl„,si,Kim{.-rrim :" ,,,,.... • i Dyes 0 No c.....--••T.3- Jr,. ADC A.1,3;a4.41H, ,Hit, .....-thir", .4,3:1:,734#.U.3.".••• 1,..3; ,..inst.-.:"Ji-...-5.7:1-,:tfc': ..:0- ''' - - - ;:f... 38.:locaainylniry iStitewjpiti: ;;;I!cs,38aVintOriT2wriAl t1"4"all Veil q i 2?1ThIStreet&rezmi"4nArgli.".„,3"-":;:li" " 3 !- .' " 38'Apt Nc' 38d.z°cc4e ;.,..,, ,?..„7:3;. .e.nct`gli.:4%;„r-,..t. fiW)-1 f. ..ffttY::--:nirff-;ti;',"'.;,:li'2%al,f;,?-,,lirria▪. - '' ....:liit???,...diilie::.:lnie-;.-2rit,?.-..,:i -• . 3 1,Transponts.op_inwry.Er_s fr. Eorees...„ *r{:la''39-1Cosonbec .stEN.KINTY.Ocw,cc....z.„..4<",red WV-ek.hr:="1 ...z. T...." PIBPONJ,C0_....a.UNTY.„{AUDIN,QR:V4, ty...„....z,....;-:isyniC'n ( -7 i>. ,. -;.'', •---qr■Wrn'iv,:-rics'IW,d111-.tin.".?-^vt -PkWil"-:::1..a,W• -4;.' a:,ie,aci:v----r '--- - i...;„I..., 41:5 Signanire;0!Person Celltylpg Causa 01Death:,=1}C-1C-f:LEIP;,-,./iii K.-.-1.1i i:ratu 1 bc----a I i pjw4 i;r11!;c-t"--,:k;: 42.Cii.“Bec(Ceeck•Only One) a .:7,z RiCKtAEKRIY.CRAWFORD:1::BYELECTRONICISIGNATURE- K:S,-;}..q",.:-<.z 0 CirtfylOg Physician . 0 Coroner 0 Health 015cer :". .0 743.inlamerAddress Knappcode Of Person 9ertfyIng Cause Of Death:irn."-A)rN Wit'.ni rp-;71;ar I f iK......11 fri,.... I tr:::.5.00rr2-c- T..;-i .,il 44.License minter 45.Date Certfie0 V •<-,i,:4V.,<-411K4',WA'aMIWktkii-:,A,F-,QIIIMILlraillratIWW-MI-feUr,40.1-;iility-.)(,: 4 -7:,..* RICKY,;EARI-.CRAWFORCrnt1202;WEST:BUENAWIS:i Ai.;''SLWITE11.00,,IEVANSVIELEMN,AZT.1 0:it:9:4-.:;";-;:...- 01031897A . 11/14/2016 „IS"Ai 0:Add:tonal Futter*Service . Oar. •421Htr'--01MIEffil r-.-r113•-••• I- ..,I,lait1Wk --minF.ti -:0,41:f,t;t:::::,;; :47. Akan it:.. ArCC"■.‘<"NK• CkLik■ ' 1,- -(Z,...<4■4`..W.C\41. .:',.. ‘a-.-:CCSSila.C.\\tg.S_ _}.C.2::. C-. • . - te 4BSegjaWre offLocaWeath OfficecilptIfirATVTy..,-111.1r,..5irrirrpf,-„;;In .,frE;ex..-1,-,..--sr" Tr4ipirr;:„.493 Eor,Begistrar.Only .Date Filed(MontlyDayfrearj- - ' - ' - O . gICKtilir*Ii7GEligaggleafgeSII6Sle6i-EUR-etiWABWI111MMIE,C4IF-.W g:jiiiVEZ'IL" ' I. It.: NOV 15 2016 .4"... \N'• ...•?1,-S-3.95:41-irdtth`n ...1,3S".A..71.)--;•. "5,"-:cr .r. --,-- 1. E4EtIPMEAT:T9 ctR:lif!Co!.TW9EAL,ThAk1476T;91126IPIMI-)s::r -, •;7 • : -7,.' : ' 1 irtirswkaillyesuuai g Jig .m.t.w.:,...-;:cv ir-425E,--ok-s":„:::,"-;y; .1":.. •::: , ; : -Ws -- ::-S4fe- -19)0)---;:t),C0:sr-04- ' ,' .. '- .-04:<‘' - '9,;-;-)= :: )----.; C:g 1 1 fieg-;;Ili 1 .. •7. it.....-.1i; ' 1 It k if ;#1: ir fit .-f !,'7 in,".- si. ! ' ‘ .2.; 1: • .C.-' ji , • ". ' je.... •-• ••••• • 'Th, ,..."'",". /` ' ;.1..,!..•-• "s ' :.•‘:: ;; • .- . - .. (r,4 4 ""-- h.%. •, *i..W. ,".k. S',..•... - KCI-,,S‘...,{iL.c. ‘. InC>:4;t:z•Zzi.:,.:2 t' ': ' '•,, AP,'''' ICI 4r-fit:I „int: ...< . ,.,..!.., ...ir."-• Ih.".....-i .4 ...r.: ,....C.., ..., --.....ar „...-.5:.%%.22... ....e.Ab .f. c.4-.,:n-....,> fr,"•. .m),...r.--k-,. .. • 4., , - ... . st;ti torra53395_11 , •Es-TATE4714"sbait ses-rtiitts-biii.4 Maki( .iirbif,__Uiri-61002.....§*,„_10.10101*Wilf165*Ziseloibfeilvtituntarcriiriethiii■Ai be iiopenafty for refusal.' ! - ./11 %-4 W-Alt i Is!I 4 INAIIDOCUFSS'AIMULTICACRIOQED"BA01 .514 +pr: _GC5bilk-ffplEcSECLIRT(V6PER-AABT.T14EDITEAT SEAthir THE STATE OF INDIANA ON BACK THAT N G:..T OA i rtii Fiord ORktErltrkEnfoth+Tritti Nitorou Piarig-hetliiobEnTvoloalfilitiirn:bifkppEAFfscvcikpAcyroCOPIED/t '-- --•4 ,r, - Clitz.",..,-"r•L'far,",1"-/I&W(r&-P.W".1..*-7T:r.Qt-41`41.4.-"ar .-14V-•"...a•r--.3,;‘,. a 0 , I , •