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Death Certificate - Stoffel, Frances C_2/14/2018 :ri' i„etac,�-�?,,e., ,n,- Z,,,: th,;..,;j x.T,i-CERTIFICATE OF DEATH';. -:,1;. . e'-- lYiT,`- ' G „& e'-. r� �/i - ';r`" INDIANAVSTTA EigE,c.ARTMENTnHEAL M F v �� 1,.- `t,�`1��1 Ir./ffLtt$ 0C\ � � \1 040.5 Et_/ rt.Deadents Legalhame(FS.Mtddle■Last) : .Y1a3•Maide 4 (I_ttemale) G 2'Se. r3. Thnea Dean r i 41Date Of Deem"(MonthlDaylre�j P ti1RWW1 ;.eatI{,} A�,•- 1\Leal%t5 11 r� nnur U un liem ) -f$ FRANCES C,STOF6a Age v JA Tl6c ,MEIER,. !FEMALE; 0630AM1„ a 1Foregn20.17a r. \'; i I�+L .-9.15 i'a;rlite. 93y5111111V ."°.??.I 'j sn.:e � lui 08/27/.19211 sMt A KE'E tINz1. 1.l((✓/�I]((( d 9.E m U S�Amed Forces?"C•111:It Death Occurred In A Hospu 1 V� 1^atfl Dear Occurred SomeAtete OterTS AF Ixrl 11110.r�x U' Ua;; �� 4`' \ �\ ��1.5 l".�j1�4HOq Fadry Q•D~eaOea Hana�AO hu_rsiq HOmerLmptem Care Fay r (sYesym !rptrnovn O'ItgatOIUttEmergencyDeparunem Outpadeli Dt Notts irks+,N) v ' i ce' \SONSRESIDENCE 1 f/� hi(C�YS +YI rv!lJ�IiTI 1vsYG✓SI a 3ilii]fItMV/ViJOaIL! it11�L .....� /�� u:�JLY%�1(� E..!FaulitY Name If Not Ins^Am;Give Sweet and Nm«D/ G� yl (� ;Y 04 68125 600IEAST IhIteafi•� 1111E ]1� 1111 1Il�t agt 1C][1L 1i41(`�`-'111�k1> '��llll[ll tl�llll� L\'''z�,Gry� :e A'ALCCode i�\ '. N"'S�\ .�� '�.13`COUnt/p.0ea_1 ,. \� \\ ta�\\" AtTome tc-, ` �� �� 3 \ t�i/ 1 \ i1i1• " \ ❑Maned❑Maned By $epar`ed ❑'om33°, ■ FFERDINAND:IN 532711 11.1il1s1 1 - / t 1 DU� BOIS1 r 4 /�((/ m Wd?wedfo1Ne M�medll 1p�1 flI "15'5 mng pous\naanlel .11, r `s+1 \1 tasNme Before cccSU/1.amage • 16!Decedents Usualoccgaroneslt7it FF1fl;;;'-'0f BBBo*,essfneun:•yr xi-3 L_1fr�„ ±11{-ii llu a� ' - R. 1,f � RETIRED Se HOOL'NURSER SCHOODNURSE � �G/�+)1 I/// G etas Ceunt l/ v1aL C yOr Tam U� •- I (�• 18µR dente s l tom/' �j� q � - /� - r INDIANA L...... '_ GIBSON �� V� OAKLAND'ard /O� -:. �T\/_�1 tAnd Number tv y t •J�-1t O O / �ro t ■ Piet. t,». ({1S Code -4-..-,1 ef:inside Ciy umu? 1t1ht/ilkl�l'`t/ s� I'` I��� Ti 1 .��G'����i / ',�I�'{� (� r t� No ,,� 7274 S 850 EAST,..k. , t //+ �`O �11 / � '-J i's. s ./c�lllllL C'6`11'll fBL 1111() 4A'O yes ©:Noel, Lde ✓ n a/� 1- � n y .et 47.660F1V e+Yt[l I tl 1 ..,Decedents;outs only � 2C"Decedent Of Hi panic ni `�\�Clt C.21NDeceden"a«y \\ \��y, .� ���4, , N1A.,TERS DEGREE((MA�MS MENG j 1��% (r'z`� \v k, a 1.-- V� (\w� ,11,q' l "p � T\V �. MED MSWI.MBAIGIIasIlJtS.1l1N1i1"% NOTt HISPANIC /1 enr Whlte ..2 111 ,,..t: / ftNIc F 1 T C i t 22 Parents Name(first:AUd Last)r- :, l� I y:y-. U 23•Parents ( stAwd' Last) IL '4 t%123a!Pare2YLas:Nate Bebe Flit Mamage` f<\ .ice AMI MEESS Uea DA � �I IBS\_ Z a '.s �0 i WILLIAM BEta I TIN:MEIER2 S I LTi\ F,REIDAAUGUSTA METER 4t SCHOLZL, 24:InWmants\ame Illy-A'.y1I �.a 2aalRelac Yp To Decedent 2409 a Address{Sreet And Nurni City Stze,Zip Code Va' 4 0 i2L114tli/J�ti1 e ��' It 1 a�i.LU hi 1Vl l/ 1110 MO S �/ tW 1 • 1�'` U'4 4 % 4� X1 1 G// 1 /a �4 �y�Ifs r/ N LARRASTOFFELA �^aFA.LI . 11 SON. >/ _ 77409 S 850iEASTr OAKLAND,CIT1Y; IN:47660� GR2� 3 tIli t✓.� 4 .,:si .'tl\\'��l�i7L :S.- fl\\��,iaL��\\n7aa.1/4, zs Pl a,a:Witilm✓aG\\\yi2n\t\ ?\ t11' n\1�.ZS�n�\\V 2 ar•Memod OlDispor: al✓ a '/ -,t2 o•Race OMDispos.a 1(Name Of Ce eery Cremr,oy,O•dter.Placer cc L°catco Cit Tam And State /' n ��111�1 iErea 118 - I1 s� ) Y 1111h�i W m_'aral O Cre Aron O Dotlacon Ercm�:e,.. ���%///���! 1�)/'r A/ r- 3 l/ p k- d. VLSI ItCi }� 1�`�6 ��ri,•-* v��N/ / (/ / ll� \� I \ 1\ cc\ ❑Re l V l \ A\ \` O O omer.(speatyypezi n_ \\. STzJOHNS:CEMETERX`�>_>y� ,.,... .„S... BUCKS�IK�IKil N/�, ` '�/J� �.. "\ 'N- O\L 26 Was C«mer Com ed?(a�<^ 27(l%� ItI3r ss0111fa1151UL 3U .4. fliMtt 1i1 ITAJL.J a, qi. INUy�'` Zia til' ,*- 'tuxnse NUr..Cer W I Cl,1t��17.'1 l'1 L. LAMB,BASHAMIMEMORIAL-CHAPEL�INC!11226 Er.WASHINGTON ST;REETi�OAKLAAND CCITY.%J1� 11 1 %�/ �{j�l7rie 0,Na„ i'Pez �"I ..t /.[ill U��t>v s .< INt47660� 1 ��11,/A��11 � 1G�'S`��__l�l�� _11%.���. 111% FH83005312 i_5 !pc>Sgnature.Oyndana Funeral Berne OCensre_d,A�a....,,, �V'- \- •PC (icense jtvneer(011icensee�)::�..Ww, v JERRY LEEBASHAML BYEllECTRONICISIGNATURE ,� R a'an ^�i �1 FD01016589. �e � �f1'.. /. Q 1 ;irry 1 ltgi}v� 011 _iI 1 C% Cause Ot Death (See lnso-ucttpns And Ezamples) '1,1; App1F4,a•e f.�ter A e�na ve{°//ssseases, D WI w - .tD rr,Pd���f t, o 9 E er I Events. . /i cet• LL .. \S Pant ardir.TheCha OLEey kr st Or saryudes OrCata no ng.gyCause .DoNot bf a ateE n'er emunalpveas ,,, �InteriStn- se; .., \SUm AS CarE ac'Airest Respua,lxy:Artes Or Veirtricular FlbnOatwn W^J1a. Srmnvip ATlte ELiologj.DO'NOt AbMevla;etiEwer Orly�One Catae 0�1 ;.ff.'s. \``\ �rTO De-% a t Lme�Add Aacittonal Lme,11Necessary N �� \1 511: �alr)Itr�llll�~��lr,tu�Eii ry-� a' ^t � � lll - lse'/ //` `/� 1-tmed a e Cause(Final Dlseaae Or CoM t on Res.Alrg In Death)I A END STAGEIRENAL DISEASE DUE,TO RENOVASCULAR DISEASE /] ► M1tONTHS . ) r�{\�.I''"n1` 1 L SLri' B w W 11�/ ! c/ `\U. T/- // aaA..c�.ga.". r/ 4 �[G V �G/ -i�t ��Seq.s\Ity LtsConditions,4 eaeeg The Ca..Se Llatetl 0` B- Is, `O` Ate``.l°y���� . - `� �`JU \ I v . a.etaa.c-..a..n v law", r Q�11 LvteA.Ener The UnderlyingCause(Dseas¢Orptry Ttiat Initiated '1ghl Ill' r -k,„S- ��',` nV��.i �`�/�//��`J�O!�'`,c,: irig I �� lr heE ents Resdtegln Oeatp Last 1141 1. / c, II IJOIIU':ul it �I1�B1Y!/lllll�l�'�lJall/// 1'1]1 Ul1lJU ECG/ ;C:q �i, A .1' -c -1 �& 4\\ �t - ' C' c. > c.. ) f' 1 0 r� � Pa211]En sr{OmereerrS W cant Coonnddwonns Conmdtfind�too Death Bta NNct RReesuliln.p�IIn II e U s en In art .' 29 Kbs AnAutopsy P r' °4 V rt' r I •+U���} i �-I �( ✓-,Aillid e lip lit¢sal 111111(�YI..It111 ll e-)'!'i1(I1. �'11 C[ 11l 1 / 13 Were uuvla° x..ieToCoIUILJ Ves�m Noy//,,IUIIUL r 14 Irl(, J S�NU° .- NI �j4•{Y, �30s,/'. cau°psy.FUMInid si taole.T..COmple.e The Cause) Deam?t sesi Nos V. ATHEROSC�EROTIGVASCULARDI$EASE ATRIAL FIBRILLATION.HYPERTEN sYL/Q`C IUI.LtL/Q it fne'!_/mF.1u9Rlis.�.chOUL!!/�Ves10(NO�y Y. 31..Qd TM.000 Use GOn'are TO Deam? �.32`tl Female�,� T1F 1 \ 3J A nnerOi am. ` �\ /.s a 1�\�>>�1J ✓I \j. u�v\\\ \q� \ _ .ia- elt ra z-�»%Ur 1. '� d'no ip . vAT l �. »+.t anon a n.»r1M42p...aaa L\.2<1.-j \ Q �NaamIQ Minutiae XX10'FCacem O�PetMrplrnesaga�°n� 1 ❑re:aO.Inl IGyfm n pllmww.e {({{Lipp !/autnyi is lug//� tTLeyy�� �d' r�luBLyi• S1 y(1 t.S• a �v� .twine )` s�y/,� li❑ 1r`(�I rns to f Lr jry.1✓/ U!�� 1as11 l35)-Tin»K t 1 r...e.a, u'N » TM�.. Illln (]5 d Loud Not Be Dexmaned iJ uy Ai VG�IUII! `-d :i..„,..1)3<`-Dae Of IniutY Wod vDaylrear) r sla 95iTana Ot mryry� l 4 136 Pace Of hp°.(E.G.,Decede is home•Cdnstrucco Sr R ataantitbWed Area) 143TSIRtay3t W.G4? `t 1?F/ ♦ \ t.. re . ' " �' PetsT 1 \„ l� ❑:Yes [IiNo I. � LdcaJon Injury s :38a.CtyOrTwm W1 mut-/� ,] / ti 4i'-n 1; 33}BSC�' CN*��'��1 3`8dLpCod '� ■��ll�j } Is-e'�154 VL � e" i GIBSC CAOU.EL >NL� In1 11JllSllll� 11 t Li v ∎.39.'Decent..Hew Irryzy Occur, +Sn \\ v - � � v \14a I1T ]°nLrsy!5°ea. �� �s\u \1'/ 1`\° S}- l'\�� \ � 'Ya tpa...wo.� 1:15 tea:.. ps .gsisn't. �, lltti:Zi S, di. u �a m / R1.% t► -:-.2... .a ire.2101dalotR dc>2.1 w -dr r 41A'Sgn re OtPen C yo-lgcauseaDerxryrJ/-af1111"�1rti7uar../ mil 44 �T pv/i43ilCerSerjFi'iy i."4 -/ tlldtfI Heath ran' 1y I ( C MAARVIAN7Z BURGESON BYtELECTRONICISIGNATURE Ill Iv . 11L-.Cmlc n.Mre PMsIcanthi`EI:Cdtoner��O�HeatOx'" MILS t 41'Name Address And by Code Of Person CeItpIr Cause Of Dea,R 'O \ « lxense Number `45 Date Cen:Sel. '" Q� t MAR Y,LANTZ?BURGESONel 40Y9E..22ND ST�?HUNTINGBURG,.INL46542• . 1 i 010289359 1 <7:1/:10/20,1.7/J o' N S6 Add onL Fu«21 Se -x Ptmiderr�,�� l I l� p��- v 1 4]!'Akas` U r/ ( cr I f i%-:sra,ure of�dl I H t 0"«L ' tn.��i�Ji' 111 Vv%G.1t � �T'C� :9yFor Re�Ya:rv��OOnlr-1D, Fn�runTm� ) �p�� 4�,,�. tC//t 1THEODOREIALBERTtWAFLART!VIA:EL-ECTRONICISIGNATURE1UC°/ltThIT .CAA�//�1[11{tli%!✓III)II NOVn13,2017�O , tteC, 1 1 • Il1B1y/2Y 1111 .ThritUs,1re fe rceSUtIWAMENOMENT2TOCERTIFICATEOF DEATH(ENTR/ORORIGINAL)IIQ �ranIll✓IaBOIII Y`l lfll.--t-'�ALIULIIG 9\? �`t 1 '� t 1 �� C�, 1t..1--Ni \AI�����/�1\��!`,4,I`I\ ...1i� ��i�il �\'��� nS Il,Ii�c`�` 0� State Form 53395.ATTENTION ESTATE The S&S I Sewnry a Is bersy eyves eC by this s a•e agerlry n'ader to pursue resppns bey Drscio u is pb.nary and mere Vi0 be ra pena'y foe retisaLq M L,%, 141, eAAIItll{ls�jly.uu'Y• 4luuutt .Ot.il flIbC.c tuuuLt----muUSt aIlunt va-/s.In:luL*✓i�l000 .-/t41111tacci/cauutnot.*-4auru.'WLd W A r.'f N I N /�_ ORIGiNAL DOCUMENT HAS A MULTICOLORED BAC!(GROUND ON SPECW.WHITE SECURLry PAPER ANO THE GREAT SEAL OF THE STATE OF.INDIANA ONL BACK THAT YYii�l aY aYll]] ntauc av/ua nc.urc.Tn Vnt..w S rasa ocirnan,,i Lwvuac.s?U c.u,rv.cs.u.u, .au...+..+. .vo..aac...,....r...,..,,,.,.ii�Li.aA t FILED FEB 14 2018 GIBSON COUNTY 963D aaaQO ©o • o43001 aG. - 90-33 - 30 © - 00k - o44 -ODi 1Q. S (000 E 1-4110,40 1-11 7532