Loading...
Death Certificate - Simmons, Mary Alice_3/22/2018 r_.G1ri.Ot-rf�.Gl,�l.L'h.4�L1.� 1 .-- ..4 ' 1_r• h.G�:ll„-., 7'tP�:41�1.1�.:/3_/ 1 LP��L-l._�Z� ¶;; ' `e •t,;, a $•. INDIANA*S TATE'UEP• 'TMENJi ALTFL _ a- 1>r t 1�'"t��"7 �'' r j �1,a fi)pI`f' 111 i/CERTIFIGATE OF DEATWCI %��'. 1 I'' IT•- I � ( � } L"Deal ND3000255 EDRINa 0.000006z1r341(50� -4-t..II state No •0595�7�1 . `\ t 1.'Decedents Lapel Namely.*MCdfe Laspr t I te�Meden NamalOIternab7 g...SS.x pane Cf Debi 4'..'s {,4'+Dte O Dea'Jr`(MortDa tn'fni`�Pregra r y MARY.SIMMONS r 4 -N4-% • �1t iJONEStS � 1i\C`i 4.II €FEMALE ca O8i101FM . 11 12/05/20.17 ✓ �' .'10.'11 Death Cccnd In'A FITSr a� '� �! f. .l0a'!U DDeaik(Z_.mad S�rasr:T 'A'N�gq V .41) �v` � � 1 9��11�'l-4`�ll'.�. � �PV.`� t�°.�11 .�. �\ �\l. p ��) a�tY �' OettdeKa Haae ®INUrsvq HmwJlaWblm�Care FaaTdy �4�� ❑iettl®No �.Unhn" ©Irpetierar(]Enwpalry DeretadLLOUyaeert Q'Oead mPnrcel ❑tteti .7 r A q�DteTtr-.•me nt!i �6•tav�<aDt>v<�uLtatYv<e1��vi:aetul:i<a..� it 'NOM', i.4 T 1 EI11 FecDtyName(BNaltadArr-''StreelatMNU7'F clan GOODSAMARITANSHOMErANDIREHABILITATIONIGENTER� ll❑1a"d�ll��Y��.1�Y+AA 1�01Y/�aYtltl� J.` �TM/��6llriRIF.�lf�1l.?�qI 12XC.4y Or Tomv Sa•arAn 2a Code \�i ` `L. 13^Gaunt Ol Deffih -i ` \�\ u.Mar6.alS aDeaT '4.\1,!< (� I t ' t r 4-� '" -� t' ,,,.-•,....,'" r 'tea 1� .,0. �0i �,t} _ .; R+� �� r "�. /I 1 t t Bp. MamedpiMamad.an st,�aled, p 3 OAKLAND CITY,;IN 47660A I '.� =;1P A��1 r� i Pr I i GIBSON r sy° 111 ^'(! t l b d®il111t^'ee�O1Ne eManw ..'n r i5r,Stannm Spouses Name K r s 44 s.1 ag Name Berore Fast Matnape r t-„ P• 8 Decedents Usral Cccpton' 17:Itrd 01 B.....„n&d.mty' ! u � _ 77" G/ 1 i'.''� .Iit l `A "�'rt�g � Y'!I��. +T �" BEACH ER _'��,1Ai-EDUCATION`►:+R (Y' 1�y 9 R e s'W e n/c e- sae'. Q A s il8a.'Cway i" 18b.Cm'OcTaN1 r. .s,*fin i I C I S•34iNDIANA>,t+. = - .:1 \ GIBSON�<<.� OAKLANDCIIY..�_,�L .-4,= � ,.� �+�e�� i . •!�� r tlac!Sbeet And Numyber � U ,A;- �' ,.a. ' 1/ q/�� 11'y14 rI- -N 1Bd Apt'NO. ulEanip Code __!Invade City Isar Ii4"r#QBI Sf D49�� 1y., - 11lEv '" it :.,4I { � `I �/- � / ®Yes thm.i 11201SaM�AINbSTia nv} g:..."`a.-1{�� �'jll . ��i�' All2-4Sia.4tt,�/r.,;y- an-; 47660 c-" uHrr it.)119.n Decedents EduunxiCtSS,i - 20,i Deceden Of Hispayi Onpn :1; a'4;121.Decedents Race.- -`�Z \1�� ! '�^- �� , 3�BAO 'S•'DEG I(BA,AB,-BS) ,_NOT HIISSPANIC:I'd1�, 17 .�Ill.Wtl e%?ri�`!.e• 1\'pC�',lr1l'.`c�"11\��f����'� fi1 -6 C ' 22PareitsName(Fast ei`dme ! it , i 1f•'�i .4 1 4I ►'.P`rssNa (Fist Middle.Last) J.t 4 ,gift-: 1 z3a1Paretss�t am Beals Fest Mannapel C CURTIS JONESa� .,d. .�°�.. . �a'aL�`i ..+ t- �. MABELtiJONESe"� �+C•'�.:'a' �+.d K11HN <. e i. +. f 24INu-arts Name I c- 24a•RetatgrpJoDemderi 240 Me3mp Ad&ess (Street AtdNWe.Ciy:Sta'e•LpCade)....1, Y ..9, U3 T r �G� r-�.ari1ION1r� 1 � onr 0.r �1SA pgNs� I IN1 6601 i . , CYNTHIA SIMMONS ae'.`tes DAUGHTER .41120 S..MAIN STr OAKLAND:CIIY.INI47660a i� � s ``%3 � ��-SSrA-9A.-- ft`N� ,® @01 et PMe a cy 0 tAan's• ) '22La® }'1�`»� 1® stt''a- \�R v 25a inc;:d Ol9.,,,," r+ FilKie siant11'25b3Flam Ol Disrpos�i-,(ti-Ol Cemetery GemT.0,.. -) 2 Lwa_w1 CdY Teoen Ard Sae .4:� i ///R it yi' ,' O Bwl ®Gramm! Q Dota4❑iEn b4 ear O)f !I' II sq Al 1 w'1 11 `I �i 11 r c t r� 4.I ,-;.4,..x. t Y 'rd t- n, LVaa zI✓" Iiio v t y./ 4 i] t j y ry I - 14fI V,+R I `f L�1R ,e w`¢A�stas •`� -. 1 f�5.� �tdl•V �Iq -a41'S \I \\11�\°\ � `ty V I Qip.D'mel(spaay) `r`!� �. z 'EVANSVILLE.CREMATORY`1 ., EVANSVILLEz.IN e.. �•=.`.'t < `L 2e.waa Caaler Carsaned? ,4 27.'Nre'AMCOrnpe•aanitess Of Ftn Fatty VnalWi0A�f11117 L271tIcuneral Hane Liceme Number. .:.t i r .C-44 1 Ti..-7"." ti-tAMaP!?��R AVIEMs1t^l� t .I'_5 'vl eINGT .I'Ytls✓•ND a+uts.M110� Da i. , p ®YNO�` -II I F IMB)BQSHAM MEMORIALSCHAPEL INC 226 E.WASHINGTON STREET,OAKLAND 'CITY.; �.� 0 t u_ -.-' ' IN'47660ra18C7��*Ih i ,d0a Imo' ;.�UfIIC% WS. F� 1 EN83005312. P-' 2ngypras,aalndana_FimrsernmLlr7msee `'1 � �\" ,�����1zlcY lCalae zrterr lo�Dmn.ek��+�n�`•, .?'`,� fl'JERRYLEE(BA¢tSHAMfiBYLtnEELlEE�O{T(IRO{7NNII/GISISI7GL�NtATURE D17 <Itrillna 'G dll F,WA6]65691F.�BCt�IV,r► IS V 3 Ntir1)ir•�IiiQYwanti ari ttV ,Acill11wwy,aOf�Dgea. /SeeeW�_onabb dnt ea) ;mot s> -a t{1 r t r q d ).ela It -` `28 Part 1 En'e,The.Chan Of EventF :Diseases hyunes„OSComybcatlons That Dracuy,Caused ThcDeath�0o Not E14etiferm I'Eventss .t.,-...,,, j°%`A 1 I nt Onset 110 ee,, S6Ct ASCarduc A-ieslr Respcamly A�estTOrVerlrlaNa'r.ribn7lata.WthoCl ShovrpsThe'E'iiobpy Do'No evaW thleTOK0neCau°se On j To D'ea'n 14Ataie.AddA rcionxl Lees YN Nt ✓ 1" '�. �\ \\ V I "� ® �9Clg $2 °4111 a /<litl?r;'T��i' % R3�,,� ` +/a /��r�j7 �%. Immee�diaatliC�euse(Final Disease Or LordAan Resu3np n Deah)t (4 A INTESTINAL OBSTRUCTION ��� ttpi I I( U<..14 u•' . .I./-✓y I I t F .10 DAYS 1 1 ■ ....ti I L.,!SQ ���'keR'' & `�4 �°, �� r� •t Fi�eC�A�t `lIC1a�'�. tom• i s '/•/t l i Yom! +a I .• entaly-Ist CaM.".ara�tt Any Leading TOtiThto Ca, Listed Ong _. STRANGULATED HERNIA a.e u 7.{_({���{I�pt�y��> rt.��R �� ��-`t fODAYS COientireThetUndayrg;ause(D�se Or Tl5..... ilate1 d!, Zt.�I.>�OlItll��,Aiv �lst , 'I �1 "'e t.t ci! ' ; c! s,, atec.su" tri Dea0l lest(Die_/ >% k t i 1.74.! s a, 1 I eat czi 1 e! " late- 7 i is :, 1 v E Ite r w.a la.,A C.,4w.°oa > 1 f 'l11 r G t,\ 1:'',4•1:1.."" .iti., +\`e 4,..c,112.4‘,...- lid.. •Rile• O;q.1 i Qth.�ya\i . i t`4 .rl�\jib _ J „ -� ` \ • 0o.,\ , ��\ ..\. ..� J4.`-. 4.--14, ,41�'+�\ �`..._ ty ,% 4,4, C Pat II.Enter OTeS5:12 lfadxns Catid2rato Deeh BNNc4 Res,itnp In TleUndelyig Cause Given In Part Ir 29tWas AnAL psyPodaned?fPtfe i i'NOlriTL✓Gillitt I4t1. .v �sJ� 7{�)`tLpry try®tRTy t p1t1��////�,j9 yiyT Yy/�/////���I({{1 R{{{7��V�////�./�r��j[1t, 1Is1 4.l loa�dou - M O Yes c /O ira .t'Stl41Pd' V['{�i 1 11!!G/ 7Lt Yf/Lt�Ol11TU61Lad I/� I moat aa4m r- To Camplse TMCausa Of Dexhi 4 t'ire TRLAUFIERI.LATI0.N. ,+ o +I'rc�a�butr©<abane>L�YO!NO✓ _4.y L1 Did Tobacco Usi COmn'+ae TOOearg 114;32 1'FenWa� JZ � 33 Maurer0l QA ti V II� �...„..„4„3- i , ....rrr.v m vna"+u.n.a O..e �•rar+.a.,a"_ma uv eCora O.a r®�N Olt alaikanle ❑eAmders Par61W Imvndpatidm ra ❑Piotmuy®(NO ❑ua'noa11 0.0ainmav pT�� male.,,.,.. n'Gta� i- -�-kea - a‘ I'ili?t��i}i • •l p Ss int7Wst Om O!_±inarst E:w�.aawsmt w rvaa]LU)�,ssnnrina!�±xa�lnvr3_r <I�1 Ilasuickw Could Na Bo DelenwW 34'IDa Of Irjry(MadMaYTYea4 ' 35'Trne a Iryzy r 4tU 938 Ofiyvy(EG.Decadeer sHometeass:niman 9'elResa,rantnArasdAme) y3T..IrayAt Work? a' P' I ` �`• i ,k . i. c ` �.. Yes ob e r 1 3BLara-an0fLttry=staa e 1 I L38a'Ci: eeTam l_ `‘.7%,....- 1 'Met r lc I pr k it Y p3aCrA`pt?NNO.f+ aaearZO cos:coh g ,�pl 1y 1-� l lri fi%I 1, �. �11 :Sa¢,$'63�d �' ILA'/.e'S�Clll1!/J.I I I -.< i\1 - %41,11,1 OA I t`f M01 Ail 7 4. l 0 139:DOwIDe How navy o_,=red �s�5 1 \` Q 47t, 40 NTrasspana crib_+' y �t 'e>s�.�I �e'Lga,--'�t\`71 \ \��- '�o:.dw..a. p=.-i atit'�Oae_1s.m "\ ,141 � .,.�d i,ri>.>/Ry%1i~?r. s ?: f f> �d �ia4��e[ .+:4�1. 1e s11s:,1a:aa.aPawc.agympceae«Deaa3nnl7.raa®O��aq� I�//��� {�J/�INAC-", IMMI{a,,eefirefleiadroiiro;e'1�4GI @p I�,��104ii*> ❑S - r4 TERRY GEHLHAUSEN tBYiELaECT RONICISIGNATl1REitIaC%a�'f111��i6!4,,,-0 C-af�s'LWN{•®:cairtWWWPlnanandfUacaoneral 4aa h0rsaer tll0 d4. Name Address And LpCOde Of 1?olson certryvq Cause or Death \ I6�llrome'Nlmber 45.Dee Ceased (t• ia q's'� .,�a rr• �cc7 ITERRYIGEHLHAUSEN 1020.WtMORTON,AAKLAND CITY,INA76601 f . i` •1 i 4� �i��. 02000730A�I r4••i 12/06/20117 E b Astme Funere!S.vae R"der$�$1I�g �yI�I�/��'4 `/- . s a A cAt tltl�/J ArgiMII "`222 p�.N.,t'.`sSIIF':��'1�4 t4."2i�LG ESas:\`�ilCd�l+t,.. N. -,�C.1 "se.� %,.. .. ∎ (In- 4 -:%.,, BRUCE BRINK SVIP;ELECTRONIC:SIGNATURE i F tiA 4t9�F iglsmraur-w riDE R"O7' L ¢h n �aa 4. 0��`I�GIf I»�������uNt"��QII`([�I�QQfQQI'DECt a4� `, , e 0-'�Bnr @ravfaz nits r.io UIEIr.ILA[I@AmaaaaaMjTOCERTIFIOATE'qual H'(ENTRY.ORORIGINAC7t®Q®PQ<OB11® 90tn✓'�1SIIW3 I1UBI'i T 1; ;~�-S ` � i'�� :•,• 4`~`',�� '� A� �:; : Ali 4 111;11 } I, IxI~%11''w%�>ektritAl1 %t t�1111;�%�~ � 111 •5;\I 1 11'-� � 1- � %,m` %w,%mss1. � �� 1,1� 1-■ ' State Faun 53395 ATTENTION ESTATE:Ira Soda)Security t a being r,• • by this alma Bc:Kai n•. .= to Prasue Dlseln-s vaAaaary a 4_hale be m panaGy b refusal e# timmr- pa fig�s,�,,-- i•'dalaA,.: ,pnon/l ASEMU 100IOP%aB cXGRO(G4tON SPE 1 11IT YCU•^t1 APE 'AN,/1n 0`J/. lLIl /.TE4P'To= FAtr(3 A I T WARNIIYG40RIGWAROMO ANG HAS`MULTCOLORED BAd(GROUND ON SP ITE?...D-T�'rP,AP4FAANDyiHE97:16SEAL OF *SUTF{OELPI' ON flAC�(JHAT� .,TURNS FROM ORANGERO.YELLOW.Wr --find E51--ORIGIFfAL7f WENf:HAS A HIDDEN.VdDAN'FAONF.THATiPPPERS'h'FIEN PHOTOCOPIED/F=JSL.C•D� - ut...�. �r. ... ..,-. R-...� _.,., ,......ra.au.. ._.... - - PL fraco-14-1 a a oo , 00-7-ooh outLaOnerl I 0 3 -aaH 3 bStyd4- FILED MAR 2 2 2018 GIBSON COUNTY AUDITOR