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Death Certificate - Slater, Ronald W_5/10/2018 w'�A, :x gINDIANAISTATE DEPeARTMENT OF HEALTH „f *'e i ///' `• �k� °� �IC � a Wm '4 dt 4E` ' egg ERTIFICA�T_E`OFDEATI A p�� �� f,'.� { � \• S .mrpr, :�} ler4.ti t} :,,y'� cfI4+. �� .L `F �a ��0. ay-�� w ` Y A. ►� tJa{3�r`q��{YVr"� {,t�o�uNox00.00) 288>J>-<� _ s Eo 0.00 OQ0063924:3txx. �;>`�..aeState Nog02."�rQ�'�o-t• t ��,e Of).0 aND Game' ititasU i ¢ 5:`: ip�j-St•," Pj$ : ta'MaiOen Naoei_Ifmlale I ��� p1 s§ C". `t°it_ A :(t. Dare Of llcaVS�(M ayYYi "{�I�� RONALD;W;SLATER "re.' :- �:5< - ice '_..'� sieIMALE>:C�L07:35,P.M`a 04/.15/2018 ' s10.'tf OeathC sred L,AHOSptal `Y re �IOJ Deem ocasmd Homer Than AHwpnal� , Q `�• gfE 'a.` .dc>`�' 'r;14'+ �i+ibn>, ���tppa'i0 tmss}°�c '.no-ntmCanFaagTyyy. r 10.r1�13 eQ eS1' ° O4wu+'n �®'I OQernenc�,DA}ePe enW}eren l�;4ad on Aral la°tMrt ittWe.�i-a i 4i L- :t�.GiF : re LIII.FaciryNainetrl IRO Yvan Give Strand Nltzn 7-4,�ti115✓:4,-„, rittir tit`4K `VIS i 1i2 b ,it..„ tgpg i - DEACONESSIGATEWAY.$Ct r2Us"`tue:• s- �a+S ':±�. �' �nl �A'VLLS6✓! <v Q 4,\ zvcrty or •Slate: nd Zip Code.”, .-: v - .Q•ats.c ba D741.1 -.:1„,,.. tt MDainaLSte�in,m-r o . 5` �(1fi'a 11 *lam r ,� `�, .' ' L ... 4�i re.,..r B ISF Mated Okra Seog-- {f❑tiared f NEWBURGH,.IN 47630 I h ' u+ '' I • 1• A y) WARRICK`.//• i i /�' L01Yddd::A�PAC4,raN OIZEFIn EHI 154SriiW+ng Spoix'sN 'tdl Sa•W+Name Rein F M 6 DetedenreUn.aIOca aonl 4 =1] ICd C(ButMeta'Wa5]Y> P •rr`�,. ` `� .' 1 "'fir .i \� 5 Y•• `it� `r*� `ay' E t O s � MARY:CANE SL'ATERI .�r i i rr< MEEKacr �a Ge 1` �/I CHEMICAL OPERATOR:i t EI!ECTRIC+.ROWER L la Resgeze Slate I y f ,i.Sa County y' rn r v nD'Cdy oo--Q. I I r { 1 a -1-.4" y >'- s 1 n ' t '< s\;;/\1 >/.. ---.-. 1 t ,` .tip;G/\ � lj.. `mss : ,1/2,,,,,,a,---„:-.:„ /A ���\ %i R INDIANA��'s- "*�•� `•�” GIBSON \� �'?" OWENSVIELE �-�s '�' '' 1 `_ t-°�1. ..`°\�` t Bc 5`eel 1.umEer S > r a Ind N F 18e Zp COde nl4lroge Ciy Lints Tit r ° 1i .- I =) " ¢ �Pt z L,1 Y05:EASJARUK M 12aSJREET, - _ , 1P' t i.a.B.Ncsr_2. r>74-47665 4 Ogee L� 2) O4PtcedentS-EdLtaton �� 120�{Recede�tOiHispat Origin i- i-,•• L. `• zt'yoecedeors Race r .a - -, fu' HIGATSCHOONGRADUATErOR GED -0 .••,e3 1 `` t TAE 1 1 1 -i 1.-•s Ci! ilg COMPLENT.E. 4 11111 lit9 NOTtldd�PHi� SP,ANIC • Writ's { ` of\ ''° !x i..[n{;Ye /! ,rJ( uenfs Name' rsttJ4 dTe)asy r# ' _ V?3:Parenfs 0(F't;Nrddle last) , u : 2Ja.Parerts Iasi Name Debra Frtn mage: Ci �wei�,t C , 11 -.4ij� �f �(�,� '- b , .b�e'4+4,44 L , y v yu PAIBERTSEATER 1><'a K t^21-4: ri;t1f)aY.�s 'Yit?'r 4LOUVONeTHOMPSONI Staid - -o i BEARD r� -^' i 1244 WornantsNAmme un G`.I; 24a Rela]aI,NpToDeceden' 24b Madmg Address r(SteelAnd Number;Oty SYe Zc t`9p1 r t r.tar !7' ai «...`'�' E wy -4`0" pr Yit rardMGle6r ak«C'S°At'�cY G dl cu 4.4 6 MARYJANEISLATER �s9a. C.At-. ''c WIFE •wa.`.§;... t 305 EA STEIRUMMITiliSTREET'OWE I E N:47 +. ` _ 4�- e ri ILIW13i!>; slirt� 'tgIGI/ .. -tLINB.- iILR.+.''rYsag1Ptt-dia°yro5 galeet5QD aS7fAa`l$11t?0. 19 D.®:�Y�Bh'�� r/rr5a,MtlrPirg os r '_25a Rac.Olpspcsacn(Name O:Cemetery - abry;Omer Rare)- 125c Lorason eky:T Arid Slxa .�,te' eC gv s p I " . i1�Bn®It❑crematbn1O�Do(1®r0 Eitanirn�egie ` r'e�-j. .- 1f' egfiFdy `'. i bpe[ •.'A a I s 1 • FYrnpM1iK�aUi \ ' ra0/ l �loRemoalFOmSe. !`' � '^ ® � I.MAY/02018 \ i Q O�DmN'(sppeeedy)_ s BICKNEL•LAMEMORIAL CEMETERY QA BICKNELLgiN ill'tia. 11 `zQiy�teb..•- ' — t 's' 28'?itscame&•rnacted] '2] Name Pled to AddmS INFtuus Feeley a nt c Va Fvluel HameuaaeNUrWr t ®� %•<'I 1 = DLIE TERB n ® RICK FUNERAL-HOME HOME I�,B5 EI 'S&®9 sAENN Y �. rGV 1 �, t DUESTERBERG-FREDRICK FUNERAL HOME INC�`524 VIGO STREETdVINCENN ,Na✓. 1 + ', O et -N°. r -,• l a,• ��- '�`\ 47591d���®���a� a'�� ���•ra`ia•:� T+e+rrH � .� �•2]O.,:ao s<e OLk,a IPTUrnc Sen a OROfeents. Ettal1�fJ ��v�/� �yT 127c.:2 l,m,sQl$SA{�fllbElkyfl fysAllDl p�� G DONALD,Et1FREDRICK�FBWELECTRONIE SIGNAT.UREIIte/Lelri11fLGSt lit1 IED0100902.11fn 64L scab unub 0 Cause OIfJiatN (See Nstruatbns And,EsamPles)el r' ,. e �u eu a an .`.ae�.aCaused DiDi E�.e,�� ' 1 �. -C 5 4 ,,:�tt 2E01,:t5 Caiaac Acres RepEventg esCdsesa)Rcular OrjIatiiwthne T• •TheEiolog Do otAb0^Na EEntef ,One ,•��1a ` O an'a onset I L�SWt�s ±J Alas Artes4Respratay�Arres Or VeSVriatlar FlbnlWtron YltMa • •T('lie Etrotogy Do Not Abbren[a'tet`Elnff�O Y�Orre Cause On ` � \� o`jIr �sr a Add Addm`aul Lires M feecea YAWS; 4•- A I Id�IfQl�//J C� �� f7811 111 %�,rs�l';1'- ./ [ia: 'A44gNl.GIDt4 g In Dei.. }iJ,L.N U �,• , r I Tom,�t r Immediate Cause,IFinal Desease Or Cordruon ResuBing In Death) A SEPSIS. MULTIORGAH SYSTEM FAIL RE �+s FEW DAYS OF /• y 1 �. i �.. . - Z.�j std 1 i``RA IS�i.: ` �' , "' - 'W D 41','� \SB PERFORATEDVISCUS' `�.a, .�.\'."` 1"+a+.�s Rt.4- :•FEW DAYS e. :Segxr.ki-tFI • uns HAnyr1a112BeOTlhe4use LUled On I a•nm..ac.sawe As•�s1BI3Tr, / IT11 Evontser U Cause D4ease Or; That*Mad� {{l, YI IJ �14��@ a av Gt1G:Y { j G t Tile Events Re `I Death)Lill( em I 1, Y��"�4-�/�°®"'�`� 1111-..t tt li 4• yY ' � kY�J181_ 15 �surrp10 ) �41 1 1 if _ C ACUIE'.KIDNEY.INJURY G , _df .:.m5 C� FEW DAYS �� \i 'l�\t�lt�4-1 '� ♦, t - w 'rt ` I a„ me<la,a 77.7oon eJ - - 1 ' a L1 \ FJ W�•'��\ \\\C C`\\� ‘ Di 1t\�'!',..�\�'\Y\`1'`� '.'L i gS4!'v '> ._&�.� .`.1►' Pn R• tetet t &n Net est"to TM, tra Cause Gsencritz ill:a U�YnurryeyP way 1saDVVQnnWiaLl 1 ppv �LaYea.����!� {pLrr r'@'ia+f ggtl .��I��YBS�INO f �t /Ei�.58CJ�A®X41[--r6zs;.+;°f6Yki� 1[b"•��sFib{9",7de21'Q IaK.� AC'wse•y FCiaA� + �+,ers mss] iO Yes r , a•A'9rn.N 3LCDid,TOaaao USe Camnub;14:-.t 'arog•emse '•r '• 33 Mamas Deem. f-{-r,---ikr �,«i Wi eel P BE:a0•No 0 o ...� �a o`er ® �s �1 tit..l�r ,L ��(( 22 • a<me.nvAr.. � r..town J.< ®NadrY,QlHartsrlde ❑AdadeN �,Wndiq trvea:ya5on LS+Y'eel ❑'PmaaOh"®No ❑.IJNmwn -v 6r�4ki erre NT,NI owerr..84 "sta. ...nee-GCN.�R@ba € t 3-rprr4 nn COON Be YGt:� g 6n6® 62hkvrH.eil1{th't+eR wyL��'"?!N•avAwn.e.+u a.r.r n«e. o. ;���Lww.aen.a.=vAM n.vus £_.� ❑:Bubde l7:DOw Nd Be Mkrtnmed��i4 ��{d 0 t>t!Oate Cf Inlay MOnm•Dsyfem) E.*'I35Xgne Of I14AY \Y'r ' 36'Place Of ln}ry(EG.1Decedenfs Hama Canstrxton Sre:Resnva,L llboded Ana)• Ferns AIKINC) yyg� •p� w r g.�ay����,, s+et fia"�i� Ig .'�. 5 it ti:,J_.s., l.z m� �e?ti),- -tr< �� t v 3 ;es 2.7 3esLOmonotlryin-sxe i'L 38a".Cey Or TOxn � f A. 3ne'Saenn Mmes a� Ci' �,r 3nc AP��.�1 y�'T- ¢igri�.s•. T<x < �' a q'pd }. mm,��11` pt{;4 � { rI'" [�.�is [I W fir` `r X'v.&'.t_ te� �1u N E f M s -lam 44A-,72 MS.'^�. a v_`r/ o- •x�4pg-T- <OtNiruuporl0Ca-�e"f. 1{ Q"� I �,�.• tirtlt,� Yft '3rd Ou..Ae..s+r:0_a.:.0ri rs.r P.5 Fl Gl�$1�t&iii9.7�...w53F' 1tci�'tr3�^/' t.;_:iv �`aeEx - .�. .�. n -cfii'n iB�a1w9 'J _Cte+"��.iP.O .a94. ,ttiPs.oaLe Ponalcstgw*cane Otoeats”pr *.. ir..I:81)S�.sk.. ryr c$ E t2-rer'aleCTnsticCIFOre)'.{r".�5, t4 �•� p� MOHAMME JYAREAN'ALyLAWX, BYaELECTRONICISIGNATUREc;:ice '�+� I anvyingetyskianS 43O_carn»r..�Lit'e:H.stO5ac 1 CRONNameAddress And Zip Code IN Person Ceetpnp CaueOrDeath y is it S fieeducense tocroeG.° y t5 ___.(__On used t � N�i�' g e � GQl 5t° ^ 6trAdVi 4% i rM@ 1 l MOHAMMED:ARFAN.ALLAW 401SGATEWAY/BLVDYSTE 3000;INEWBURG+WN1B7630 ti 01045554A I: l 0424/2018' '� e Aw ;¢\• �' �E ® a SS 141"--el Ze 'Rn " agt:t �, L ® t �� S � to a s n „ ris $ i gIN • IGKYALY.EAGERVVIA.EECTRONIC:SIGNATURE >. $ sXia1in voa.a,APR252018 el sum is a s.au ui ttSi `48P14YKaz.zzhlLr weUAMENOMENTTO GERM FICATE OFDEAIH(ENTRY,ORORIGINAL); EteRaf .-fta'linRrA a ltaRI 3D"COMHll yII 7 4itisi } A • A� 4sE Jf }oo 3gooT y y a ) �1 y . � a O r • - a 6 z� a a;ci a r4bt a ,4 ; . i Z L OStata Fram 5332S41TATTENTION'ESTATEAh1 SiC J o tiCe'aagg rr¢iaaueeeed ppyy(ton stile mry n order to pxsua responspti•y1Ols`tluat ii iictifaifirriiiittieirol1 Ea vJLVAa9`�a9� yC4lsrinWci atf lonrre SUa1TH A�1 ill WARNIG1ORJGRULD000MENTH MULTICOLORED BACKGROUND.O SPECIAL.WHITESECIRLI PAPERNDyTHEGREATSEALOETHESATEO1FDtA NAONBAC—T3 n.•:WRNS FROM O T OY.NHEt RUBBED RGINADOCUMENCHAS A HIDDENVOIDO&FAONT.THATMPPEARS YMVN PHOTOCOPIED K1a'a� 0 RI v k