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Death Certificate - Burkhart, Joy, E_6/13/2018 t^..,44.- ;_Lti. -,_.•a&' •yi 1.iu:0�vi:•fi?iirin✓% .i_i/r�.l _ • ^ i a.T>G arv..G.li :s.•..r-!J_�'.NI..Te C.. Z ; \- x•s c a a1W :ITSI,S,1\\\ _. to a - O.�Fi r. i N. % o� •" r (` ,.•+' � � INDIANAeSFAtE-DEP�•CR_TMEN-�• FiHEALT��� ��� � � � � 1� M 1!V1' Ir- r%CERTIFICATE(OF DEAuTH '1 ( Al r-4- N II ,�'. \ ,--• `�" �� 0285 O s � � _�� !_L P a LOwl Nos00�,1!38 - �EDRINoti , Z48Q� State No a - \ �1Ie Decedents Legal Name; Midda!Last) �Maitlm Nanleci(of female) "'attic /�3.Tae OI Death 4.1DSe OI DeaN• mtl aa/Y rM Wsg11VUS4 � ��.•g is R1C n�° � ,t1 �u inn�� C,•••:;JOY,ECOISE;BURKHART ��o..• ! "C'�\ SCHMITiELER FEMALE C141-15 , 06/02/2 re 1 •5`° a Seamty Nine ea'Age_.Yn 5c tUnSer.l Year BO;Under I Moen(,ea.Underl Dry ;setiundee rut &7..Data a emntrnamwarrcear) se•9Mgafe((C.H and Saa-se Foreign Carttj) ( 3 �r-e--is `>aaout�bbLat^v.G at.eswai�auC 7 o t ,� I ' Death Occurred In A Hcepaal: 10a'll DeaNOfaared SomewtetOtno•Ttan'AHmpitalp re �/ i�,�, FaaLty ®DerodeSa Hare�l]1Nttsng HonMag-term Care Facility �/ ❑,Yes ®NO D,Unkrwwn oleem•o Emergency Department Pryr4em O'Dea?on Amval ie'°HI>' sVF'. ,s\r••� *\ a. aotllll d UNFlf_7 'utt1YtY�al NlLtise!_.i lIMSOC®D usfB.'w'Y111R!'IQ 1�rthM.�.....-.. /.( %M ail 1 •:/'.A ti' a� 17l� ' L1f.L/?�bNrnei(IINU 1ru.ttaL Grve Steet arw Nimpe�r)✓�,,�-C`�( �,�q�{� 1gp�����p������� (( ��g��p�y,��-��7pp❑t ��p �{ 42,Cdyc T+OAATRpcod..I �' a�.fl�.iQ@lwm - ��aLl WPAIIl%cit�w17ots Of T�I�L` 6 %5��vFl4 Man awta tDeS - t% fit\WJa `9 1n'' :;Am 2m Croce, .} `Z .ti-jr ♦- }}1�'` 3.Cany Of Deem-c 3 1 y5"cernteslawuretie lath A \aC//.3iI W1 u (�� 1 �� {r/! MIq�\ j� � �i�51)Ma2mM0 M meE'BUl` •7ertpaf�a'.Etl O P PRINCETON.INN 47670_+4 K. (` i i e 1 e t i1 l GIBSONIF f 1 I� �OL as�yN ma.nib 10 U •V� .yT 1�1.5:nueivirg Spouse's Name ".. lir � � 1\. 5a4a a Before Flat Mamag `, ;-.a 16.NDecedenr.Usual ocaroauonE 4 •pelf,waa,w,�lmaety-- 0,./F/BURL M BURKHA 1 I t.1 ,e. �. y• „ �i\�.! I HOMEMAKER •. 1 OWN1HOME-.� IJltlm / a^Re:aenoe e -Z 11 Me urt . l l ij\, 601 cya o.,���J .//• j i V 5134111 y�I ! i( - �1 'k INDIANA ,.CS.. -��w\. GI Ni`w s.ko- �'•\ v. RR TON\`t 4.W.-% >,e.=`�tit/��" %�-.,?,a"- / l48c_a eel Artl Neater flj' I i 3, 1: ..� r." � � :! � rA L( L slew ApL NO Be Zip COde erWedeCryLimits7 •1 t �n2� 11 .4 , • t d i 1%� n j j+ i -- ` coma Ito9V E_An OAAK0.,RE..Tl iC_ i '111 ��4!�i/' h.� 6. -.Al 4x ® 1. +� ' et. 47670 S. I• N. t19tDecedenY E c:ton�1: :I .1l 12g Oe Ment_OI HepaNC Ongn 21 Decedents Racal i "'�.• IS `. HIG-11 CHOOL GRADUAT�EX)R_ I1G� ED a ��atlLOtt y t ,�/���� t o+rt „ a ,1,....-"p,11• 4�+i p, = 1k `•`� P COMPLETEDitira22agganI� li` NOTFHISP•ANICi! 1 i i'/a 1 White's f i t .;1 t, �.(11II �t i I : _R} tr/ * 1 I 1.a •22..'ParerrsName(:zt. • dIeLas (•se ` . J Lam, (23LParenr nacre.-dr'MmletLaw� - iL i 1 Y I23aPPaaremsLntN eBe' eFu %�i ` � � A_ .te a- -'a�' \ \. �• i +��. .'.�r WO \> ij l .. PAUL SCHMI3TL1 ; - rr•- ! s.I f .. 1 on +De dent �ROZELLAISEHMITTLER. L TS'a WOODS r 0 24nnornanes Name . II' I,, I sSe4a!RdalicnsnOTO De<saent 24o.Ma ededress(Stott no NUmeer C 4Sa•e Zip COCe) 1 s W /1 1 fi�t. .- l i�9 :.1 a;: 15U\ire.- :nor oti r l�Uk'"•`i,' ,; tt e,' W BURL•BURKHART YaS..,"At` �'� HUSBAND ."4`'c 4 F .• '40MAST;;OAK!STREETnRRINCETONIINA767.0 a••a� 1 ;7 eta.'-i.�. 4 Iin1 "R• 11e6a1 bX0 Ee®ttanaS`CSY.d� ara:Dl:o >d" Ert Eris. CSS2 1Wee rrak it 1C G�L25a•Meed Ot Dispo :ena¢A11� �/ 1idr'.250 flx Of Dspmaon(Name Of Cemetery.,Cieieany Ote Place j 25cftoc nrCiy.TO.m AM SIae r t '>.T/ t `Y `' .W ®Paal croyrmrn O portion oErca 1' t�ri � l i f �� � y L i � I¢� - hemalF�mmmtvi ` , - �..4 '•����� � \ - '� l� 1. � I ` O Sim err` S4% � . BOWMANICEAETER :?,-: PETERSBURG,eIN` .`""s`�,.-- ► \ -N-...� o 20. I I Was Caroller Catacted7 2T Name''AM CanpleeAddness Of Rental Fealty' { n 27a.Fiawxl Hornet enseMmeer' tv 1 0111\' F1 1 i>` W `off w.. .. DOYLEIF.UNERALSHOME„520:S.MAINIST�`P.RINCETON�IN47.670r.-1 . ` . NN.ere EH:10400010Itts I- InbISgnaNeOl ln:Una Rowel Service Licensee:� 1G1ALWrepi L�\��, 127c`zLrenee NUrt:dr��IX L�xer�ue_a): ?p y�(�\� Q 0 BARRETr W'DOYLE BYtELECTRONIC SIGNATURE ores HIIIry�b�:11 _2 CO295000091�1R71��11�GUZYdJ.dll1n �4_lfll[iB U.$ % ' •/I /►�1s>ri i0� A Ifl 1WI l' .n. ,I.e� auu.-err c lula ATndra n.aut 7(Ifl{1N/ T .e t,! . APP-.,,W,21 t•41,:- 28:Pan1 Er The CIan IX Eve!te iseases 4pnae Or cceetkos;That thr Causeilf Da De i&prNotEds TereaLnmal E..vv��ww'5��••L r t` �A . ,.�s� 4cnI-iOrlaafkU O L`h_AulACEAC-Afee lLumlNa �«Vertiio`pllar FioNlatian.Mlle SLSfwicg The Elid 3gy}D�OpflolabrevlaaTelE4,0nty Onet>RwA_y lt' ��r-. \\\..J�\\�T'o DeaN\\;'a\�v/>•, O /medarecJU4ltase a ig hi L1) V TEIl DIAL INFARCTION s... a�g ZL 2 � : t !kit MATES S 4nmadate Catne(FaW Disease Or CoM:twn Reststtag In Death) '11L1 A ACUTE MYOCARDIAL Ie. U �il11! 1 .MINUTES ` 5 1}y1' 411' \A . °"v`:g -e.e«. e / .i o "•%4 \ Seu.2,Ilk C«Wdm3 If Any.LeadiglTOLha Cause Liked On t (% &.ieerTh`e Underyeg Cattle(DseaseOr That Wtia:ed�/tee {�I��/���� C1���t}'�a^4wm��10•}['ssyr°%y/'•{�1?�.(,��V� Lry{ ye �' ✓/ nia-Everas RdesmYSg In Deathh)Last %/. i�t}1 tIr;•:l/IEWar tS 11t11I1 ti1UUs M\It t�1 ti l (-0\Ji 2' } ti• !I! 1 jt )l✓t V ✓ ,,, cox rJ-c.. ?qt1..� (; � �''..f'a.�..7•'Y�t\\S"r' \\�'�`\.�\�R�D`���`l� �\� ;���..1� N » �ki`'�.�.�`\'�sk\ \5.��\�I /T Z�Q\6• sPatlLErlbrOther5iai5cenlCaMtosCOmotnmmDeedfBenNatResd:rgInTheUndeayigCauseGivenInPend .c.... s N'• °P•/ Y° %OQ a r ('`( Nora t¢� fiat 1 4 1[1'� Ceveeven In oriels e��� era D, asYL®No LL p� �f'C 1 / 1��21YSaA� tl�titfi� ca�D i1C/��VII�� �I�•Nbre Alaoosit d✓g Ay4 aMe ro Complete Te Caine Of Death 's it T�_6I �� la _ �tl +L ❑ vadL�,>unL.c>,vPluer+.dvnut?a"5 es 7:1; 31`DWTaoaaoUeCmNbleTpDeathol 32^IIF,ema ., 33,MaerraDearr � ��� +. I, Tor 1.1:1_ i y i�953'�� � wa,-t» (IY/d (T7(�� x..#S`��ttt Y� �D�rrsn.ws x.., �'m:�su a st�.wtmPUS aunw�svc.ea ow•ap.c� ®NatvalO Horzvde�0° Amderc H(]PrICa91m'estgaiore s/ D Yes Prooatiy O' No ®Un4lawn daSiil UUs�P ills 4.Qlsti cre..e UURY I�l/L._ta0C/M o4ttic=t ss�/eta! �j�L��hu'Patel d1Ja•UDamiDay. •IJI14' 119. v;--- t•r• -;r-emn o-aJ l]IL- .EWDeedert;r- ns SuaeeO• Cold Na Be Deamened �..V Wore? ! t L=j/s3.'DaaIXlryeaY(MOn6✓D+YIYeatl!tiL11�/- ' ,35:�IXlsgay \\ 38 %oeF Ol µryIEG`t7edxe'eH��srvrmn1S`a:ResasraK�VAnded Area X37 LT+Y At NbA'I co k,TI E R?�,`�J i �''WW�lrl� � e i�� -1r e- A a tl" . .- es. l71No 3aSLaraonOl}h,_,pyy Seel t ,, 38a. crtyorlocin 1 - "r _3atsSte(et�a'Numer I ( 73& Apm.° sea.zepcode it (d Ce<�fY.��it9 .•••'4.141 .k. _r9�! fl��J1 ll�ad�'L18 ��l:/aV.S� .r�!`' ` [� �j1J1 / 0t l S 1 �11 }�1 /i1 �L' uiV \I ' tl � 1 �� 39gDaenteHw TrOmmW1� �1° �� �pvy 4004.7 vu'ianfoTa w WI ����tlt1 '9 t arT✓. ?t i����R��e��t 1P��r�L(!��j�tP z,e to s�13IIP_ ®au ri�u �...a -�•,,,,,s w:urc.OcPescn Ceryeq Cause Of fl fire l ®liCrea1J� "n�.,j�y r iirfe-..ge«*w'i74,1 J1❑��� i 1(�� J1RU I ) <MISTYG4HOKE BY?ELECTRONIC:SIGNATURE �`WIl ��YP t O:c-ragwortor�.U1uN:eaa1r211C=a:Hearn00:er 1FItSf' (�-43`Namp AddeesAMZpeeorpeis.a:casa cause OfDeath ���yy .>�."t •ay 441-�NUlloer � asya'eerrad +1 LL"} Me�HOKE 420315.<P.R�" T�PRINCETON, 101/670. ��/a�`��(1I ��1t�� I � i`/ O6/08I278 "',�lllll �'Aaata,alFt„ralsanemp,odder. I`C •y ' J so J J"f ♦ 47 Aeaa� �4"c� '7 ���� �;e5.��`. ��Q� �� ���L-<. tor` �� ' �..e!swyrerslxal a5� s 49 For;ReglsbvOM/ maFlLd� en6w+rrc.am�'���rr {� r i, �,. . it r '1 rr(,R ?�tlatI .s'aut t ��i I I��/�1�ITe�%` tg e ...•�.��'�i�tl!1'�' tie. C¢BR UCEBRINKJ4avIArELECTRONICSIGNATURE241V1Nff2111tlti1!/�U! i ti_•ZI !i d® ��PJUNiO&20�18 .4. _., l S•NAnP� S11V'flarartlra U AM ENDMENT1TO.CERTIFFlCATEOF,DEATH(ENTRY.oR OWGItImmutne7�H nsoria1BBJ etyt-i-/ate gam`- r\c �� eLg „ �� ��;+ VZ>x`\` jr \. .. 1. C t„4.s 'IA 6, =` 1I.1 - . °© 1! ' 01 s. Tan-024-�1r i i, y1-�.���'1-���''�'.: 1�,�. 1te!; ST,FOry iATLfENTIONESTATEaTIIrSpwl•$egai.YY.e�esg veaeY� u� u�i .bI --"e*,,;-.;i � -.all there will or,46t` A I\ i VORIGINAAL DOCUMENT HAS A MULT1COZOREO BACKGROUND ON SP`CLLL WHTE SECURITY tP PER;ANO THE GREA!.SEA OOF_{THE.SFATE,Of INDLeNA ON BACK THAT p. WAR - •.TUFN.S FROM'ORANGE.TO-YELLOW.WHEWRUBBED ORIGINAL!DOCUMENT WS A HIDDEN:VOID ON.FRONiaTHAFA APPEARS WHEN PHOTOCOPIED d�9il.''// U