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Death Certificate - Smith, Wanda G , ryli f� .,.0 __ __-"— • l 1.;.". ner_t il____- friV 4�A1/ a a . -INDINAtSTA,TEDEPARTMENT`OP HEALTH''' , y • 2 / 1 .a�dantre? 6 .+h". .ee= ..1 f+'i ° i '� l4 a EERITIF_ ATE,OFSDEATH 10 f CF.;�L` uLocal)Non60R1.8��r73r - �s,'...)EDR ND,@,O©0�066328© State:Noc04.3282h . _ !• 'Decedeor LagaLNama�(Fvs1,Nd01e;Lasty • 1a:MaidenName•(Iffemke) 2.,Se.r' 4 3}Tvne Of Death 4ADateOIDeath'Mon:.vDay. T/ . -Inaagnsgr ♦k ;;/I s 1 F111 :�hl�- o s1r?l x ttm i" 6averi 1 r t WANDA,VSMITH j 1 1 s� , ��B8AaaNGL•E> a'U FEMALE) S402i54IRMr . ), 09/02/20:18:�. .Tge^Yrs//- 1►U iY! &.0&1b¢albO 1Day a 5t]LJ H 1"]'Dke IAgMal(Mm•JVDayfYrx)L rBJBirIMerpe{'1CiNact Staten/FatiOnCant1s11 11 wei t1 "Itl1194 lMorare% �Ot1 loan��aa�s L«n�aaaC�'/iu�,.�es 08/02/d924 �k�{P-�RyINCEtTOtN�g,LNt, 1 i+,� 1 9 Ever" U S Armed Famssi,n .0 I Death Occurred In A Hose• �re IOaa•II Deat'OrarTOE ppmev.Tete�ON�er�Tnan'ojta`Yawii•; t • r or `, 21 t M T is ❑Hospice mF yty `❑' D�e�a�eiTH-oimne'`p Nwwq Home/Long Care Faapn \ `�, . r ,°Yew') 5libt �®n`e°i l:tAn °eVaan i tir tit i71_41'e' LLI(LZYIf� 2i i✓J:r..)A44vJ2. �1 / 1J u1IFaaty Name(II Not rystit*Give SaeetaM Number) �{t �/���❑t�., y�J��p {�J�pU a �y1� [//��� yJ/��p tt/// 1 EL ONESSIHOSP,ITALAIN i�i, 'J LI�I©L.S�IJIIL�� I/ tit�i. i'attl�/. lCltl t/..4�1ti9 A`4IiR��C�11.1Qt/�6:C`ll �/ l j]z��aCgGyO��rT 9as`Artl Lp Code �`;;�- - q'1] Cojw�y O(DeaN�l' S, taTMarilk SJatis�t•Tone Ol OeaT 1 I� x!!e'1 eO;nwnea❑:+dame¢&,I saps¢m p oNareal 1 $I LVANSVILL 47747 IW�I VANDERBURGH til i©1�'sglsL a ee�iclI..airre40 Al 1 Ct 15 S&Kig Spouse's Name `LI i5a'(2st NameRefoe rstManage 91650cedenrs Usual OCa e,ap " Fe TKud. sire 5ussllydu.ry y la IS'Is . % at i r sf. Z yr 'y /� GEMOL'OGIST :i et�'UEWERL•Y,STORE ` i L I B IResdence Sure / s y-� 1 ` 18a�Cwmy G ab:C ty Or aamr l ✓- -tell v/ Q� �\1 ®���`'� %�1jll �fbl` ll li )_.� ' te `.AIj' �I V INDIANA.��M�'\�: .� GIBSON '� PRINCETONt., a� s'.i�`\`*�`` `\- \e ':a r lBcvSyeecAMNmber A1. - 1r` Bat ••UNo ��Ji1Be Zipeode✓- 1 1BI I,ede Cay Limes " I,780ATA�YLOR�AI%ENUE �,t.. •s 47,glow-670 •a\ f \<el f i tJ9D cedenr Eduw R 4•- -``'20 Deced,t Of Hispani Onc. .S 721 Decegenrs:Race I "ice �l'9 "1l BAGHEi t`O 3 DEGREE'.(BA,iAB,.BS) ' NOTilI ClOrif1 3 _1YVhi� t�ti - - ri lI 221 rs Name(Fisl MJddieLas - k,C •. 23,ParenrsN (FeseMiddle last) tt'9; 4 t f23a Parents Last NameBefore M gel' / aI1 f, `�I <`�. O,a\1 F g I• PAULW/ANGLE -. 2 _ i ELIZABETH P ANGLE ..,al ti, FLETCHER~ ...I; • r 24 rtsName - 1 )-C 1 24a'RelsaonslipTODecoders 24b Ma ng_ '6ntr 1(StrselAMNumbey'City;State ZipCode) ,{� ,} t 1 JAMES:KENTeSMITH- 4 CAti� SONt. 11a13,SOUTHiKENSINGTONI-DRIVE?:PRINCETON,±INC47670. 2 _1 totr�Cs�]th...1 .11.Z' 7"136aa 12ltir... '45RaCaawPo n';G�'Sy1JtS��s+J[74a�'.�+`a''i t.a au.i�s7latr`OtiMiriti.+J I r2jaeddd Of Gsm ®Q Ws213� 25b'Race Of Pspovpon'(Nane Ol CemneN GemabryiOtMr Race) rSC Locate() C sit s • y/ iI 11 1®IBuve11❑C ematdn�O.Oaa:on❑Entombment �IC i 113• S� " •P J 1 LA♦` G '❑R real From.SMte '+`a + y '` •\�, � \�\ e I ll 1.s�peoh) ODD,F.EBUOWS.UEMETERY P.-RINCET,ON,`IN .1),-...N... _V� r``.. • 1•26LYtas Coroner Comm 2]TName'Mid CompleteaddressOt tneral Fealty , 1 e •Pa?FutemJ'HomelicemetJum•- 1t 11 trill Now �� ®plflo��t i' � t' �' ;;- ' alas fray ..COL•VIMEUNERALIHOMEtINC 425JNiMAIN,ST-.,RRINCET..ON5INL47670 ♦ Fa33005671:\�'- . rnb sigipa r Irav,a F,utenl Se Licensee ItIts. 11- 4�\ }-���127�nicenx Number la t&n \ l' T 4. RICHARD DEANIHICKRODISBYS.ELECTRONIC SIGNATURES??�n- uum ait(Ari, ��+e llllLt�tf FD010A2�53fi1t' , ppy('Gi'.. 4a rt�A 1 i !fir 1 Cause Or DeaU1'��Sae Insauctlons Ana Exam es iv s i' / IQJ�a7-.c. 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