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I C»e No.

TYPE OR PRINT D
( O NOT FILL IN)

MEDICAL EXAMINER'S REPORT


Berrien County, Michigan

DOE, Jane 88-1 40-60 F Cauc


....... ...... ......... .............................................................. Age ..... . ..... Sex ..... . ....... Race .....
(last) (fir,t) (middle)

Unknown Marital
Unknown
Address ..................................... ......................................................................................................... MW SD Occupation ............. .................. ..

Next of Kin·
LAST SEEN ALIVE OR POLICE VIEW OF BODY
DEATH INCIDENT SURROUNDING DEATH INVESTIGATION BY MED. EXAM.

8 April 88 9 April 88
Date

Time 10 AM

Lake Mic i an Memorial


,

Location h g
New Buffalo MA-.-0-11<>

Police Investigator: ..............P.?Y.�....B.!:!:!}.9JgY................................................................... Department: ......N�w. ...�.1J.f..-fal9....P..�.P..,...........................


Description of body (identifying characteristics & positive findings of disease or injury)

. .ped...and...no.ur.i .be.d...a.dul.t....ca.uca .ian...£.e.ma.le.., ....w.i.thout.... s.i.gn.s....o.f.....fo.ul ....p.lay.•.


...No.rm.ally.....de:v.e.lo
s s

...?..;.?.�.�.�?..... �.� ......bra .'....pan_try ...ho s e_, ....j o gging ... s hor.t.s ..and ..)ean s ...............................................................................................................

Type ofDeath:
Natural Violent or Unnatural O Unattended by Physician
O Instantaneous without obvious cause O Accident: (type) D Attending Physician
O Found dead without obvious cause 0 Suicide Name ................................................................................................
O Unexplained rapidly fatal illness O Homicide Address ..........................................................................................

Description of incident surrounding death: (or previous medical history if natural)

Unknown

Autop�y 0 Not indicated @ Authorized


1f2084
Cause of death· ............................................................................................................................................................................................................................................ .

. . . . . . . . . . . . · · - . . . . . . . . . &'t··f · · · · ·. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . .


(As it appears on Death Certificate)

.......... ...................... .......................... ...... Aceid e n t al ...drown.ing .. ........................................................................................................... .....................

By Medical Examiner: Signed:


Date: ................. ......

r .... ....... ........ ........ ........ .......................................................... RECEIVED
........................R.• L ..... c.lark , ....�..�.lJ..'...... ..................................................................
(print or type name) ,MAY 2 0 1988
(address)
B.C.H.D.
BCHO-.. ADM-4 06/81

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