Professional Documents
Culture Documents
TYPE OR PRINT D
( O NOT FILL IN)
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
Location h g
New Buffalo MA-.-0-11<>
...?..;.?.�.�.�?..... �.� ......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 ..........................................................................................
Unknown