Lillian Bell SLIDINGER (Hepner Maughan) Death Certificate

INDIANA STATE BOARD OF HEALTH
DIVISION OF VITAL RECORDS
MEDICAL CERTIFICATE OF DEATH

Local No. 177
State No. '67 009526

1. PLACE OF DEATH
a. COUNTY: Madison
b. CITY, TOWN, OR LOCATION: Anderson
c. Length of Stay in 1b: 5 Years
d. NAME OF HOSPITAL OR INSTITUTION: New Haven Nursing Home
e. IS PLACE OF DEATH INSIDE CITY LIMITS? YES

2. USUAL RESIDENCE
a. STATE: Indiana
b. COUNTY: Madison
c. CITY, TOWN, OR LOCATION: Anderson
d. STREET ADDRESS: 2417 Bethany Road
e. IS RESIDENCE INSIDE CITY LIMITS? YES
f. IS RESIDENCE ON A FARM? ["NO" box is smudged]

3. NAME OF DECEASED: Lillian B. Maughan
4. DATE OF DEATH: March 14, 1967
5. SEX: Female
6. COLOR OR RACE: Caucasian
7. WIDOWED
8. DATE OF BIRTH: 7/5/1877
9. AGE (In years last birthday): 89
10a. USUAL OCCUPATION: Housewife
10b. KIND OF BUSINESS OR INDUSTRY: [blank]
11. BIRTHPLACE: Cicero, Indiana
12. CITIZEN OF WHAT COUNTRY? U.S.A.
13. FATHER'S NAME: Frank Slidinger
14. MOTHER'S MAIDEN NAME: Elizabeth Dick
15. WAS DECEASED EVER IN U. S. Armed Forces? No
16. SOCIAL SECURITY NO.: 312-34-5787
17a. INFORMANT'S NAME: Mrs. Alfred Sweeny
17b. INFORMANT'S ADDRESS: 2417 Bethany Road, Anderson, Indiana
17c. RELATIONSHIP TO DECEASED: Daughter

MEDICAL CERTIFICATION:

18. CAUSE OF DEATH:
PART I: DEATH WAS CAUSED BY:
IMMEDIATE CAUSE (a) Generalized ateriosclerosis
DUE TO (b) Senility
PART II: [blank]
19. WAS AUTOPSY PERFORMED? NO
[Remainder of Medical Certification is blank]

21. ATTENDING PHYSICIAN: I certify that I attended the deceased from 1966 to death and last saw her alive on Feb. 1967. Death occurred at 12:45 p.m. E.S.T. on the date stated above; and to the best of my knowledge, from the causes stated.
22. HEALTH OFFICER: [blank]
23a. Signature of Attending Physician or Health Officer: F. H. Beeler, M.D.
23b. ADDRESS: Anderson, Ind.
23c. DATE SIGNED: 3-17-67

24a. BURIAL, CREMATION, REMOVAL: Burial
24b. DATE: 3/17/1967
24c. NAME OF CEMETERY OR CREMATORY: Beverly Cemetery
24d. LOCATION: Blue Island, Illinois

DATE REC'D BY LOCAL HEALTH OFFICER: 3/16/67
SIGNATURE OF HEALTH OFFICER: [unclear]

25. FUNERAL DIRECTOR: 228 East 12th St.
Brown & Butz Funeral Home, Anderson, Ind.
FUNERAL DIRECTOR'S LICENSE No. 2238
EMBALMER'S NAME: J. H. Weddel
LICENSE No. 3979