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200903616
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Last modified
5/12/2009 2:20:31 PM
Creation date
5/11/2009 3:59:01 PM
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200903616
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<br /> <br /> <br /> Ib ~f'° dy ib ','It Illy`b <br /> <br /> <br /> <br /> <br /> DEATH CERTIFICATE <br /> <br /> DECEDENT'S NAME DANIEL SCOTT EVANS 200,10-36 t g <br /> <br /> <br /> DECEDENT'S.ALIAS <br /> <br /> SEX, SOCIAL SECURITY MALE 505-94.5603 <br /> NUMBER <br /> RESIDENCE (COUNTY AND HALL GRAND ISLAND, NEBRASKA <br /> CITY, STATE) <br /> DATE AND PLACE OF,BIRTH MAY 28,1965 GRAND ISLAND, NEBRASKA <br /> <br /> MARITAL STATUS MARRIED <br /> SPOUSE'S'NAME LISA KROLIKOWSK! 1 <br /> PARENT(S) NAME(S) DON .EVANS <br /> <br /> MARJQRIE HOOVER' <br /> i <br /> , <br /> DATE OF DEATH APRIL 09, 2006 <br /> PLACE OF DEATH OLMSTED ROCHESTER <br /> (COUNTY AND CITY): <br /> FUNERAL HOME MACKEN FUNERAL HOME, INC. <br /> CAUSE OF DEATH COMPLICATIONS OF END-STAGE RENAL DISEASE (POSSIBLY SECONDARY TO <br /> IMMEDIATE H-YPEROXYLURIA) <br /> UNDERLYING <br /> <br /> <br /> <br /> OTHER CONTRIBUTING STATUS POST RENAL TRANSPLANT;'PULSELESS ELECTRICAL ACTIVITY; <br /> CONDITIONS CORONARY ARTERY DISEASE; ANEMIA; DIABETES MELLITUS; HYPERTENSION; <br /> MONONUCLEOSIS; SECQNQ <br /> ARy F{YPERPARATHYRQIDISM;-PERICARQITIS. <br /> MANNER NATURAL <br /> CORONER; MEDICAL ERIC A PFEIFER, M.Q. <br /> EXAMINER OR PHYSICIAN <br /> 200 1ST STREET S. W., ROCHESTER, MINNESOTA 55905 <br /> <br /> <br /> <br /> <br /> <br /> 55A-002,00.59 <br /> THIS IS AiTRUE AND OFFICIAL. RECORD OF THE DEATH REGISTERED IN THE * 1 0 ~ 0 0-5 9 'k <br /> OFFICE OF THE STATE REGISTRAR., DATE FILED: APRIL 12, 2006 <br /> yd~~HE~`~g1 ~Ep <br /> PLACE ISSUED: OLMSTED ~ <br /> PATE IS$L(ED: APRIL, 18,200Q STATE REGISTRAR t. = I <br />
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