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<br />y / ; CERTIFICATE OF DEATH �
<br />! ` STATE FILE NUMBER 2011-MN- ��„
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<br />DECEDENT �GENE WATSON CAMPBELL
<br />NAME PRIOR TO =-
<br />FIRST MARRIAGE � �'
<br />ALSO KNOWN AS � T
<br />SOCIRL SECURITY NUMBER 506 - 28 -1938 � ' ~ �
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<br />SEX, MALE —
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<br />BORN MAY 21,1924 -
<br />� REPUBLI�.-;� ,, ;^�,�� �.�.� i ��f -��; KANSAS =—
<br />DATE OF DEATH JU1����0�, �1'f, �� '�e�-{� �' dE'� � �.°4� �`.N',>';, �a
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<br />, PLACE QF DE,4TH ,��,��Z}t� �HO�I'l'i�L�� � , �; � �� k �d j `�;� , �
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<br />MARITAL �
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<br />C�NDITIONS �
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<br />MANNER NATURAL
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<br />MEDICAL EXAMINER, KIMBERLY TJADEN, M.D. 1 -
<br />• CORONER OR PHYSIGIAN 1301 SOUTH 33RD STREET, SAINII CLOUD, MINNESOTA, 56�03 _
<br />THIS RECORD HAS NOT BEEN AMENDED � � _
<br />� _ MR&C Certificate ID
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<br />� • 7140159
<br />I WllII�I� IIIIII�I��I�I�I� A RUE ANQ CORRECT RECf�RD OF DEATH REGISTERED IN THE MINNESOTA OFFICE OF TH�STATE REGISTRAR. -
<br />0 01111�01 '� � � —
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<br />��� THE ST - �,.
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<br />� y.�.�olL�ouN oT�,O FILED: JUNE 09. 2011 .. ��p�LEDU,y� o,�
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<br />_ - -_ =i -=����z J ! STEVE �LKINS o :- `- --- =r _ :�
<br />r� = �`= ily� THIS CERTIFICATION IS VALID ONLY WHE�EPRODUCED ON WATERMARKED SES�f�i�'�@��'Rqa ��^ �'
<br />��� ° ;�p� 1NITH /� RAI�ED BORDER' AND RAISED STATE SEAL pF MINN�SOTA. �'p• `
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