Ohio Department of Health
VITAL STATISTICS
CERTIFICATE OF DEATH

Reg. Dist. No. 3101
Decedent's Name:  Lillian N. KNEIPP           2. Sex: Female
3. Date of Death: July 23, 2001
4. Social Security No. 277-58-4317             5. Age last birthday: 88
6. Date of Birth: Jun. 23, 1913                    6. Birthplace: Cincinnati, Oh
8. Was Deceased ever in U. S. Armed Forces?  No
9. Place of Death:   Nursing Home
 Facility Name: Deupree Community 
 City of Death: Cincinnati             County of Death:  Hamilton
10. Marital Status: Widowed
11. Surviving Spouse:  ____
12. Decedent's Usual Occupation: Homemaker
 Kind of business: Home
13. Residence State:  Ohio         County: Hamilton   City: Cincinnati
 Street & Number:  4401 Rosslyn Drive
 Inside City limits:  Yes             Zip Code: 45209
14. Was Decedent of Hispanic Origin?  No
15. Race: White
16. Decedent's Education: 11
17. Father's Name:  Clyde Lutz
18. Mother's name:  Anna Coleman
18a. Informant's Name: Marilyn Carter
19a. Mailing Address:  11 W. 14th Street, Newport, Kentucky  41071
20a. Method of Disposition: Burial
20b. Place of Disposition: Laurel Cemetery
20c. Location: Cincinnati, Ohio
20d. Date of Disposition: July 26, 2001
21a. Name of Embalmer: Michael Cline
21b. License No. 8309-A
22a. Signature of Funeral Director: ___Illegible____
22b. License Number: 7988
23. Name and Address of Facility:
 Thomas-Justin Funeral Home
 4418 Wetsel Avenue
 Cincinnati, Ohio  45227
24. Registrar's signature: _______illegible_
25. Date Filed: Aug. 10, 2001
26. ______
28c. Dated Pronounced Dead: 7/23/01
28d. Was Case Referred in Coroner? No
28e. Signature and Title of _____: Frank ________
28f. License Number 46428        28g. 8/3/01
29. Name and address of person who completed cause of death:
 Frank Perr__n - 4411 Montgomery Rd. #201  Norwood, Oh 45
30. Immediate cause: Congestive Heart Failure
HTN
Edema
DM
Chr. Anemia
Chr. __ Skelatal pain
31. Was an Autopsy performed?  No.