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A medical examiner has officially ruled the death of an Appalachian State University freshman a suicide.

An autopsy report for Anna Marie Smith, 18, of High Point, ruled her death a suicide, according to the medical examiner's report.

She was found about 100 feet off Poplar Grove Road in a wooded hillside, on Sept. 13. A blue strap was around her neck and tied to a tree limb about three to four feet from her body, according to the report. She was found lying on her back on the ground.

According to the autopsy report, Smith's body showed indications of asphyxiation. A letter was also found with her body that she appeared to have written.

According to the medical examiner's report, Smith had a history of depression.

Smith was last seen Sept. 3.

She visited her family in High Point over the Labor Day weekend. According to the university, Smith left her computer and cell phone with her family when she returned to campus.

Her parents, Laurie and Daniel Smith, organized daily searches for her following her disappearance but found no signs of their missing daughter.