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Death Certificate - Arhuthnot, Lillian_4/25/1975.. .��.. � , �' � 1 �,,, �: - � ± . . �RECORD OF DEATH . - , �'r' GIBSON COliNTl DEPART�4L�'I�TT OF�HEALTH • . . . ' � . PRINCF.TO*I, INDI.�INA , . � - � �. ' . , . . . , ., � - l � � - - . � .'. THIS'IS TO CERTIFY', that our records sho�v_ �?��-a�cJ ��^�c..�.�� _ - died • / �/� �.� l� � �oy e �„� e�. ��//o.�r at-��-�`- lOO��::l�.•^ t�i�iiG �� ,�.. -,�_ ,'�`'+ '. .��'"month '°� 'day . year ' • . .. hour�of d�.�th ' i,- :S'�- �•`�:stm_., hospital� rural �'?'a�`._. . . . . ._ ,. . .. � � . , - . •. c.c i c. : �� . - , Age at Death `�� -Se� �-�x-<-�/ Coloi• �� ' -�_Z�� .' — - - - . cears � . - a�rite�whether�marTied�or�single� '� "� , ' . �.,; ,• _ . ,.• , M:.,. . ' Primary cause of death given ��°as '�-�=�-f J�'`_ ,�>�'`<. `" '� - . . — — � ; - '�'+`-. . ..,._ � 1 . . . ` ��•' . . �:., t :� �/ . •� : Signed by --t�—_��7� � --�i�-t�-��ce*��c�' - � '- '" physicianor-curuner- - - � -- °-- -- -�-�� '�--xdlres�•.,—"—•`� .r--,--,- - � . ? /� � . .. , :; Place of•burial or removal-��_�,_�Z`1.��-- ��-2xc:-�-d �• �� a_�.4i . `� � � • name of cemetery � • address T . � � � � , ., . � ` '' / / �j . i� • � . fr Date of burial lo' S�c-� �-c�x�La-L/� cJ` .,' ' �rQc�.c�i . � , . ��'. Fnneral Director . � . � address „r� _'I � . SEAL . ` Signed v`��--r/ LL—�/� _ I Cih=on County Health Commissim � ;' � " . . � � �/%t�r�CL-�Cw�_�� .t�;-eeri _ (O ..2 9 . � � � . . � �-� address � � � . , � dat �� ,,'.- . = . - I Reco}•ded Iceally ; n book ATo. �% � U Page No. .� _ '- , ' r, , + ,' .. . i • .' . � , � . . � � � - . , �. ' � -. . . -. . . ... . . , ,. . . . i