Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Death Certificate - Baxter, Samuel F_4/19/1969
.. _. RECORD OF DE:1TH- � • � . ' ' GIBSO\T COUNTY =DEPt1RT\$EI�TT OF HEALTII ' ': - � - • - " ' - ' - � . PRINCETON,I\DIANA . .... � . . � ' THIS IS T0 CEP�TIFY, that om•. records show ° S9MUEL F. 'S,AXTEf? "_ ' � died r _ � January ' 2,7 " 1960 ' atiAPM Gib. Geri. Hosp. Princeton, Ind.. . � � � � � month , day - � . . yeaz� • , . � . hour of ,death- . � . . street,. fiospital, ruraF � � - . . .. Age at-Death 84 Sex'�T�ale —Color ' White . MarTied - }•ears � - � � � � � - � - n-rite a-hether. married or, single � Primarv cause of-death given was Sarcoma of the rectum - • . .. __ � . .. . _ . , gig„Ad by.a . Wllliam A:._Wel�ls� 'M.D. Prinr.Ptnn Ind' . .. ----+-- ° � . - � physician or coroner- . — -�-��---- . �: .._ . � .. � . ._ , •. .._ . address � . - � '-- - _ , . : . . . . . .. . ' i . , - ' .. .. ' ` � • ... ' ' .` -. , , � :Place,of burial or removal Maple HS11 Cemetery ' PrineP*.on; Ind . . :' ' name' of cemetery• �:. . . . . ,.. �.address � - .' , . Date of burial- 1/ 0 68 ' Colvin & Son _ Prineeton Ind: ' ' , � � . Funeral Ditector, . . � � , .' . � a ress:. . � . - '. - .' " SEAL �- . . Signed ' • ' . . : . ' : � �= � 'i � � � �- � �� - � �� Gib os ount ea th o missioner ' "' ' ' ' : ,1, . ,, ` - , `'�;_�, _: , . : � Princeton; Irid: 4/8/69 ' . -% t � . � , addmss . . . . : . . . ' , . . . _ . . , � � . . . � � Date . :� . ' - . � -. ' - . . . . . .- - Recoi�ded locally in �book+Ny 7_:_ ; Page No. 19$ Filed: 1/30/68 ' . fi . _ � . . - . ��'? _ _. � - .�, d . . . . . . , , . , . . .. . �. . . . � . . . . . . . . , . . _ . . . ..