Death Certificate - Boxell, James E_3/7/1975. ' �-- �,
iZFCOHll OP DEaTH •
��^'�' ___ " GI1�SO�T COUNTY DEYAI:T�1L:\'P OF IIE:�1'LTH ' ,� � • :` •,�... .
YRIVCETOA', I\'D[aVa . .
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✓PHIS IS TO CLRTIFI", thaC our,records slio�c TAMF'S F'. ?QXELT died
Dec. S, 1970 at .. 109i9 RP. �#1 Brodleiah Pk Princetor. Ind.
inaiili dag }�ear hour oC death strect, I�uspital, rtii'al
A z at Deatli g� 'Sec ' Male Coloi•_ la!iite _\farital, Status Ms.rr_i?d
S . . �vrite �chether married or sinole
}'ear
Contt. F.eart Failure
1'rimary cause of dea'th given tivas -
Sie,�ed by Bruce Brink. D.O. P�i,nceton_,�d.
. pl�ysician or cormier °��'�'��" -
Place of buri�l m•
P?aole Hill
mm�e oC cemetery
Fairfield, I11.
aildress
Date of UuriaL_ 1.2/_11�?d KPndalL�tne_zl__Home Princeton Hnd.
. Funersl llirectur . aud!'ess-
SE?,L
� �'.,;�c',���%��"/(,•,�� �
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�Iblle(�--
� - GiLson Countt• Health Commissioner
Princeton,.Ind. ?/7/75
address � date
P.ecorded locally in lwok Nu.—�--i'aige No.-2Q_FilacL• 12L29L7�