Death Certificate - Brandenberger, Gusta_6/19/1975RECORD OP llE�1TH �
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GILSON COtiNTY llEP�RT�Il�\7' OI' HI;ALTFI
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THIS IS TO CEPTIFY, tliat our reeord; sho�� '�ii:�"�9 =P.,;;i;i�t,TV,y�_�? _di.
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monih day year hour of death street, hospital, mral .
Age at Death_. �4 Ses Fer-^.le �o��l._ 'ri'r.ite _Pqarital Status l'lrrip!j
years write �cheiher married or sina
Primarp cau;e of death gir-en
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Signed by— ��'�ri?'��� �t-�.,�nr, t:� r,,.�:n;;�-11Le_.1nr?.
plip�ieian or cm�oner _ � _ addres.
I'lace of bw•ial or removaL 3etnl_��;�— —���'•yaiile, ir:d.
name ot cemeTerp address
n1tBOfUU1'1:1�_�l�"��i.i 1,'qc� f. =i01?. �r�c. :=un��ir.z'r,,;r.=, i21fj-
I�uncral Directm• �ddrzss
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Gibson Counh• }iealth Comrnissioner
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. address datc
P.ecorded locailj in lwuk No.—� ^_` Pa�;e No._' —Filed: =i_'/�[