Death Certificate - Burnes, Russell J_3/3/1976RECORD OF DEATH �
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GIBSO\T COUNTY DEPART\IE\TT OF HEALTH
PRINCETOA*, lA'LIANA
THIS IS TO CERTIFY, that our records show RUSSELL J. BURNES died
Feb. 14, 1976 at 6AM 614 S, i?ace Princeton, Ind.
month day year hour of death _ street, hospital, rural _
Age at Death 42 Se�M3� �, Coloi�.�lhLtt� ':farital Statuc MarT�,BA ~
� years w-rite whether married or single
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Primary cause of death given w.�s Pulmonarv thrombosi c
S�g�ed by� Donsld Rlslev• M•D. Mt. C:s�rmol I�� _
. ph��sician or coroner . address
Place of burial or i•emo�-al � � I..'O. O. F. ° �� n�Pton, Ind
name nf c=mecery address
Date of Uurial 2/17176 Rei:dai i FnnerB' Home Princeton Ind.
. F�neral Direc.or address
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Gibson County Health Commissioner
_ _ Oakland Cit.v Ind. - /18%76" - -- --ii
; ' address �� -
Becorded locally in book No. 9 Page No._- 21—Filed: 2/18L�6 _,� _ 'I��
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