Death Certificate - Blaize, Cornelius J_10/14/1999�
RECORD OF DEATH
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GIBSO\ COli\TY DEP�RTJIENT OF HEALTH
PRI;iCETON, I\DIa,Iq
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THI$ IS TO CERTIFY, that our records show CORNELIUS J. BLArZE
r3iarl
9
moath day year
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hour of death
G
Gen
so. Princeto
street, hospi;al, rura�
Ave at Death 72 qe� blale Color �'�'-te �1larital Statu
pears
Primarp cau;e of death gi�•en
Ind.
Ffarried
a'ri[e a-nether married or single
Acute lymphocytic leukemia
S;�::_.. _ --„�_ ,. �-;.,.- „- -
' i i r� 'rnn Tn �
ph}-sician or coroaer
address
Place of burial or remocal I'�•�•F• Hazleton, Ir.d.
name of cemetery
addres;
DateofburiaL 2/11/85 Colvin Princeton Ind
Fhneral Director address
SEAL
G��,��/��-��° �,�,�
Gibson County Healih Commi4,Q�e�•
Oakland Citv, Ind. 2/15/85
address ��R
Recorded locallp in book 1Vo. 10 page No. 138 �led: Z/14/85